BIOTRONIKS-Safety and Clinical Performance of the First Drug-Eluting Generation Absorbable Metal Stent In Patients with de Novo Lesions in Native Coronary Arteries (BIOSOLVE-I study) (2024)

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Last updated:

To evaluate safety and clinical performance of the investigation product (drug-eluting absorbable metal stent system)

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Ethical review

Approved WMO

Status

Completed

Health condition type

Coronary artery disorders

Study type

Interventional

Source

ToetsingOnline

Brief title

BIOSOLVE-I Study

Condition

  • Coronary artery disorders

Synonym

coronary stenosis, narrowing of the vessels (arteries) which supply the heart with blood

Research involving

Human

Intervention

Keyword :

Absorbable, Coronary, Drug-Eluting, Stent

Outcome measures

Primary outcome

The primary endpoint of the study is MACE* at 6 month follow-up for cohort 1

and at 12 months follow-up for cohort 2.

*composite of cardiac death, myocardial infarction, clinically driven target

lesion revascularization

Secondary outcome

In-stent late lumen loss at 6 / 12 months (depending on patient cohort)

In-segment late lumen loss at 6 / 12 months (depending on patient cohort)

Percent in-stent diameter restenosis at 6 / 12 months (depending on patient

cohort)

Percent in-segment diameter restenosis at 6 / 12 months (depending on patient

cohort)

Binary in-stent restenosis at 6 / 12 months (depending on patient cohort)

Binary in-segment restenosis at 6 / 12 months (depending on patient cohort)

For both cohorts:

Cumulative MACE* rate at 1, 6, 12, 24 and 36 months

(*composite of cardiac death, myocardial infarction, clinically driven Target

Lesion Revascularization)

Stent thrombosis rate

Device success

Procedural success

Background summary

Stent placement is a common practise in cardiovascular intervention. There is a
lot of experience and clinical evidence with balloon cathethers, bare metal
stents and drug-eluting stents. There are also some running studies
investigating bioabsorbale stents. Our investigational product is a
drug-eluting absorbable metal stent and the goal of this first in man study is
to evaluate safety and clinical performance of this new stent technology in
humans.

Study objective

To evaluate safety and clinical performance of the investigation product
(drug-eluting absorbable metal stent system)

Study design

A prospective, multi-centre, first in man trial with follow-up investigations
at 1, 6, 12, 24 and 36 months

Intervention

Percutanous Coronary Intervention with stent placement

Study burden and risks

The study has the goal to prove safety of the device in humans. Although animal
data showed safety and all possible risk mitigation measures have been taken
there are remaining risks, e.g. the risk to have a thrombosis due to stent
fragments (caused by the degradation process). As this is a new technology
there is also the risk that clinical performance is not as expected. The risk
to have a reintervention due to restenosis of the same area is given. Risks are
also associate the with additional invasive image follow-up. These risks are
the same as for each intervention and not related to the investigational
device.

This new technology would provide certain benefits, e.g. easy re-intervention
if clinically needed as no metal or polymer is left behind, possible (to be
proven) shorter dual antiplatelet therapy.

The burden to the patient could be the number of follow-up visits (five) and
the required invasive image follow-ups. However, this is a first in man trial
and the follow-up visits are for the patient*s safety. The image follow-up will
help to see whether the treated area is still free of narrowing. In case of
re-narrowing, re-treatment can be done immediately.

Public

Biotronik AG

Ackerstrasse 6
8180 Bülach
CH

Scientific

Biotronik AG

Ackerstrasse 6
8180 Bülach
CH

Listed location countries

Netherlands

Age

Adults (18-64 years)

Elderly (65 years and older)

Inclusion criteria

1. Patient is between >/= 18 year and 2. Written patient informed consent available prior to PCI
3. Patients with stable or unstable angina pectoris or documented silent ischemia
4. Patient eligible for PCI
5. Patient acceptable candidate for coronary artery bypass surgery
6. Patients with a maximum of two lesions in two separate coronary arteries which have to be de novo lesions.
7. Target reference vessel diameter by visual estimation, assisted by QCA / IVUS: 3.0 - 3.5 mm
8. Target lesion length by visual estimation, assisted by QCA / IVUS: 9. Target lesion stenosis by visual estimation, assisted by QCA / IVUS: >/= 50% - < 100%

Exclusion criteria

1. Left ventricular ejection fraction of < 30%
2. Patients with three-vessel where all three vessels require treatment
3. Myocardial infarction (STEMI/NSTEMI) within 4 weeks of the intended treatment. Determination of CKMB and/or troponin T or I is required.
Notes:
Laboratory assessments to be done within 24 hours prior to intervention.
Patients with CKMB and/or troponin T or I > 3 fold the upper limit of normal must not be included in the trial.
4. Patients with risk of either acetylsalicylic acid, clopidogrel or Prasugrel cessation
5. Impaired renal function (serum creatinine > 2.0mg/dl or 177 umol/l, determined within 72 hours prior to intervention)
6. Additional coronary lesions (restenotic or de novo) in the same vessel which requires treatment
7. Lesions located within arterial or venous graft
8. Ostial lesions

Design

Study type :

Interventional

Masking :

Open (masking not used)

Control :

Uncontrolled

Primary purpose :

Treatment

Recruitment

NL

Recruitment status

:

Completed

Start date (anticipated) :

Enrollment :

10

Type :

Actual

Medical products/devices used

Generic name :

Medical device called Drug-Eluting Absorbable Metal Stent (AMS-3.0) Coronary Stent System

Registration

:

No

Approved WMO

Date :

Application type :

First submission

Review commission :

MEC-U: Medical Research Ethics Committees United (Nieuwegein)

Followed up by the following (possibly more current) registration

No registrations found.

