MagicTouch for Treatment of In-Stent Restenosis in Coronary Artery Lesions
A Prospective, Multicenter, Randomized, Two-Arm, Single-blind Superiority Trial to Evaluate the Safety and Efficacy of the MagicTouch™ Sirolimus- Coated Balloon in the Treatment of Coronary Drug-Eluting Stent In-Stent Restenosis. Subjects with prior DES implantation presenting with ISR lesions undergoing PCI will be randomized into two groups: treatment with the MagicTouch™ sirolimus-coated balloon or POBA on a 2:1 basis. Approximately 492 subjects will be enrolled in the randomized study in a maximum of 50 study sites located in the United States. The goal is to establish the safety and efficacy of the MagicTouch™ sirolimus- coated balloon in treatment of coronary in-stent restenosis (ISR).
Conditions:
In-Stent Restenosis Cardiovascular Diseases Coronary Artery Disease
Study Start (Actual) 2024-04-16
Primary Completion (Estimated) 2025-09
Study Completion (Estimated) 2028-02
Enrollment (Estimated) 492
Study Type INTERVENTIONAL
Phase NA
Locations:
📍 Clearwater, Florida, United States
📍 Tupelo, Mississippi, United States
📍 Pomona, New Jersey, United States
📍 Bronx, New York, United States
📍 New York, New York, United States
📍 New York, New York, United States

Eligibility Criteria

Description

    Inclusion Criteria:

    • 1. Subject is at least 18 years old
    • 2. Subject (or legal guardian) understands the trial requirements and treatment procedures and provides written informed consent prior to any trial-specific tests or treatment
    • 3. Patient with an indication for PCI due to suspected in-stent restenosis
    • 4. Non-target lesion PCI are allowed in non-target vessels to be treated with approved interventional devices prior to randomization as follows:
    • Inclusion Criteria:

      • 1. In-stent restenosis after drug-eluting stent implantation(s) in the target lesion
      • 2. Target lesion must have visually estimated stenosis ≥50% and less than 100% diameter stenosis in symptomatic patients; or a visually estimated target lesion diameter stenosis of ≥70%, or by evidence of ischemia by coronary physiology (fractional flow reserve \[FFR\] ≤0.80 or non-hyperemic pressure ratio \[NHPR\] ≤0.89) in absence of symptoms
      • 3. Successful lesion preparation (residual stenosis \<30%), without complications (no or slow flow, flow-limiting dissection, perforation, distal embolization) and without plan for stenting
      • 4. Target lesion in a native coronary artery
      • 5. Thrombolysis In Myocardial Infartction (TIMI) grade flow ≥1 in target lesion
      • 6. Target reference vessel diameter (visual estimation) \>2.0 and ≤4.0 mm
      • 7. Target lesion length (including tandem lesions) ≤36.0 mm (visual estimation) and can be covered by only one balloon
      • 8. One ISR target lesion (overlapping stents are allowed) to be treated per patient and in single major coronary artery or side branch (reference vessel diameter \>2.0 mm)
      • 9. Other coronary lesions (ISR or non-ISR) in non-target vessel are allowed and may be treated by any approved interventional device, but must be treated successfully prior to randomization

      Exclusion Criteria:

