FORWARD CAD IDE Study

NCT ID: NCT06662500

Last Updated: 2025-11-12

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

158 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-04-04

Study Completion Date

2028-07-31

Brief Summary

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The FORWARD CAD IDE Study is a Prospective, Multicenter, Single-Arm, Investigational Device Exemption (IDE) Study conducted to assess the safety and effectiveness of the Shockwave Intravascular Lithotripsy (IVL) System with the Javelin Coronary IVL Catheter for the treatment of calcified, stenotic de novo coronary artery lesions prior to stenting.

Detailed Description

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The Shockwave Javelin Coronary IVL Catheter was developed to address the current challenges clinicians face when treating tight, difficult to cross, calcified coronary lesions and was designed as a rapid exchange catheter to deliver intravascular lithotripsy to those complex lesions in the coronary vasculature.

The intended benefit of the Shockwave Javelin Coronary IVL Catheter is to allow the catheter to modify calcium in tight, difficult to cross lesions to increase the compliance of the vessel and allow further crossing of the device or additional treatment at the discretion of the physician.

Up to 158 subjects (150 evaluable) subjects with moderate-to severely calcified, stenotic de novo, coronary artery lesions presenting with stable or following stabilization after acute coronary syndrome (ACS) that are suitable for non-emergent percutaneous coronary intervention (PCI) will be enrolled at up to 35 sites.

Conditions

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Coronary Arterial Disease (CAD)

Keywords

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Intravascular Lithotripsy

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Shockwave Javelin Coronary IVL Catheter

The Shockwave Javelin Coronary IVL Catheter will be used to treat subjects with moderate-to-severely calcified, stenotic de novo coronary artery lesions presenting with stable angina or following stabilization after acute coronary syndrome (ACS) that are suitable for non-emergent percutaneous coronary intervention (PCI).

Group Type EXPERIMENTAL

Intravascular Lithotripsy

Intervention Type DEVICE

The Shockwave Intravascular Lithotripsy (IVL) System with the Shockwave Javelin Coronary Catheter is intended to treat calcified stenosis, including calcified stenoses that are anticipated to exhibit resistance to balloon crossing, full dilatation or subsequent uniform coronary stent expansion.

Interventions

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Intravascular Lithotripsy

The Shockwave Intravascular Lithotripsy (IVL) System with the Shockwave Javelin Coronary Catheter is intended to treat calcified stenosis, including calcified stenoses that are anticipated to exhibit resistance to balloon crossing, full dilatation or subsequent uniform coronary stent expansion.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

1. Subject is ≥18 years of age
2. Subject is able and willing to comply with all assessments in the study.
3. Subjects with native coronary artery disease including stable angina or following stabilization after acute coronary syndromes (ACS) for non-emergent percutaneous coronary intervention (PCI)
4. Biomarkers (troponin) must be:

1. less than or equal to the upper limit of lab normal within 24 hours prior to the procedure or may be drawn from the side port of the sheath at the time of index if the PCI is a non-emergent procedure and has stable angina (result will not be known prior to procedure); OR
2. if above the upper limit of lab normal, biomarker result must be less than 5 times the upper limit of lab normal within 24 hours prior to the procedure and the following criteria must be met: • The procedure must not be emergent and the subject cannot have angina at rest.
5. Left ventricular ejection fraction (LVEF) \>30% within 6 months (note: in the case of an event (MI or Revascularization) the LVEF must be taken post-event and in the case of multiple assessments of LVEF, the measurement closest to enrollment will be used for this criterion; may be assessed at time of index procedure).
6. Subject, or legally authorized representative, signs a written Informed Consent form to participate in the study, prior to any study-mandated procedures.
7. Estimated life expectancy \>1 year.
8. Lesions in non-target vessels requiring PCI may be treated either:

1. \>30 days prior to the study procedure if the procedure was unsuccessful or complicated; OR
2. \>24 hours prior to the study procedure if the procedure was successful and uncomplicated (defined as a final lesion angiographic diameter stenosis \<30% and TIMI 3 flow (visually assessed) for all non-target lesions and vessels without perforation, cardiac arrest or need for defibrillation or cardioversion or hypotension/heart failure requiring mechanical or intravenous hemodynamic support or intubation, and no evidence of elevated biomarkers post-procedure; OR
3. \>30 days after the study procedure

9. The target lesion must be a de novo coronary lesion that has not been previously treated successfully with any interventional procedure
10. Single de novo target lesion stenosis of protected LMCA, or LAD, RCA or LCX (or of their branches)
11. The target vessel reference diameter must be ≥2.5 mm and ≤4.0 mm
12. The target lesion must meet one of the following criteria:

