MagicTouch for Treatment of In-Stent Restenosis in Coronary Artery Lesions

NCT ID: NCT05908331

Last Updated: 2025-02-25

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

Clinical Phase

NA

Total Enrollment

492 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-04-16

Study Completion Date

2028-07-31

Brief Summary

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A Prospective, Multicenter, Randomized, Two-Arm, Single-blind Superiority Trial to Evaluate the Safety and Efficacy of the MagicTouch™ Sirolimus- Coated Balloon in the Treatment of Coronary Drug-Eluting Stent In-Stent Restenosis.

Subjects with prior DES implantation presenting with ISR lesions undergoing PCI will be randomized into two groups: treatment with the MagicTouch™ sirolimus-coated balloon or POBA on a 2:1 basis. Approximately 492 subjects will be enrolled in the randomized study in a maximum of 50 study sites located in the United States.

The goal is to establish the safety and efficacy of the MagicTouch™ sirolimus- coated balloon in treatment of coronary in-stent restenosis (ISR).

Detailed Description

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All subjects providing informed consent will have their medical history reviewed and will undergo a physical examination, laboratory screen, and a standardized 12-lead ECG within 7 days of procedure. Women of childbearing potential will have a pregnancy test within one week prior to the procedure. If subjects meet the inclusion and exclusion criteria of the study, they will be randomized to one of two treatment groups, and will then undergo treatment with MagicTouch™ sirolimus-coated balloon or POBA of the target ISR lesion, per trial protocol.

One pre-procedure and all post-procedure biomarker blood draws will be sent to a central core laboratory for analysis of troponin T. Evaluation of post-procedural biomarker blood draws in local laboratories are not mandated but may be performed as part of standard of care.

During the index hospitalization, patients will undergo a clinical assessment and 12-lead ECG; and they will have cardiac biomarkers drawn before the intervention to establish baseline biomarker level and confirmation that the biomarkers are falling. At least one post procedure biomarker (core lab) will be drawn at a minimum of 4 hours after PCI as part of the assessment of periprocedural myocardial infarction and significant periprocedural myocardial injury (at 6-8 hour intervals depending on whether the patient remains admitted). If no procedural complications have occurred and there are no signs of ischemia on post-procedure ECG or clinical assessment, the patient may be discharged per local practice and no additional biomarker levels need to be drawn (beyond the protocol-mandated core laboratory draw at a minimum of 4 hours). If the patient remains admitted cardiac biomarkers (core lab) should be drawn every 6-8 hours until at least 2 total post-procedural core laboratory biomarker draws have passed or clinical standard-based biomarker levels have peaked per local labs or the patient is discharged.

After hospital discharge, subjects will be followed at 30 days (+1 week), 6 months (+2 weeks), and 12 months (+1 month) and then 24, 36, 48 and 60 months (+1 month) post procedure. Yearly vital status information will be collected by telephone follow-up. At the 12-month visit, subjects will undergo 12-lead ECG, blood count, coagulation profile and blood chemistry tests. New and ongoing AEs and concomitant medications will also be assessed.

All elective angiograms performed on the target vessel during the 12-month follow-up period should be preceded by a physician evaluation, during which the physician will indicate whether the subject's clinical status warrants revascularization, i.e. the subject has clinical evidence of ischemia. All films, including unscheduled angiograms, are to be sent to the angiographic core laboratory for review. The angiographic core laboratory will be blinded.

Conditions

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In-Stent Restenosis Cardiovascular Diseases Coronary Artery Disease

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

2:1 randomized trial (MagicTouchTM vs. "plain old" balloon angioplasty \[POBA\])
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors
The patient will be blinded till the primary endpoint of 12 months and the angiographic core laboratory will be blinded.

Study Groups

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MagicTouch Sirolimus-Coated Balloon

Magic TouchTM is a Sirolimus Coated Balloon catheter intended to be used in coronary applications, treats the atherosclerosis of the coronary arteries by eluting the immunosuppressant agent Sirolimus without leaving behind a metallic scaffold.

Group Type EXPERIMENTAL

Sirolimus Drug Coated Balloon

Intervention Type DEVICE

Magic TouchTM (Concept Medical) is a semi-compliant sirolimus drug coated balloon (SCB) for PCI, based on a polymer-free and nanocarrier based drug delivery technology.

POBA

plain old balloon angioplasty

Group Type ACTIVE_COMPARATOR

Plan balloon Angioplasty (POBA)

Intervention Type DEVICE

Plan balloon used to open clogged or narrow coronary arteries due to underlying atherosclerosis

Interventions

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Sirolimus Drug Coated Balloon

Magic TouchTM (Concept Medical) is a semi-compliant sirolimus drug coated balloon (SCB) for PCI, based on a polymer-free and nanocarrier based drug delivery technology.