      • General Exclusion Criteria (all must be absent for the patient to be eligible):
      • 1. STEMI within 72 hours of presentation to the first treating hospital, whether a transfer facility or the study hospital
      • 2. NSTEACS in whom the biomarkers have not peaked
      • 3. PCI within the 24 hours prior to the index procedure (not including PCI performed in non-target lesions during the index procedure)
      • 4. Cardiogenic shock (defined as persistent hypotension \[systolic blood pressure \<90 mm Hg\] or requiring vasoactive or hemodynamic support, including IABP)
      • 5. Subject is intubated
      • 6. Known left ventricular ejection fraction \<30%
      • 7. Relative or absolute contraindication to DAPT for at least 1 month (e.g., planned surgeries that cannot be delayed)
      • 8. Subject has an indication for chronic oral anticoagulation treatment and a contraindication for concomitant treatment with a P2Y12 inhibitor
      • 9. If femoral access is planned, significant peripheral arterial disease which precludes safe insertion of a 6F sheath
      • 10. Hemoglobin \<9 g/dL
      • 11. Platelet count \<100,000 cells/mm3 or \>700,000 cells/mm3
      • 12. White blood cell count \<3,000 cells/mm3
      • 13. Active infection undergoing treatment
      • 14. Clinically significant liver disease
      • 15. Renal insufficiency as defined by estimated glomerular filtration rate (eGFR) to be \<30ml/min by the MDRD formula
      • 16. Active peptic ulcer or active bleeding from any site
      • 17. Bleeding from any site requiring active medical attention within the prior 8 weeks
      • 18. History of bleeding diathesis or coagulopathy or likely to refuse blood transfusions
      • 19. Cerebrovascular accident (CVA) within 3 months or has any permanent neurological defect as a result of CVA
      • 20. Known allergy to the study device components or protocol-required concomitant medications:
      • - sirolimus (as well as other limus drugs, analogues, or similar compounds), aspirin, clopidogrel and prasugrel and ticagrelor, heparin and bivalirudin, or iodinated contrast that cannot be adequately pre-medicated
      • 21. Any co-morbid condition that may cause non-compliance with the protocol (e.g. dementia, substance abuse, etc.) or reduce life expectancy to \<24 months (e.g. cancer, heart failure, lung disease, severe valvular disease)
      • 22. Patient is participating in or plans to participate in any other investigational drug or device trial that has not reached its primary endpoint
      • 23. Women who are pregnant or breastfeeding (women of child-bearing potential must have a negative pregnancy test within one week before index procedure)
      • 24. Women who intend to become pregnant within 12 months after the index procedure
      • 25. Patient has received an organ transplant or is on a waiting list for an organ transplant
      • 26. Patient has received chemotherapy within 30 days before the index procedure or scheduled to receive chemotherapy any time after the index procedure
      • 27. Patient is receiving oral or intravenous immunosuppressive therapy or has known life-limiting immunosuppressive or autoimmune disease. Inhaled steroid and steroid use for contrast- allergy prophylaxis or treatment are allowed
      • Angiographic Exclusion Criteria (visual estimate) (all must be absent for the patient to be eligible):
      • 1. More than 1 ISR lesion in the target vessel in segments that cannot be treated by a single 40 mm length DCB (see Angiographic Inclusions #5 and #6 above)
      • 2. Unprotected left main lesions \>50% or left main intervention
      • 3. Primary PCI for STEMI
      • 4. Coronary artery disease judged more suitable for surgical revascularization per guidelines and local heart team discussion
      • 5. Another lesion in either the target vessel or non-target vessel is present that requires or has a high probability of requiring PCI within 12 months after the index procedure
      • 6. Prior brachytherapy or DCB treatment of target lesion
      • 7. Target lesion is a bifurcation restenosis involving both branches of a bifurcation in which the side branch reference vessel diameter is \>2.0 mm
      • 8. Target lesions located within an arterial or saphenous vein graft or distal to a diseased arterial or saphenous vein graft
      • 9. Target lesion contains large thrombus
      • 10. Target lesion is heavily calcified
      • 11. Target lesion is a chronic total occlusion
      • 12. Diffuse distal disease to target lesion with impaired runoff
Ages Eligible for Study: 18 Years to 110 Years (ADULT, OLDER_ADULT)
Sexes Eligible for Study: ALL
Accepts Healthy Volunteers: No

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates

  • First Submitted2023-06-01
  • First Submitted that Met QC Criteria2023-06-09
  • First Posted2023-06-18

Study Record Updates

  • Last Update Submitted that Met QC Criteria2024-07-12
  • Last Update Posted2024-07-15
  • Last Verified2024-07