Other (possibly less up-to-date) registrations in this register

No registrations found.

In other registers

Register ID
CCMO NL32563.060.10
BIOTRONIKS-Safety and Clinical Performance of the First Drug-Eluting Generation Absorbable Metal Stent In Patients with de Novo Lesions in Native Coronary Arteries (BIOSOLVE-I study) (2024)

FAQs

What are first generation drug-eluting stents? ›

Drug-eluting stents (DES) are vascular prostheses used by interventional cardiologists to reopen and maintain patent coronary arteries narrowed by arteriosclerosis. The history of interventional cardiology began with balloon angioplasty in 1977. Sigwart et al. introduced the first bare metal stent (BMS) in 1986.

What are the long term outcomes of patients receiving drug-eluting stents? ›

The rate of the composite outcome of death or repeat revascularization was 12.0% for the drug-eluting stents and 15.8% for the bare-metal stents (adjusted OR 0.40, 95% CI 0.33–0.49). In the subgroup of patients who had acute coronary syndromes, the adjusted OR for this composite outcome was 0.46 (95% CI 0.35–0.61).

What is the problem with drug-eluting stents? ›

A drug-eluting stent is coated with a slow-release medicine to help stop blood clots from forming in a stent. Blood clotting in a stent can cause a future blockage, called restenosis, and may lead to a heart attack.

Why do drug-eluting stents require longer antiplatelet therapy than bare-metal stents? ›

1 Drug eluting stents (DES) are usually preferred over bare metal stents (BMS) because of less restenosis and fewer repeat revascularization procedures. However, DES require a longer duration of dual antiplatelet therapy to minimize the chance of stent thrombosis.

What is the life expectancy of a drug-eluting stent? ›

Once placed, you'll have it for life, which your body can safely tolerate. If your arteries narrow again, you'll need to have the procedure again to correct it. If this happens, it's usually within the first 6 months. One newer type of drug-eluting stent completely dissolves after about 3 years.

What to avoid after a stent? ›

In most cases, you'll be advised to avoid heavy lifting and strenuous activities for about a week, or until the wound has healed.
  • Driving. You shouldn't drive a car for a week after having a coronary angioplasty. ...
  • Work. ...
  • Sex.

What are the side effects of drug-eluting stents? ›

Potentially dangerous side effects of drug-eluting stents are adverse drug interactions, incomplete stent apposition and increased in-stent thrombosis rates. Demonstration of long-term efficacy is mandatory since in some animal studies a delayed healing has been observed.

How long does a drug-eluting stent release the drug? ›

Pacl*taxel-eluting stents perform optimally by releasing their drug either very rapidly (within a few hours) or very slowly (over periods of several months up to one year) at concentrations considerably lower than current DES.

Which is the best drug-eluting stent? ›

  • Nobori - The top drug-eluting stents. Stent: Nobori. ...
  • Cypher - The top drug-eluting stents. Stent: Cypher. ...
  • Taxus/Taxus Element - The top drug-eluting stents. ...
  • Promus Element - The top drug-eluting stents. ...
  • Promus - The top drug-eluting stents. ...
  • Endeavor/Resolute - The top drug-eluting stents. ...
  • Xience - The top drug-eluting stents.
Nov 12, 2012

Why do drug-eluting stents cause thrombosis? ›

The drug coating is depleted and there is no new tissue coating the stent struts. As a result, blood flows directly over a "bare" surface, a perfect set-up for thrombus formation.

Does stent reduce life span? ›

Having a stent placed in your heart may improve your life expectancy, but it depends on factors like what condition the procedure is used to treat and your age and overall health. Percutaneous coronary intervention (PCI) is a procedure that includes angioplasty and stenting.

Is PCI drug-eluting stent better than bare metal? ›

Background. Drug-eluting stents (DES) compared to bare metal stents (BMS) have shown superior clinical performance, but are considered less suitable in complex cases. Most studies do not distinguish between DES and BMS with respect to their mechanical performance.

What are second-generation drug-eluting stents? ›

Contemporary second-generation drug-eluting stents (DES) have markedly improved outcomes in patients undergoing percutaneous coronary intervention by reducing the risk of restenosis, stent thrombosis, and myocardial infarction (MI), and may improve survival in comparison with bare metal stents and first-generation DES.

What are the different generation of stents? ›

First-generation DES include sirolimus-eluting stents (SES; 2003) and pacl*taxel-eluting stents (PES; 2004) (TABLE 1). Second-generation DES, including zotarolimus- and everolimus-eluting stents (ZES, EES), were approved for use in the United States in 2008 (TABLE 1).

What are the different types of drug-eluting coronary stents? ›

Outline
  • Everolimus-eluting stents.
  • Zotarolimus-eluting stents.
  • Everolimus- versus zotarolimus-eluting stents.
  • 2012 comparison of drug-eluting stents.
  • Ridaforolimus-eluting stent.
Feb 7, 2023

What are third generation stents? ›

Several stents of this new third generation of DES have been developed over recent years. Besides using biodegradable polymers, most of these new stents also use cobalt-chromium or platinum-chromium platforms (allowing ultra-thin struts) and several have only abluminal polymer distribution (Table 1).

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