The study design is a prospective, multicenter, single-arm study to evaluate the safety and effectiveness of the Shockwave Medical Coronary Intravascular Lithotripsy (IVL) System in de novo, calcified, stenotic coronary arteries prior to stenting.
Subject Population: Subjects ≥ 18 years of age with de novo, calcified coronary artery lesions presenting with stable, unstable or silent ischemia that are suitable for percutaneous coronary intervention. Approximately 72 subjects at 8 sites in Japan will be enrolled. Subjects will be followed through discharge, 30 days, 6, 12 and 24 months.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
72
Deliver Lithotripsy to the target vessel prior to placing a coronary stent
Tenjinkai Shin-Koga Hospital
Kurume, Fukuoka, Japan
Sapporo Higashi Tokushukai Hospital
Sapporo, Hokkaido, Japan
Sakurakai Takahashi Hospital
Kobe, Hyōgo, Japan
Higashi-Takarazuka Satoh Hospital
Takarazuka, Hyōgo, Japan
Percentage of Participants Who Experienced Freedom From MACE Within 30 Days Post-procedure
The primary safety endpoint was freedom from major adverse cardiac events (MACE) at 30 days - a composite of cardiac death, myocardial infarction (MI) and target vessel revascularization (TVR). The primary endpoints were analyzed using the Intent To Treat (ITT) population.
Time frame: Within 30 days of index procedure
Percentage of Subjects With Procedural Success
The primary effectiveness endpoint was Procedural Success defined as stent delivery with a residual in-stent stenosis \<50% (core laboratory assessed) and without in-hospital MACE
Time frame: 12-24 hours post procedure or at discharge, whichever is earlier, but at least 6 hours post procedure
Number of Participants With Device Crossing Success
A secondary endpoint was Device Crossing Success defined as the ability to deliver the IVL catheter across the target lesion, and delivery of lithotripsy without serious angiographic complications immediately after IVL. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: At end of procedure, with a mean total procedure time of 62.5 minutes
Number of Participants With Angiographic Success (Residual Stenosis <50%)
A secondary endpoint was Angiographic Success defined as stent delivery with \<50%residual stenosis and without serious angiographic complications. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: At end of procedure, with a mean total procedure time of 62.5 minutes
Number of Participants With Procedural Success (Residual Stenosis <=30%)
secondary endpoint was Procedural Success defined as stent delivery with aresidual stenosis \<=30% (core laboratory assessed) and without in-hospital MACE. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
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Shonan-Kamakura General Hospital
Kamakura, Kanagawa, Japan
Johas Kanto Rosai Hospital
Kawasaki, Kanagawa, Japan
Kyoto-Katsura Hospital
Kyoto, Kyoto, Japan
Miyazaki Medical Association Hospital
Miyazaki, Miyazaki, Japan
Time frame: 12-24 hours post procedure or at discharge, whichever is earlier, but at least 6 hours post procedure
Number of Participants With Angiographic Success (Residual Stenosis <=30%)
A secondary endpoint was Angiographic Success defined as stent delivery with\<=30% residual stenosis and without serious angiographic complications. These secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: At end of procedure, with a mean total procedure time of 62.5 minutes
Number of Participants With Serious Angiographic Complications
A secondary endpoint was Serious Angiographic Complications defined as severedissection (Type D to F), perforation, abrupt closure, and persistent slow flow or persistent no reflow. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: At end of procedure, with a mean total procedure time of 62.5 minutes
MACE Rate at 6 Months
The MACE rate at 6 months - a composite of cardiac death, myocardial infarction (MI) and target vessel revascularization (TVR)- is presented as Kaplan-Meier (K-M) estimated event rate. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: within 6 months of index procedure
MACE Rate at 12 Months
The MACE rate at 12 months - a composite of cardiac death, myocardial infarction (MI) and target vessel revascularization (TVR)- is presented as Kaplan-Meier (K-M) estimated event rate. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: within 12 months of index procedure
MACE Rate at 24 Months
The MACE rate at 24 months - a composite of cardiac death, myocardial infarction (MI) and target vessel revascularization (TVR)- is presented as Kaplan-Meier (K-M) estimated event rate. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: within 24 months of index procedure
