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The DynamX (Bioadaptor) study is a prospective, consecutive enrollment study designed to enroll up to 50 patients requiring treatment of a single, de novo lesion ≤ 24 mm in length located in a vessel ≥ 2.5 mm and ≤ 3.5 mm in diameter. All patients be followed clinically at 30 days, 6 and 9 months, and 1, 2 and 3 years.
All patients will undergo imaging (angiography and IVUS) follow-up with approximately one-half of the patients returning for follow up at 9 months and approximately one-half returning for follow up at 12 months.
The DynamX (Bioadaptor) study is a prospective, consecutive enrollment study designed to enroll up to 50 patients requiring treatment of a single, de novo lesion ≤ 24 mm in length located in a vessel ≥ 2.5 mm and ≤ 3.5 mm in diameter. All patients be followed clinically at 30 days, 6 and 9 months, and 1, 2 and 3 years.
All patients will undergo imaging (angiography and IVUS) follow-up with approximately one-half of the patients returning for follow up at 9 months and approximately one-half returning for follow up at 12 months.
At select centers, a subset of approximately 20 patients will undergo FFR pressure wire measurement at baseline and at follow-up (or at a minimum follow-up) in conjunction with the IVUS imaging, and will also undergo OCT imaging at 9 or 12 months.
The primary safety endpoint is Target Lesion Failure at 6 months. TLF is a composite endpoint defined as cardiac death, target vessel MI, and clinically-indicated target lesion revascularization.
The primary imaging/efficacy endpoints for those patients undergoing imaging follow-up is the change in mean in-device area and mean lumen area at 9 or 12 months compared to post-procedure as measured by IVUS.
Co-primary imaging/efficacy endpoints for those patients undergoing imaging follow-up is late lumen loss as measured by QCA and IVUS at 9 or 12 months.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Treatment | Experimental | All patients will undergo imaging (angiography and IVUS) follow-up with approximately one-half of the patients returning for follow up at 9 months and approximately one-half returning for follow up at 12 months. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Percutaneous Coronary Intervention | Device | Drug eluting stent implant |
|
| Measure | Description | Time Frame |
|---|---|---|
| Target Lesion Failure (TLF) | Target Lesion Failure (composite of cardiac death, target vessel MI, and clinically-indicated target lesion revascularization) | 6 months |
| Change in Mean In-Device Area compared to post-procedure as measured by IVUS | 9 or 12 months | |
| Change in Mean Lumen Area compared to post-procedure as measured by IVUS | 9 or 12 months | |
| Late Lumen Loss (LLL) as measured by QCA | 9 or 12 months | |
| Late Lumen Loss (LLL) as measured by IVUS | 9 or 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| Device Success | Successful delivery of the device and a final residual stenosis < 30% by QCA | During Procedure |
| Procedure Success | Successful delivery of the device and a final residual stenosis < 30% by QCA without TLF through hospital discharge |
| Measure | Description | Time Frame |
|---|---|---|
| Acute Recoil | Acute Recoil by QCA | During Procedure |
| Minimum Lumen Diameter (MLD) | MLD by QCA | During Procedure |
General Inclusion Criteria:
Angiographic Inclusion Criteria - Target Lesion/Vessel
Angiographic Inclusion Criteria - non-Target Lesion/Vessel Treatment
1. Treatment of a single, non-target lesion located in a separate major epicardial vessel (defined as LAD with septal and diagonal branches, LCX with obtuse marginal and/or ramus intermedius branches and RCA and any of its branches) attempted during the index procedure must be completed first using an approved 'olimus drug eluting stent. The segment must be located such that any injury that might occur during intervention can be clearly attributable to the treated non-target vessel. If the procedure is deemed uncomplicated and optimal, treatment of the target lesion with the DynamX stent can be considered.
