Safety and Efficacy Evaluation of Orbital Atherectomy System in de Novo Calcified Lesions

NCT ID: NCT05417022

Last Updated: 2023-12-20

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Total Enrollment

300 participants

Study Classification

OBSERVATIONAL

Study Start Date

2022-06-15

Study Completion Date

2025-06-01

Brief Summary

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This is a French, prospective, single-arm, multi-center registry to confirm the safety and efficacy of the Diamondback 360 TM Orbital Atherectomy System in the preparation of de novo calcified coronary lesions before implantation of a coronary endoprothesis in adult subjects. The primary safety endpoint is 30-day MACE and the efficacy endpoint is procedural success.

Detailed Description

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Treatment of calcified lesions, caused in 6 to 20% of patients, remains a challenge.

Presence of coronary calcifications complicates stent placement resulting in up to 50% malapposition or under-expansion of the stent and is associated with a higher frequency of major adverse cardiac events (MACE).

In order to reduce these risks, preparation of these lesions before the implantation of a coronary stent is essential. The arrival on the European market of a new Orbital atherectomy system leads to consider its use in the preparation of such lesions.

The orbital atherectomy system uses a diamond-coated eccentric crown that abrades calcified plaque and develops pulsatile forces on the wall. It reduces calcified plaque and modifies plaque with fractures, facilitating stent placement and allowing for optimal stent expansion.

ORBIT I and ORBIT II clinical trials were conducted in the United States to evaluate the safety of using the Orbital Atherectomy System in de novo calcified coronary lesions in adults. These 2 trials demonstrated that orbital atherectomy not only facilitated stenting, but also improved clinical outcomes compared to historical outcomes.

The recent obtaining of CE marking allows the use of this very promising medical device in France.

Conditions

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Angiography Coronary Calcification

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Diamondback 360TM orbital atherectomy system

Diamondback 360TM orbital atherectomy system

Intervention Type DEVICE

Use of the Diamondback 360TM orbital atherectomy system in the preparation of calcified coronary lesions before implantation of a coronary endoprothesis

Interventions

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Diamondback 360TM orbital atherectomy system

Use of the Diamondback 360TM orbital atherectomy system in the preparation of calcified coronary lesions before implantation of a coronary endoprothesis

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Subjects ≥ 18 years
* Patients with a clinical indication for coronary angioplasty and presenting a de novo calcified lesion
* The target vessel reference diameter must be \>= 2.5mm and \<= 4.0 mm.
* Lesion length \<= 40 mm
* The target vessel must be a coronary artery with a stenosis of \>70%
* Patients able to understand and provide informed consent
* Patients with Social Security coverage

Exclusion Criteria

* Patients with an LVEF \< 25%.
* Patient with hypersensitivity to egg, soy or peanut proteins or to one of the active substances or one of the excipients of ViperSlide lubricant.
* Pregnant or breastfeeding woman
* Unwilling or unable to sign the Informed Consent
* Patients under judicial protection, tutorship or curatorship
* Angiographic criteria: Intra-stent stenosis, Presence of a chronic total occlusion (CTO), Bypass lesion, Target vessel excessively tortuous, Presence of a thrombus, Presence of a single permeable vessel
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Centre Recherche Cardio Vasculaire Alpes