Target Lesion Failure (TLF) at 30 Days
Target Lesion Failure (TLF) is defined as cardiac death, target vessel MI (TV-MI) or ischemia-driven target lesion revascularization (ID-TLR), and is presented as proportions at 30 days. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: Within 30 days of index procedure
Target Lesion Failure (TLF) at 6 Months
Target Lesion Failure (TLF) is defined as cardiac death, target vessel MI (TV-MI) or ischemia-driven target lesion revascularization (ID-TLR). TLF is presented as Kaplan-Meier estimated event rate at 6 months. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: Within 6 months of index procedure
Target Lesion Failure (TLF) at 12 Months
Target Lesion Failure (TLF) is defined as cardiac death, target vessel MI (TV-MI) or ischemia-driven target lesion revascularization (ID-TLR). TLF is presented as Kaplan-Meier estimated event rate at 12 months. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: Within 12 months of index procedure
Target Lesion Failure (TLF) at 24 Months
Target Lesion Failure (TLF) is defined as cardiac death, target vessel MI (TV-MI) or ischemia-driven target lesion revascularization (ID-TLR). TLF is presented as Kaplan-Meier estimated event rate at 24 months. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: Within 24 months of index procedure
All-Cause Death at 30 Days
The 30-day rates of all-cause death are presented as proportions. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: Within 30 days from index procedure
All-Cause Death at 6 Months
All-cause death at 6 months is presented as Kaplan-Meier estimated event rate. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: within 6 months of index procedure
All-Cause Death at 12 Months
All-cause death at 12 month is presented as Kaplan-Meier estimated event rate. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: within 12 months of procedure
All-Cause Death at 24 Months
All-cause death at 24 month is presented as Kaplan-Meier estimated event rate. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: within 24 months of procedure
Myocardial Infarction (MI) at 30 Days
The 30-day MI rates are presented as proportions. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: within 30 days of index procedure
Myocardial Infarction (MI) at 6 Months
MI is presented as Kaplan-Meier estimated event rate at 6 months. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: Within 6 months of index procedure
Myocardial Infarction (MI) at 12 Months
MI is presented as Kaplan-Meier estimated event rate at 12 months. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: Within 12 months of index procedure
Myocardial Infarction (MI) at 24 Months
MI is presented as Kaplan-Meier estimated event rate at 24 months. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: Within 24 months of index procedure
Myocardial Infarction Attributable to Target Vessel (TV-MI) at 30 Days
The Myocardial Infarction attributable to the target vessel (TV-MI) rates at 30 days are presented as proportions. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: within 30 days of index procedure
Myocardial Infarction Attributable to Target Vessel (TV-MI) at 6 Months
The Myocardial Infarction attributable to the target vessel (TV-MI) is presented as Kaplan-Meier estimated event rate at 6 months. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: Within 6 month of index procedure
Myocardial Infarction Attributable to Target Vessel (TV-MI) at 12 Months
The Myocardial Infarction attributable to the target vessel (TV-MI) is presented as Kaplan-Meier estimated event rate at 12 months. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: Within 12 months of index procedure
Myocardial Infarction Attributable to Target Vessel (TV-MI) at 24 Months
The Myocardial Infarction attributable to the target vessel (TV-MI) is presented as Kaplan-Meier estimated event rate at 24 months. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: Within 24 months of index procedure
Stent Thrombosis at 30 Days
The Stent Thrombosis rate at 30 days is presented as a proportion. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: Within 30 days of index procedure
Stent Thrombosis at 6 Months
Stent thrombosis is presented as Kaplan-Meier estimated event rate at 6 months. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: within 6 months of index procedure
Stent Thrombosis at 12 Months
Stent thrombosis is presented as Kaplan-Meier estimated event rate at 12 months. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: within 12 months of index procedure
Stent Thrombosis at 24 Months