Intervention Type DEVICE

Plan balloon Angioplasty (POBA)

Plan balloon used to open clogged or narrow coronary arteries due to underlying atherosclerosis

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

1. Subject is at least 18 years old
2. Subject (or legal guardian) understands the trial requirements and treatment procedures and provides written informed consent prior to any trial-specific tests or treatment
3. Patient with an indication for PCI due to suspected in-stent restenosis
4. Non-target lesion PCI are allowed in non-target vessels to be treated with approved interventional devices prior to randomization as follows:


1. In-stent restenosis after drug-eluting stent implantation(s) in the target lesion (i.e. single and multiple stent layer ISR cases are eligible)
2. Target lesion must have visually estimated stenosis ≥50% and less than 100% diameter stenosis in symptomatic patients; or a visually estimated target lesion diameter stenosis of ≥70%, or by evidence of ischemia by coronary physiology (fractional flow reserve \[FFR\] ≤0.80 or non-hyperemic pressure ratio \[NHPR\] ≤0.89) in absence of symptoms
3. Successful lesion preparation (residual stenosis \<30%), without complications (no or slow flow, flow-limiting dissection, perforation, distal embolization) and without plan for stenting
4. Target lesion in a native coronary artery
5. Thrombolysis In Myocardial Infartction (TIMI) grade flow ≥1 in target lesion
6. Target reference vessel diameter (visual estimation) \>2.0 and ≤4.0 mm
7. Target lesion length (including tandem lesions) ≤36.0 mm (visual estimation) and can be covered by only one balloon
8. One ISR target lesion (overlapping stents are allowed) to be treated per patient and in single major coronary artery or side branch (reference vessel diameter \>2.0 mm)
9. Other coronary lesions (ISR or non-ISR) in non-target vessel are allowed and may be treated by any approved interventional device, but must be treated successfully prior to randomization

Exclusion Criteria

1. STEMI within 72 hours of presentation to the first treating hospital, whether a transfer facility or the study hospital
2. NSTEACS in whom the biomarkers have not peaked
3. PCI within the 24 hours prior to the index procedure (not including PCI performed in non-target lesions during the index procedure)
4. Prior DCB treatment (coronary or off-label peripheral) of target lesion ISR
5. Cardiogenic shock (defined as persistent hypotension \[systolic blood pressure \<90 mm Hg\] or requiring vasoactive or hemodynamic support, including IABP)
6. Subject is intubated
7. Known left ventricular ejection fraction \<30%
8. Relative or absolute contraindication to DAPT for at least 1 month (e.g., planned surgeries that cannot be delayed)
9. Subject has an indication for chronic oral anticoagulation treatment and a contraindication for concomitant treatment with a P2Y12 inhibitor
10. If femoral access is planned, significant peripheral arterial disease which precludes safe insertion of a 6F sheath
11. Hemoglobin \<9 g/dL
12. Platelet count \<100,000 cells/mm3 or \>700,000 cells/mm3
13. White blood cell count \<3,000 cells/mm3
14. Active infection undergoing treatment
15. Clinically significant liver disease
16. Renal insufficiency as defined by estimated glomerular filtration rate (eGFR) to be \<30ml/min by the MDRD formula
17. Active peptic ulcer or active bleeding from any site
18. Bleeding from any site requiring active medical attention within the prior 8 weeks
19. History of bleeding diathesis or coagulopathy or likely to refuse blood transfusions
20. Cerebrovascular accident (CVA) within 3 months or has any permanent neurological defect as a result of CVA
21. Known allergy to the study device components or protocol-required concomitant medications:

\- sirolimus (as well as other limus drugs, analogues, or similar compounds), aspirin, clopidogrel and prasugrel and ticagrelor, heparin and bivalirudin, or iodinated contrast that cannot be adequately pre-medicated
22. Any co-morbid condition that may cause non-compliance with the protocol (e.g. dementia, substance abuse, etc.) or reduce life expectancy to \<24 months (e.g. cancer, heart failure, lung disease, severe valvular disease)
23. Patient is participating in or plans to participate in any other investigational drug or device trial that has not reached its primary endpoint
24. Women who are pregnant or breastfeeding (women of child-bearing potential must have a negative pregnancy test within one week before index procedure)
25. Women who intend to become pregnant within 12 months after the index procedure
26. Patient has received an organ transplant or is on a waiting list for an organ transplant
27. Patient has received chemotherapy within 30 days before the index procedure or scheduled to receive chemotherapy any time after the index procedure
28. Patient is receiving oral or intravenous immunosuppressive therapy or has known life-limiting immunosuppressive or autoimmune disease. Inhaled steroid and steroid use for contrast- allergy prophylaxis or treatment are allowed


1. More than 1 ISR lesion in the target vessel in segments that cannot be treated by a single 40mm length DCB (see Angiographic Inclusions #5 and #6 above)
2. ISR lesion in the target vessel in a segment that corresponds to a previously established/documented bare metal stent (BMS)
3. Unprotected left main lesions \>50% or left main intervention
4. Primary PCI for STEMI
5. Coronary artery disease judged more suitable for surgical revascularization per guidelines and local heart team discussion
6. Another lesion in either the target vessel or non-target vessel is present that requires or has a high probability of requiring PCI within 12 months after the index procedure
7. Prior brachytherapy or DCB treatment of target lesion
8. Target lesion is a bifurcation restenosis involving both branches of a bifurcation in which the side branch reference vessel diameter is \>2.0 mm
9. Target lesions located within an arterial or saphenous vein graft or distal to a diseased arterial or saphenous vein graft
10. Target lesion contains large thrombus
11. Target lesion is heavily calcified
12. Target lesion is a chronic total occlusion (or subtotal) without adequate lesion preparation.\* Total and subtotal occlusions may be enrolled assuming they can be crossed with a wire and demonstrate TIMI grade 3 flow at the time of randomization.
13. Diffuse distal disease to target lesion with impaired runoff
Minimum Eligible Age