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Jacques Monségu

Role: PRINCIPAL_INVESTIGATOR

Groupe Hospitalier Mutualiste de Grenoble

Locations

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GCS-ES Axium-Rambot

Aix-en-Provence, , France

Site Status NOT_YET_RECRUITING

Centre Hospitalier Antibes - Juan-Les-Pins

Antibes, , France

Site Status RECRUITING

Hôpital Européen de la Roseraie

Aubervilliers, , France

Site Status NOT_YET_RECRUITING

Centre Hospitalier d'Avignon

Avignon, , France

Site Status RECRUITING

Clinique Rhône Durance

Avignon, , France

Site Status NOT_YET_RECRUITING

Centre Hospitalier Universitaire de Clermont-Ferrand

Clermont-Ferrand, , France

Site Status RECRUITING

Pôle Santé République - ELSAN

Clermont-Ferrand, , France

Site Status RECRUITING

Groupe Hospitalier Mutualiste de Grenoble

Grenoble, , France

Site Status RECRUITING

Centre Hospitalier de Haguenau

Haguenau, , France

Site Status RECRUITING

Centre Hospitalier Marne la Vallée

Jossigny, , France

Site Status RECRUITING

Hôpital de la Timone

Marseille, , France

Site Status RECRUITING

Hôpital Privé du Confluent

Nantes, , France

Site Status RECRUITING

Centre Hospitalier Universitaire de Nîmes

Nîmes, , France

Site Status RECRUITING

Clinique Saint Hilaire

Rouen, , France

Site Status RECRUITING

Institut Arnault Tzanck

Saint-Laurent-du-Var, , France

Site Status NOT_YET_RECRUITING

CHU Strasbourg

Strasbourg, , France

Site Status NOT_YET_RECRUITING

Centre Hospitalier Intercommunal Toulon - La Seyne/Mer

Toulon, , France

Site Status RECRUITING

Countries

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France

Central Contacts

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Jacques Monségu

Role: CONTACT

Phone: +33621273352

Email: [email protected]

Angélique Grangier

Role: CONTACT

Phone: +33476707440

Email: [email protected]

Facility Contacts

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Marc Silvestri

Role: primary

Anne Bellemain-Appaix

Role: primary

Hakim Ben-Amer

Role: primary

Marine Quillot

Role: primary

Jean-Pascal Peyre

Role: primary

Pascal Motreff

Role: primary

Nicolas Durel

Role: primary

Jacques Monségu

Role: primary

Angélique Grangier

Role: backup

Pierre Leddet

Role: primary

Simon Elhadad

Role: primary

Pierre Deharo

Role: primary

Ashok Tirouvanziam

Role: primary

Luc Cornillet

Role: primary

Alexandre Canville

Role: primary

Léo Cuénin

Role: primary

Olivier Morel

Role: primary

Gonzalo Quaino

Role: primary

References

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Sturm R, Martinsen BJ, Valle JA, Waldo SW, Behrens AN, Armstrong EJ. Orbital Atherectomy for Treatment of Complex Severely Calcified Coronary Artery Lesions: Insights from a Veterans Affairs Cohort. Cardiovasc Revasc Med. 2020 Mar;21(3):330-333. doi: 10.1016/j.carrev.2019.06.013. Epub 2019 Jun 28.

Reference Type BACKGROUND
PMID: 31307929 (View on PubMed)

Mosseri M, Satler LF, Pichard AD, Waksman R. Impact of vessel calcification on outcomes after coronary stenting. Cardiovasc Revasc Med. 2005 Oct-Dec;6(4):147-53. doi: 10.1016/j.carrev.2005.08.008.

Reference Type BACKGROUND
PMID: 16326375 (View on PubMed)

Onuma Y, Tanimoto S, Ruygrok P, Neuzner J, Piek JJ, Seth A, Schofer JJ, Richardt G, Wiemer M, Carrie D, Thuesen L, Dorange C, Miquel-Hebert K, Veldhof S, Serruys PW. Efficacy of everolimus eluting stent implantation in patients with calcified coronary culprit lesions: two-year angiographic and three-year clinical results from the SPIRIT II study. Catheter Cardiovasc Interv. 2010 Nov 1;76(5):634-42. doi: 10.1002/ccd.22541.

Reference Type BACKGROUND
PMID: 20690152 (View on PubMed)

Fitzgerald PJ, Ports TA, Yock PG. Contribution of localized calcium deposits to dissection after angioplasty. An observational study using intravascular ultrasound. Circulation. 1992 Jul;86(1):64-70. doi: 10.1161/01.cir.86.1.64.

Reference Type BACKGROUND
PMID: 1617791 (View on PubMed)

Moussa I, Di Mario C, Moses J, Reimers B, Di Francesco L, Martini G, Tobis J, Colombo A. Coronary stenting after rotational atherectomy in calcified and complex lesions. Angiographic and clinical follow-up results. Circulation. 1997 Jul 1;96(1):128-36. doi: 10.1161/01.cir.96.1.128.