Optimal lesion/vessel treatment defined as:
General Exclusion Criteria
Angiographic Exclusion Criteria
Target lesion(s) meets any of the following criteria:
The target vessel contains visible thrombus
Another clinically significant lesion (>40%) is located in the same major epicardial vessel as the target lesion (including side branches)
Patient has a high probability that a procedure other than pre-dilatation and stenting and (if necessary) post-dilatation will be required at the time of index procedure for treatment of the target vessel (e.g. atherectomy, cutting balloon)
Target vessel was previously treated with any type of PCI < 6 months prior to index procedure
Non-Target vessel was previously treated with any type of PCI < 30 days prior to the index procedure
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| Name | Affiliation | Role |
|---|---|---|
| Stefan Verheye, MD | ZNA Middelheim | Principal Investigator |
| Antonio Colombo, MD | San Raffaele Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| AZ Middelheim Hospital | Antwerp | 2020 | Belgium | |||
| Ospendale San Raffaele |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39076703 | Derived | Verheye S, Vrolix M, Montorfano M, Giannini F, Bedogni F, Dubois C, De Bruyne B, Costa RA, Chamie D, Costa JR Jr, Abizaid A, Colombo A. Final 36-Month Outcomes from the Multicenter DynamX Study Evaluating a Novel Thin-Strut Novolimus-Eluting Coronary Bioadaptor System and Supporting Preclinical Data. Rev Cardiovasc Med. 2023 Aug 1;24(8):221. doi: 10.31083/j.rcm2408221. eCollection 2023 Aug. |
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| ID | Term |
|---|---|
| D003324 | Coronary Artery Disease |
| ID | Term |
|---|---|
| D003327 | Coronary Disease |
| D017202 | Myocardial Ischemia |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
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| ID | Term |
|---|---|
| D062645 | Percutaneous Coronary Intervention |
| ID | Term |
|---|---|
| D057510 | Endovascular Procedures |
| D014656 | Vascular Surgical Procedures |
| D013504 | Cardiovascular Surgical Procedures |
| D013514 | Surgical Procedures, Operative |
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All patients will undergo imaging (angiography and IVUS) follow-up with approximately one-half of the patients returning for follow up at 9 months and approximately one-half returning for follow up at 12 months.
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| In Hospital through Discharge |
| Target Lesion Failure (TLF) | Target Lesion Failure (composite of cardiac death, target vessel MI, and clinically-indicated target lesion revascularization) | 30 days, 1, 2 and 3 years |
| Cardiac Death | Cardiac Death | 30 days, 180 days, 1, 2 and 3 years |
| Non-Cardiac Death | Non-Cardiac death | 30 days, 180 days, 1, 2 and 3 years |
| Q-wave Myocardial Infarction (Q-MI) | Q-MI | 30 days, 180 days, 1, 2 and 3 years |
| Non-Q-wave Myocardial Infarction (NQ-MI) | NQ-MI | 30 days, 180 days, 1, 2 and 3 years |
| Target Vessel Myocardial Infarction (TV-MI) | Target Vessel MI | 30 days, 180 days, 1, 2 and 3 years |
| Non-Target Vessel Myocardial Infarction (NTV-MI) | Non-Target Vessel MI | 30 days, 180 days, 1, 2 and 3 years |
| Clinically-Indicated Target Lesion Revascularization (CI-TLR) | CI-TLR | 30 days, 180 days, 1, 2 and 3 years |
| Non-Clinically Indicated Target Lesion Revascularization (Non-CI-TLR) | Non-CI-TLR | 30 days, 180 days, 1, 2 and 3 years |
| Clinically Indicated Target Vessel Revascularization (CI-TVR) | CI-TVR | 30 days, 180 days, 1, 2 and 3 years |
| Non-Clinically Indicated Target Vessel Revascularization | Non-CI-TVR | 30 days, 180 days, 1, 2 and 3 years |
| Target Vessel Failure (TVF) | Composite of cardiac death, target vessel MI, clinically indicated target vessel revascularization | 30 days, 180 days, 1, 2 and 3 years |
| Stent Thrombosis | Definite & Probable Stent Thrombosis (per ARC) | 30 days, 180 days, 1, 2 and 3 years |
| % Diameter Stenosis (DS) | % DS by QCA | During Procedure |
| Late Lumen Loss (LLL) | Late lumen loss (in-stent and in-segment) by QCA | 9 months |
| Change in mean and minimum lumen, stent and vessel areas from post-procedure | Change in mean lumen are, device area and vessel area by IVUS | 9 or 12 months |
| In-stent % neointimal obstruction | In-stent % neointimal obstruction by IVUS | 9 or 12 months |
| In-stent late lumen loss (LLL) | In-stent late lumen loss (LLL) byIVUS | 9 or 12 months |
| Vasomotion (Pulsatility) | Vasomotion (Pulsatility) assessment at during systole and diastole by IVUS | 9 or 12 months |
| Stent malapposition | Acute, persistent and late stent malapposition by IVUS | During procedure, 9 or 12 months |
| Fractional Flow Reserve (FFR) | FFR measurements in the treated vessel | During procedure, 9 or 12 months |
| Assessment of disengagement segments | Assessment of disengagement segments by OCT | 9 or 12 months |
| Incomplete scaffold/device apposition | Incomplete scaffold/device apposition by OCT | 9 or 12 months |
| Scaffold/Device Area and Lumen Area | Scaffold/Device Area and Lumen Area on OCT | 9 or 12 months |
| Milan |
| 20132 |
| Italy |
| D001161 |
| Arteriosclerosis |
| D001157 | Arterial Occlusive Diseases |
| D014652 | Vascular Diseases |
| D019060 | Minimally Invasive Surgical Procedures |