18 Years

Maximum Eligible Age

110 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Cardiovascular Research Foundation, New York

OTHER

Sponsor Role collaborator

Concept Medical Inc.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Cardiology, PC - Princeton Baptist Medical Center

Birmingham, Alabama, United States

Site Status RECRUITING

Dignity Health - Mercy Gilbert Medical Center

Gilbert, Arizona, United States

Site Status RECRUITING

Cedars - Sinai Medical Center

Los Angeles, California, United States

Site Status RECRUITING

Yale University / Yale New Haven Hospital

New Haven, Connecticut, United States

Site Status RECRUITING

Cheek-Powell Heart and Vascular Pavilion

Clearwater, Florida, United States

Site Status RECRUITING

Clearwater Cardiovascular and Interventional Consultants

Clearwater, Florida, United States

Site Status RECRUITING

The Cardiac & Vascular Institute Research Foundation

Gainesville, Florida, United States

Site Status RECRUITING

Tampa General Hospital / University of South Florida

Tampa, Florida, United States

Site Status RECRUITING

Atlanta VA Medical Center

Decatur, Georgia, United States

Site Status RECRUITING

Beth Israel Deaconess Medical Center

Boston, Massachusetts, United States

Site Status NOT_YET_RECRUITING

Metropolitan Heart and Vascular Institute

Coon Rapids, Minnesota, United States

Site Status NOT_YET_RECRUITING

Minneapolis Heart Institute Foundation

Minneapolis, Minnesota, United States

Site Status RECRUITING

Cardiology Associates Research, LLC

Tupelo, Mississippi, United States

Site Status RECRUITING

Cardiology Associates Research, LLC

Tupelo, Mississippi, United States

Site Status RECRUITING

AtlantiCare Regional Medical Center

Pomona, New Jersey, United States

Site Status RECRUITING

VA New York Harbor Healthcare System

New York, New York, United States

Site Status RECRUITING

NYU Langone Health

New York, New York, United States

Site Status RECRUITING

Columbia University Medical Center/NYPH

New York, New York, United States

Site Status RECRUITING

Montefiore Medical Center - Moses Division

The Bronx, New York, United States

Site Status RECRUITING

NC Heart and Vascular Research, LLC

Raleigh, North Carolina, United States

Site Status NOT_YET_RECRUITING

Cleveland Clinic

Cleveland, Ohio, United States

Site Status RECRUITING

Oklahoma University Health (OU Health)

Oklahoma City, Oklahoma, United States

Site Status RECRUITING

Providence St. Vincent Medical Center

Portland, Oregon, United States

Site Status RECRUITING

Prisma Health

Greenville, South Carolina, United States

Site Status RECRUITING

Centennial Medical Center

Nashville, Tennessee, United States

Site Status RECRUITING

Baylor Scott and White Heart and Vascular Hospital

Dallas, Texas, United States

Site Status RECRUITING

Baylor Scott & White - The Heart Hospital - Plano

Plano, Texas, United States

Site Status RECRUITING

West Virginia University and Vascular Institute

Morgantown, West Virginia, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Dario Gattuso

Role: CONTACT

+393292467132

Farhana Siddique

Role: CONTACT

+919725495366

Facility Contacts

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Jennifer Vermillion

Role: primary

480-728-9973

Mitch Gheorghiu

Role: primary

310 4236152

Bernardo Stein

Role: primary

Jaclyn Rutledge

Role: primary

1-727-467-9393

Marti Roberson

Role: primary

(352)244-0208

Hiram Bezerra

Role: primary

8138448287

Savitha Shivaraj

Role: primary

1 4042638204

Jenifer M Kaufman

Role: primary

01-617-632-8956

Derek Vang

Role: primary

763-236-9347

Tamara O Black

Role: primary

612-863-6226

Barry Bertolet

Role: primary

Yvonne Ray

Role: primary

662-377-5447

Jackie White

Role: primary

609-404-7654

Leandro Maranan

Role: primary

347-228-6951

Natalie S. Massenburg

Role: primary

Ajay Kirtane

Role: primary

Azeem Latib

Role: primary

James Pierre-Loius

Role: primary

919-784-7695

Susan Hejl

Role: primary

216-445-6817

Michael Stout

Role: primary

14502719060

Bethany Wilson

Role: primary

5032167275

Lindsey Bentley

Role: primary

864-455-7377

Drew Quillen

Role: primary

6154171035

Rebecca Baker

Role: primary

214-820-9903

Osniel Gonzalez Ramos

Role: primary

469-814-4862

Josh Bomabrd

Role: primary

3042851980

Other Identifiers

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CM-US-R02

Identifier Type: -

Identifier Source: org_study_id

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