Reference Type BACKGROUND
PMID: 9236427 (View on PubMed)

Bhatt P, Parikh P, Patel A, Chag M, Chandarana A, Parikh R, Parikh K. Orbital atherectomy system in treating calcified coronary lesions: 3-Year follow-up in first human use study (ORBIT I trial). Cardiovasc Revasc Med. 2014 Jun;15(4):204-8. doi: 10.1016/j.carrev.2014.03.004. Epub 2014 Mar 19.

Reference Type BACKGROUND
PMID: 24746600 (View on PubMed)

Chambers JW, Feldman RL, Himmelstein SI, Bhatheja R, Villa AE, Strickman NE, Shlofmitz RA, Dulas DD, Arab D, Khanna PK, Lee AC, Ghali MG, Shah RR, Davis TP, Kim CY, Tai Z, Patel KC, Puma JA, Makam P, Bertolet BD, Nseir GY. Pivotal trial to evaluate the safety and efficacy of the orbital atherectomy system in treating de novo, severely calcified coronary lesions (ORBIT II). JACC Cardiovasc Interv. 2014 May;7(5):510-8. doi: 10.1016/j.jcin.2014.01.158.

Reference Type BACKGROUND
PMID: 24852804 (View on PubMed)

Benezet J, Diaz de la Llera LS, Cubero JM, Villa M, Fernandez-Quero M, Sanchez-Gonzalez A. Drug-eluting stents following rotational atherectomy for heavily calcified coronary lesions: long-term clinical outcomes. J Invasive Cardiol. 2011 Jan;23(1):28-32.

Reference Type BACKGROUND
PMID: 21183767 (View on PubMed)

Bouisset F, Barbato E, Reczuch K, Dobrzycki S, Meyer-Gessner M, Bressollette E, Cayla G, Lhermusier T, Zajdel W, Palazuelos Molinero J, Ferenc M, Ribichini FL, Carrie D. Clinical outcomes of PCI with rotational atherectomy: the European multicentre Euro4C registry. EuroIntervention. 2020 Jul 17;16(4):e305-e312. doi: 10.4244/EIJ-D-19-01129.

Reference Type BACKGROUND
PMID: 32250249 (View on PubMed)

Kobayashi Y, Okura H, Kume T, Yamada R, Kobayashi Y, Fukuhara K, Koyama T, Nezuo S, Neishi Y, Hayashida A, Kawamoto T, Yoshida K. Impact of target lesion coronary calcification on stent expansion. Circ J. 2014;78(9):2209-14. doi: 10.1253/circj.cj-14-0108. Epub 2014 Jul 14.

Reference Type BACKGROUND
PMID: 25017740 (View on PubMed)

Genereux P, Madhavan MV, Mintz GS, Maehara A, Palmerini T, Lasalle L, Xu K, McAndrew T, Kirtane A, Lansky AJ, Brener SJ, Mehran R, Stone GW. Ischemic outcomes after coronary intervention of calcified vessels in acute coronary syndromes. Pooled analysis from the HORIZONS-AMI (Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction) and ACUITY (Acute Catheterization and Urgent Intervention Triage Strategy) TRIALS. J Am Coll Cardiol. 2014 May 13;63(18):1845-54. doi: 10.1016/j.jacc.2014.01.034. Epub 2014 Feb 19.

Reference Type BACKGROUND
PMID: 24561145 (View on PubMed)

Parikh K, Chandra P, Choksi N, Khanna P, Chambers J. Safety and feasibility of orbital atherectomy for the treatment of calcified coronary lesions: the ORBIT I trial. Catheter Cardiovasc Interv. 2013 Jun 1;81(7):1134-9. doi: 10.1002/ccd.24700. Epub 2013 Mar 5.

Reference Type BACKGROUND
PMID: 23460596 (View on PubMed)

Lee M, Genereux P, Shlofmitz R, Phillipson D, Anose BM, Martinsen BJ, Himmelstein SI, Chambers JW. Orbital atherectomy for treating de novo, severely calcified coronary lesions: 3-year results of the pivotal ORBIT II trial. Cardiovasc Revasc Med. 2017 Jun;18(4):261-264. doi: 10.1016/j.carrev.2017.01.011. Epub 2017 Jan 23.

Reference Type BACKGROUND
PMID: 28162989 (View on PubMed)

Other Identifiers

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2021-A02662-39

Identifier Type: -

Identifier Source: org_study_id