Stent thrombosis is presented as Kaplan-Meier estimated event rate at 24 months. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: within 24 months of index procedure
All Revascularizations at 30 Days
The 30-day revascularization rate is presented as a proportion. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: within 30 days of index procedure
All Revascularizations at 6 Months
All revascularizations are presented as Kaplan-Meier estimated event rates at 6 months. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: within 6 months of index procedure
All Revascularizations at 12 Months
All revascularizations are presented as Kaplan-Meier estimated event rates at 12 months. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: within 12 months of index procedure
All Revascularizations at 24 Months
All revascularizations are presented as Kaplan-Meier estimated event rates at 24 months. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: within 24 months of index procedure
Ischemia-Driven Target Vessel Revascularization (ID-TVR) at 30 Days
The ischemia-driven Target Vessel Revascularization at 30 days is presented as a proportion. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: within 30 days of index procedure
Ischemia-Driven Target Vessel Revascularization (ID-TVR) at 6 Months
The ischemia-driven Target Vessel Revascularization (ID-TVR) is presented as Kaplan-Meier estimated event rate at 6 months. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: within 6 months of index procedure
Ischemia-driven Target Vessel Revascularization (ID-TVR) at 12 Months
The ischemia-driven Target Vessel Revascularization (ID-TVR) is presented as Kaplan-Meier estimated event rate at 12 months. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: within 12 months of index procedure
Ischemia-driven Target Vessel Revascularization (ID-TVR) at 24 Months
The ischemia-driven Target Vessel Revascularization (ID-TVR) is presented as Kaplan-Meier estimated event rate at 24 months. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: within 24 months of index procedure
Ischemia-Driven Target Lesion Revascularization (ID-TLR) at 30 Days
The ischemia-driven Target Lesion Revascularization (ID-TLR) 30-day rate is presented as a proportion. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: within 30 days of index procedure
Ischemia-Driven Target Lesion Revascularization (ID-TLR) at 6 Months
The ischemia-driven Target Lesion Revascularization (ID-TLR) is presented as Kaplan-Meier estimated event rate at 6 months. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: within 6 months of index procedure
Ischemia-Driven Target Lesion Revascularization (ID-TLR) at 12 Months
The ischemia-driven Target Lesion Revascularization (ID-TLR) is presented as Kaplan-Meier estimated event rate at 12 months. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: within 12 months of index procedure
Ischemia-Driven Target Lesion Revascularization (ID-TLR) at 24 Months
The ischemia-driven Target Lesion Revascularization (ID-TLR) is presented as Kaplan-Meier estimated event rate at 24 months. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: within 24 months of index procedure
Non-Ischemia-Driven Target Vessel Revascularization (Non-ID-TVR) at 30 Days
The non-ischemia-driven Target Vessel Revascularization (Non-ID-TVR) 30-day rate is presented as a proportion. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: within 30 days of index procedure
Non-Ischemia-Driven Target Vessel Revascularization (Non-ID-TVR) at 6 Months
The non-ischemia-driven Target Vessel Revascularization (Non-ID-TVR) is presented as Kaplan-Meier estimated event rate at 6 months. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: within 6 months of index procedure
Non-Ischemia-Driven Target Vessel Revascularization (Non-ID-TVR) at 12 Months
The non-ischemia-driven Target Vessel Revascularization (Non-ID-TVR) is presented as Kaplan-Meier estimated event rate at 12 months. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: within 12 months of index procedure
Non-Ischemia-Driven Target Vessel Revascularization (Non-ID-TVR) at 24 Months
The non-ischemia-driven Target Vessel Revascularization (Non-ID-TVR) is presented as Kaplan-Meier estimated event rate at 24 months. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: within 24 months of index procedure
Non-Ischemia-Driven Target Lesion Revascularization (Non-ID-TLR) at 30 Days
The non-ischemia-driven Target Lesion Revascularization (Non-ID-TLR) 30-day rate is presented as a proportion. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: within 30 days of index procedure
Non-Ischemia-Driven Target Lesion Revascularization (Non-ID-TLR) at 6 Months
