FRACTURE IDE trial of the Boston Scientific SEISMIQ™ 4CE Coronary Intravascular Lithotripsy Catheter meets primary safety and effectiveness endpoints
Late-breaking data from global pivotal study achieved high rates of freedom from major adverse cardiac events and procedural success in patients with severe coronary artery disease
Moderate-to-severe coronary calcification – a hardened build-up of calcium that can narrow coronary arteries – is present in nearly one-third of patients undergoing percutaneous coronary intervention (PCI) to treat CAD, presenting a major challenge that can complicate stent delivery and expansion and increase the risk of procedural complications such as vessel dissection.1 The SEISMIQ 4CE catheter is an intravascular lithotripsy (IVL) device that uses laser energy within a balloon catheter to generate acoustic pressure waves that fracture calcium. The system's visible, directional emitters are designed to provide controlled, consistent energy delivery at low pressure to treat the calcium and prepare the vessel for stent implantation and maximum stent expansion to restore blood flow.
"As the prevalence of coronary artery disease and adoption of IVL therapy to address it continue to grow rapidly, data from this important trial will help advance our understanding of treatment for severely diseased, previously untreated coronary lesions and could help broaden the scope of coronary IVL treatment options over time," said Dr.
The prospective, non-randomized, single-arm FRACTURE trial enrolled 420 patients with severe CAD. Findings from the trial met all pre-specified safety and effectiveness endpoints. Of note:
- The primary safety endpoint was met with a 93.3% rate of freedom from MACE, including cardiovascular death, myocardial infarction or target vessel revascularization at 30 days, exceeding a prespecified performance goal of 86.2% (p < 0.0001).
- A 93.7% rate of procedural success met the primary effectiveness endpoint, defined as successful stent delivery with a final residual stenosis of less than 50% and freedom from in-hospital MACE, exceeding a prespecified performance goal of 85.8% (p 0.0001).
- Treatment with the SEISMIQ 4CE device resulted in 100% successful stent delivery and final in-stent residual stenosis less than 50%.
- A sub-analysis of the data found a 94.2% average stent expansion rate at the most calcified segment of the artery, with favorable stent sizing that exceeded clinically significant thresholds, helping to create space within the vessel and support optimal stent placement.2
"Representing one of the fastest growing medical device segments in both peripheral and coronary care, IVL therapy can help address a critical level of coronary artery narrowing or blockage that poses a threat of heart attack, heart failure and other serious complications," said
The trial enrolled patients who will be followed for two years after their procedure across 46 sites in
For more information on the FRACTURE trial, visit bostonscientific.com/fracture.
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1 Barbato E, Gallinoro E, Abdel-Wahab M, et al. Management strategies for heavily calcified coronary stenoses: an EAPCI clinical consensus statement in collaboration with the EURO4C-PCR group.
2 Räber L, Mintz GS, Koskinas KC, Johnson TW, Holm NR, Onuma Y, Radu MD, Joner M, Yu B, Jia H, Meneveau N, de la Torre Hernandez JM, Escaned J, Hill J, Prati F, Colombo A,
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