1. Target lesion stenosis \>90% up to 40 mm in length and evidence of moderate or severe calcification at the lesion site. Moderate calcification defined as angiography with densities noted only during the cardiac cycle prior to contrast injection; severe calcification defined as angiography with fluoroscopic radio-opacities noted without cardiac motion prior to contrast injection involving both sides of the arterial wall; OR
2. Chronic total occlusion presenting with J-CTO score of 1 with evidence of calcification and occlusion length up to 20 mm.
13. Guidewire must be in true lumen, distal to the lesion, and not subintimal, prior to insertion of Shockwave Javelin Coronary IVL catheter (antegrade wire technique only)

Exclusion Criteria

1. Any comorbidity or condition which may prevent compliance with this protocol, including follow-up visits
2. Subject is participating in another research study involving an investigational agent including pharmaceutical, biologic, or medical device that has not reached the primary endpoint
3. Subject is pregnant or nursing (a negative pregnancy test is required for women of child-bearing potential within 7 days prior to enrollment)
4. Unable to tolerate antiplatelet/anticoagulation therapy per society guidelines
5. Subject has an allergy to imaging contrast media which cannot be adequately pre-medicated
6. Subject experienced an acute STEMI within 30 days prior to index procedure
7. New York Heart Association (NYHA) class III or IV heart failure
8. Subject has acute or chronic renal disease with eGFR \<30 ml/min/1.73m2 (using institutional formula)
9. History of a stroke or transient ischemic attack (TIA) within 60 days, or any prior intracranial hemorrhage or permanent neurologic deficit
10. Active peptic ulcer or upper gastrointestinal (GI) bleeding within 3 months
11. Untreated pre-procedural hemoglobin \<10 g/dL or intention to refuse blood transfusions if one should become necessary
12. Coagulopathy, including but not limited to platelet count \<100,000 or International Normalized ratio (INR) \>1.7 (INR is only required in subjects who have taken warfarin within 2 weeks of enrollment)
13. Subject has a hypercoagulable disorder such as polycythemia vera, platelet count \>750,000 or other disorders
14. Subject has an active systemic infection on the day of the index procedure with either fever, leukocytosis or requiring intravenous antibiotics
15. Subjects with clinical evidence of cardiogenic shock
16. Uncontrolled severe hypertension (systolic BP \>180 mm Hg or diastolic BP \>110 mm Hg)
17. Subjects with an estimated life expectancy of less than 1 year
18. Non-coronary interventional or surgical structural heart procedures (e.g., TAVR, MitraClip, LAA or PFO occlusion, etc.) within 30 days prior to the index procedure
19. Planned non-coronary interventional or surgical structural heart procedures (e.g., TAVR, MitraClip, LAA or PFO occlusion, etc.) within 30 days after the index procedure
20. Subject refusing or not a candidate for emergency coronary artery bypass grafting (CABG) surgery
21. Planned use of atherectomy, scoring or cutting balloon, sub-intimal reentry device, or any investigational device other than coronary IVL

22. Unprotected left main diameter stenosis \>30%
23. Evidence of a serious angiographic complication in the target vessel prior to treatment with coronary IVL (dissection, perforation, abrupt closure, persistent slow-flow or persistent no reflow)
24. Definite or possible thrombus by angiography in the target vessel
25. Evidence of aneurysm in target vessel within 10 mm of the target lesion
26. Second lesion with \>50% stenosis in the same target vessel as the target lesion including its side branches
27. Chronic total occlusion of the target lesion, J-CTO ≥2
28. Target lesion is located in a native vessel that can only be reached by going through a saphenous vein or arterial bypass graft
29. Previous stent within 5 mm of the target lesion
30. Failure to successfully cross the guidewire across the target lesion
31. Planned use of antegrade dissection and reentry (ADR), retrograde guidewire (RW), or retrograde dissection and reentry (RDR) crossing technique at any time during the procedure.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Shockwave Medical, Inc.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Robert W Yeh, M.D., M.Sc, M.B.A

