OCT Guided Magmaris RMS in STEMI

Universitaire Ziekenhuizen KU Leuven100 enrolled

Overview

Percutaneous treatment of coronary artery disease depends on the implantation of stents within diseased coronary segments. Compared with conventional bare-metal and drug- eluting stents, which remain permanently within the coronary anatomy, bioresorbable scaffolds (BRS) offer several potential advantages due to its resorbable properties. The resorbable magnesium scaffold Magmaris has demonstrated favourable outcomes in patients with stable coronary artery disease. In particular, in comparison to polymeric bioresorbable scaffolds, no cases of stent thrombosis have been reported in over two years of follow-up suggesting that magnesium-based resorbable scaffolds have low thrombogenicity and might be particularly beneficial for patients presenting with ST- segment myocardial infarction. A recent pilot study in eighteen patients supports this concept, which has led to the development of the proposed prospective multicentre study including intra-coronary imaging with long-term clinical follow-up.

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Enrollment

100

Conditions

STEMI

Interventions

Eligibility

Sex: ALLMin age: 18 YearsMax age: 70 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Patients presenting with a ST-elevation myocardial infarction (STEMI) with symptoms onset \<24 hours or with ongoing symptoms. 2. Signed patient informed consent. Exclusion Criteria: 1. Age \< 18 or \> 70 years. 2. Pregnancy or breastfeeding. 3. Cardiogenic shock. 4. Creatinine clearance ≤30 ml/min/1.73 m2 (as calculated by MDRD formula for estimated GFR) and not on dialysis. Note: chronic dialysis dependent patients are eligible for enrolment regardless of creatinine clearance. 5. Infarct-artery reference diameter \< 2.7 or \> 4.0 mm (within the segment of the culprit lesion) by visual estimation, and OCT infarct-artery distal reference mean lumen diameter \< 2.7 or \> 3.7 mm 6. Non-optimal vessel preparation after predilatation: residual stenosis \>30%. 7. Culprit lesion length \> 21 mm. 8. Culprit lesion located within a previously stented segment (stent thrombosis or in-stent restenosis). 9. Culprit lesion involving a saphenous vein graft. 10. Culprit lesion involving a bifurcation with an intended two-stent implantation strategy. 11. Ostial right coronary artery 12. Severe calcification or tortuosity of the infarct-related artery. 13. Absolute contraindication to a 12 months dual antiplatelet therapy. 14. Life expectancy \< 3 years. 15. Patients taking oral anticoagulant therapy

Outcomes

Primary Outcomes

A device oriented composite endpoint (DOCE) including cardiac death, target vessel myocardial infarction (attributable to the culprit lesion) and ischemic-driven target lesion revascularization (TLR) within 12 months after the index procedure.

DOCE at 12 months

Time frame: 1 year

Secondary Outcomes

Procedural success defined as the delivery and deployment of RMS at the intended target lesion with a final residual stenosis ≤20% by visual estimation.

Procedure succes

Time frame: in-hospital

DOCE at 1-,6- and 24-months follow-up periods.

DOCE at 1,6 and 24 months

Time frame: 2 years

Definite or probable scaffold thrombosis.

incidence scaffold thrombosis

Time frame: 2 years

Vessel healing assessment through an angiographic with OCT follow- up procedure at 15 months in predetermined participating centres

Healing characteristics on OCT evaluation

Time frame: 15 months

All-cause death, cardiac death, non-TVR, any revascularization at 1, 6, 12 and 24 months.

MACE

Time frame: 2 years

OCT Guided Magmaris RMS in STEMI

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes

Central Contacts