The objective of the PINNACLE I Clinical Study is to assess safety and performance of the LithiX Coronary Hertzian Contact Intravascular Lithotripsy Catheter (LithiX Coronary HCIVLC; LithiX) to treat moderately to severely calcified coronary artery lesions by calcium fragmentation utilizing Hertzian contact stress from LithiX HCIVLC.
This study is a prospective, multicenter, single-arm clinical study. Enrollment of up to 60 patients requiring percutaneous coronary intervention (PCI) on up to two de novo coronary artery lesions with reference vessel diameters ≥ 2.25 mm and ≤ 3.5 mm, and lesion lengths of ≤ 34 mm, with moderate to severe calcification. The LithiX Coronary HCIVLC is a proprietary Hertzian contact intravascular lithotripsy catheter delivered through the coronary arterial system to visualize and treat calcified stenoses potentially resistant to full stent expansion. The LithiX Coronary HCIVLC consists of a semi-compliant balloon featuring multiple rows of stainless-steel hemispheres which are intended to atraumatically fragment calcium via Hertzian contact intravascular lithotripsy. In the Optical Coherence Tomography (OCT) imaging subgroup, approximately 30 patients will undergo OCT imaging at pre-procedure, post-LithiX treatment, and the end of procedure following stent deployment. Subjects will be followed through hospital discharge and will have clinical follow-up conducted by phone at 30 days and 6 months post-index procedure.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
60
Vessel preparation of moderately to severely calcified coronary artery lesions prior to stenting allows for full stent expansion and apposition to the vessel wall
ZNA Middelheim
Antwerp, Belgium
Ziekenhuis Oost-Limburg, Campus Sint Jan
Genk, Belgium
Jessa Ziekenhuis
Hasselt, Belgium
Universitaire Ziekenhuizen Leuven
Leuven, Belgium
Clinical success
This is the primary effectiveness and safety endpoint and defined as residual stenosis \<50% after final treatment (with or without stenting) with no evidence of in-hospital major adverse cardiovascular events (MACE).
Time frame: At the end of procedure
Major adverse cardiovascular events (MACE)
This is the primary safety endpoint and defined as a per-subject composite endpoint of cardiovascular death, myocardial infarction, and target vessel revascularization.
Time frame: 30 days
Angiographic success
defined as success in facilitating stent delivery with \<50% residual stenosis and without serious angiographic complications
Time frame: During the procedure
Optical Coherence Tomography (OCT) imaging
assessment of the lesion and stent in a subset of patients
Time frame: During the procedure
All myocardial infarction
Q-wave and non-Q-wave
Time frame: Through study completion, an average of 6 months
Target vessel revascularization
defined as any repeat percutaneous intervention or surgical bypass of any segment of the target vessel including the target lesion.
Time frame: Through study completion, an average of 6 months
Target lesion revascularization
defined as any repeat percutaneous intervention of the target lesion or bypass surgery of the target vessel performed for restenosis or other complication of the target lesion
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Meander Medical Centre
Amersfoort, Netherlands
Catharina Ziekenhuis
Eindhoven, Netherlands
Maasstad Ziekenhuis
Rotterdam, Netherlands
Time frame: Through study completion, an average of 6 months
Target lesion failure
defined as a per-subject composite endpoint of cardiovascular death, target vessel myocardial infarction, and clinically-indicated target lesion revascularization
Time frame: Through study completion, an average of 6 months
Stent thrombosis
definite and probable stent thrombosis
Time frame: Through study completion, an average of 6 months
All-cause death
Cardiovascular and non-cardiovascular death
Time frame: Through study completion, an average of 6 months