Role: PRINCIPAL_INVESTIGATOR

Beth Israel Deaconess Medical Center

James C Spratt, MD, MB, ChB, FRCP, FESC, FACC

Role: PRINCIPAL_INVESTIGATOR

St. George's University NHS Trust

Robert F Riley, MD, MS, FACC, FAHA, FSCAI

Role: PRINCIPAL_INVESTIGATOR

Overlake Medical Center & Clinics

Locations

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Scripps Health

La Jolla, California, United States

Site Status RECRUITING

University of California, San Francisco

San Francisco, California, United States

Site Status RECRUITING

South Denver Cardiology Associates, P.C

Littleton, Colorado, United States

Site Status RECRUITING

Hartford Hospital

Hartford, Connecticut, United States

Site Status RECRUITING

Medstar Washington Hospital Center

Washington D.C., District of Columbia, United States

Site Status RECRUITING

The Cardiac and Vascular Institute

Gainesville, Florida, United States

Site Status RECRUITING

Piedmont Heart Institute

Atlanta, Georgia, United States

Site Status RECRUITING

Emory University Hospital

Atlanta, Georgia, United States

Site Status RECRUITING

Massachusetts General Hospital

Boston, Massachusetts, United States

Site Status RECRUITING

Brigham and Women's Hospital

Boston, Massachusetts, United States

Site Status RECRUITING

Beth Israel Deaconess Medical Center

Boston, Massachusetts, United States

Site Status RECRUITING

Minneapolis Heart Institute

Minneapolis, Minnesota, United States

Site Status RECRUITING

NYU Langone Health

New York, New York, United States

Site Status RECRUITING

Columbia University Medical Center/New York Presbyterian Hospital

New York, New York, United States

Site Status RECRUITING

Lenox Hill Hospital

New York, New York, United States

Site Status RECRUITING

St. Francis Hospital & Heart Center

Roslyn, New York, United States

Site Status RECRUITING

NC Heart and Vascular Research, LLC

Raleigh, North Carolina, United States

Site Status RECRUITING

The Christ Hospital

Cincinnati, Ohio, United States

Site Status RECRUITING

Providence St. Vincent

Portland, Oregon, United States

Site Status RECRUITING

Wellspan York Hospital

York, Pennsylvania, United States

Site Status RECRUITING

Centennial Heart

Nashville, Tennessee, United States

Site Status RECRUITING

Baylor Scott & White Research Institute Dallas

Dallas, Texas, United States

Site Status RECRUITING

Houston Methodist Hospital

Houston, Texas, United States

Site Status RECRUITING

Baylor Scott and White - The Heart Hospital Baylor Plano

Plano, Texas, United States

Site Status RECRUITING

Intermountain Medical Center Heart Institute

Salt Lake City, Utah, United States

Site Status RECRUITING

Overlake Medical Center

Bellevue, Washington, United States

Site Status RECRUITING

Swedish Medical

Seattle, Washington, United States

Site Status RECRUITING

University of Washington Medical Center

Seattle, Washington, United States

Site Status RECRUITING

Basildon University Hospital

Basildon, UK, United Kingdom

Site Status RECRUITING

Bristol Heart Institute

Bristol, UK, United Kingdom

Site Status RECRUITING

Leeds Teaching Hospital NHS Trust

Leeds, UK, United Kingdom

Site Status RECRUITING

Glenfield Hospital

Leicester, UK, United Kingdom

Site Status RECRUITING

St. Thomas Hospital

London, UK, United Kingdom

Site Status RECRUITING

St. George's Hospital

London, UK, United Kingdom

Site Status RECRUITING

Countries

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United States United Kingdom

Central Contacts

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Randee Randoll

Role: CONTACT

Phone: 408-577-7856

Email: [email protected]

Lesli DeSimone

Role: CONTACT

Phone: 916-261-5189

Email: [email protected]

Facility Contacts

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Brendan Neilan

Role: primary

Kaye Reambonanza

Role: primary

Rachel Kim

Role: primary

Marianne McCarthy

Role: primary

Michelle Singh

Role: primary

Marti Roberson

Role: primary

Suzanne Corley

Role: primary

Mutsa Seremwe

Role: primary

Sidney Searles

Role: primary

Barbora Zvarova

Role: primary

Jenifer Kaufman

Role: primary

Opeyemi Akindumila

Role: primary

Natalie Massenburg

Role: primary

Kate Dalton, MS, RD, CCRC

Role: primary

Sara Velichkovikj

Role: primary

Elizabeth Haag

Role: primary

James Pierre-Louis

Role: primary

Kiera Carlisle

Role: primary

Sheryl Ames

Role: primary

Lori Slenker

Role: primary

Sean O'Malley

Role: primary

Geoffrey Gong

Role: primary

Padmaja Naik

Role: primary

Selena Ortega

Role: primary

Michael Tomlinson

Role: primary

Gowri Rajendran

Role: primary

Tina Pratt

Role: primary

John Tushinski

Role: primary

Kelly Musson

Role: primary

Marissa Kearns

Role: primary

Dean Waugh

Role: primary

Judith Fisher

Role: primary

Emma Perchard

Role: primary

Sophie Horne

Role: primary

Other Identifiers

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CP 71886

Identifier Type: -

Identifier Source: org_study_id