This is a French, prospective, single-arm, multi-center registry to confirm the safety and efficacy of the Diamondback 360 TM Orbital Atherectomy System in the preparation of de novo calcified coronary lesions before implantation of a coronary endoprothesis in adult subjects. The primary safety endpoint is 30-day MACE and the efficacy endpoint is procedural success.
Treatment of calcified lesions, caused in 6 to 20% of patients, remains a challenge. Presence of coronary calcifications complicates stent placement resulting in up to 50% malapposition or under-expansion of the stent and is associated with a higher frequency of major adverse cardiac events (MACE). In order to reduce these risks, preparation of these lesions before the implantation of a coronary stent is essential. The arrival on the European market of a new Orbital atherectomy system leads to consider its use in the preparation of such lesions. The orbital atherectomy system uses a diamond-coated eccentric crown that abrades calcified plaque and develops pulsatile forces on the wall. It reduces calcified plaque and modifies plaque with fractures, facilitating stent placement and allowing for optimal stent expansion. ORBIT I and ORBIT II clinical trials were conducted in the United States to evaluate the safety of using the Orbital Atherectomy System in de novo calcified coronary lesions in adults. These 2 trials demonstrated that orbital atherectomy not only facilitated stenting, but also improved clinical outcomes compared to historical outcomes. The recent obtaining of CE marking allows the use of this very promising medical device in France.
Study Type
OBSERVATIONAL
Enrollment
300
Use of the Diamondback 360TM orbital atherectomy system in the preparation of calcified coronary lesions before implantation of a coronary endoprothesis
GCS-ES Axium-Rambot
Aix-en-Provence, France
NOT_YET_RECRUITINGCentre Hospitalier Antibes - Juan-Les-Pins
Antibes, France
Safety Endpoint : Major Adverse Cardiac Event (MACE)
The Diamondback 360°® Orbital Atherectomy System safety was evaluated by a composite of MACE at 30-days post procedure. MACE is composed of : * Myocardial infarction : Type I and/or Type IV * TVR - defined as revascularization at the target vessel after the completion of the index procedure. * Cardiac death.
Time frame: 30 days
Efficacy Endpoint : Revascularization success rate
Revascularization success was defined as successful stent placement with \< 30% residual stenosis and without severe angiographic complications during intervention and/or MACE during the period of the patient's hospitalization. Severe angiographic complications were defined as severe dissection (Type C to F) , perforation and persistent slow flow or no flow, Atrioventricular conduction disorder.
Time frame: Until hospital discharge after index procedure, average estimated at 48 hours
Safety Endpoint : 12 Month MACE
See MACE definition in the primary outcome.
Time frame: 12 months
Safety endpoint : Comparison of MACE with rotational atherectomy
The safety of Orbital Atherectomy System will be compared to rotational atherectomy by comparing the MACE rate at 1 month recorded in this study and that recorded in the Euro4C Study.
Time frame: 30 days
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Hôpital Européen de la Roseraie
Aubervilliers, France
NOT_YET_RECRUITINGCentre Hospitalier d'Avignon
Avignon, France
RECRUITINGClinique Rhône Durance
Avignon, France
NOT_YET_RECRUITINGCentre Hospitalier Universitaire de Clermont-Ferrand
Clermont-Ferrand, France
RECRUITINGPôle Santé République - ELSAN
Clermont-Ferrand, France
RECRUITINGGroupe Hospitalier Mutualiste de Grenoble
Grenoble, France
RECRUITINGCentre Hospitalier de Haguenau
Haguenau, France
RECRUITINGCentre Hospitalier Marne la Vallée
Jossigny, France
RECRUITING...and 7 more locations