The non-ischemia-driven Target Lesion Revascularization (Non-ID-TLR) is presented as Kaplan-Meier estimated event rate at 6 months. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: within 6 months of index procedure
Non-Ischemia-Driven Target Lesion Revascularization (Non-ID-TLR) at 12 Months
The non-ischemia-driven Target Lesion Revascularization (Non-ID-TLR) is presented as Kaplan-Meier estimated event rate at 12 months. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: within 12 months of index procedure
Non-Ischemia-Driven Target Lesion Revascularization (Non-ID-TLR) at 24 Months
The non-ischemia-driven Target Lesion Revascularization (Non-ID-TLR) is presented as Kaplan-Meier estimated event rate at 24 months. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: within 24 months of index procedure
Procedural MI at 30 Days
The procedural MI 30-day rate is presented as a proportion. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: within 30 days of index procedure
Procedural MI at 6 Months
The procedural MI is presented as Kaplan-Meier estimated event rate at 6 months. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: within 6 months of index procedure
Procedural MI at 12 Months
The procedural MI is presented as Kaplan-Meier estimated event rate at 12 months. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: within 12 months of index procedure
Procedural MI at 24 Months
The procedural MI is presented as Kaplan-Meier estimated event rate at 24 months. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: within 24 months of index procedure
Non-Procedural MI at 30 Days
The non-procedural MI 30-day rate is presented as a proportion. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: within 30 days of index procedure
Non-Procedural MI at 6 Months
The non-procedural MI is presented as Kaplan-Meier estimated event rate at 6 months. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: within 6 months of index procedure
Non-Procedural MI at 12 Months
The non-procedural MI is presented as Kaplan-Meier estimated event rate at 12 months. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: within 12 months of index procedure
Non-Procedural MI at 24 Months
The non-procedural MI is presented as Kaplan-Meier estimated event rate at 24 months. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: within 24 months of index procedure
Myocardial Infarction (MI) Using the Fourth Universal Definition of MI, at 30 Days
The 30-day rate of MI using the Fourth Universal Definition of MI is presented as a proportion. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: within 30 days of index procedure
Myocardial Infarction (MI) Using the Fourth Universal Definition of MI, at 6 Months
MI using the Fourth Universal Definition of MI is presented as Kaplan-Meier estimated event rate at 6 months. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: within 6 months of index procedure
Myocardial Infarction (MI) Using the Fourth Universal Definition of MI, at 12 Months
MI using the Fourth Universal Definition of MI is presented as Kaplan-Meier estimated event rate at 12 months. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: within 12 months of index procedure
Myocardial Infarction (MI) Using the Fourth Universal Definition of MI, at 24 Months
MI using the Fourth Universal Definition of MI is presented as Kaplan-Meier estimated event rate at 24 months. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: within 24 months of index procedure
Myocardial Infarction (MI) Using the Society for Cardiovascular Angiography and Interventions (SCAI) Definition, at 30 Days
The 30-day rate of MI using the SCAI Definition of MI is presented as a proportion. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: within 30 days of index procedure
Myocardial Infarction (MI) Using the Society for Cardiovascular Angiography and Interventions (SCAI) Definition, at 6 Months
MI using the SCAI definition is presented as Kaplan-Meier estimated event rate at 6 months. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: within 6 months of index procedure
Myocardial Infarction (MI) Using the Society for Cardiovascular Angiography and Interventions (SCAI) Definition, at 12 Months
MI using the SCAI definition is presented as Kaplan-Meier estimated event rate at 12 months. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: within 12 months of index procedure
Myocardial Infarction (MI) Using the Society for Cardiovascular Angiography and Interventions (SCAI) Definition, at 24 Months
MI using the SCAI definition is presented as Kaplan-Meier estimated event rate at 24 months. The secondary endpoints were analyzed using the Intent To Treat Analysis Set.
Time frame: within 24 months of index procedure