BIOFLOW-III Canada Satellite Registry

Study Overview
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Brief Summary
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For the majority of Coronary Artery Disease (CAD), treatment with Percutaneous Transluminal Coronary Angioplasty (PTCA) provides high initial procedural success. However, the medium to long-term complications range from rather immediate elastic recoil or vessel contraction to longer processes like smooth muscle cell proliferation and excessive production of extra cellular matrix, thrombus formation and atherosclerotic changes like restenosis or angiographic re-narrowing. The reported incidence of restenosis after PTCA ranges from 30%-50%. Such rates of recurrence have serious economic consequences. Bare Metal Stents (BMS), designed to address the limitations of PTCA, reduced the angiographic and clinical restenosis rates in de novo lesions compared to PTCA alone and decreased the need for CABG. BMS substantially reduced the incidence of abrupt artery closure, but restenosis still occurred in about 20%-40% of cases, necessitating repeat procedures. The invention of Drug Eluting Stents (DES) significantly improved on the principle of BMS by adding an antiproliferative drug (directly immobilized on the stent surface or released from a polymer matrix), which inhibits neointimal hyperplasia. The introduction of DES greatly reduced the incidence of restenosis and resulted in a better safety profile as compared to BMS with systemic drug administration. These advantages and a lower cost compared to surgical interventions has made DES an attractive option to treat coronary artery disease. This observational registry is designed to investigate and collect clinical evidence for the clinical performance and safety of the Orsiro Drug Eluting Stent System in an all-comers patient population in daily clinical practice.

Official Title
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Safety and Performance Registry for an All-comers Patient Population With the Limus Eluting Orsiro Stent System Within Daily Clinical Practice - III Canada

Conditions
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Coronary Artery Disease, Myocardial Ischemia

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Symptomatic coronary artery disease or documented silent ischemia Subject informed consent for data release Subject is geographically stable and willing to participate at all follow ups assessments Exclusion Criteria: Subject did not sign informed consent for data release Pregnancy Known intolerance to aspirin, clopidogrel, ticlopidine, heparin or any other anticoagulation/antiplatelet therapy required for PCI, stainless steel, sirolimus Planned surgery within 6 months of PCI unless dual antiplatelet therapy will be maintained

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Orsiro DES<br>Subjects requiring coronary revascularization with Drug Eluting Stents (DES). subgroups: Subjects presenting with Diabetes (all types) Small vessels (≤2.75 mm) Chronic total occlusion (CTO) Acute Myocardial Infarction (incl. STEMI and NSTEMI) | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Target Lesion Failure | Composite of cardiac death, target vessel Q-wave or non-Q wave Myocardial Infarction (MI), Emergent Coronary Artery Bypass Graft (CABG), clinically driven Target Lesion Revascularization (TLR) | 12 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Target Lesion Failure | Composite of cardiac death, target vessel Q-wave or non-Q wave Myocardial Infarction (MI), Emergent Coronary Artery Bypass Graft (CABG), clinically driven Target Lesion Revascularization (TLR) | 6 and 12 months | 
| Target Vessel revascularization (TVR) | Any repeat revascularization of the target vessel | 6 and 12 months | 
| Target Lesion Revascularization (TLR) | Any repeat revascularization of the target lesion | 6 and 12 months | 
| Stent Thrombosis | Definite, Probable and Possible Stent Thrombosis | 6 and 12 months | 
| Clinical Device Success | Successful delivery and deployment of the investigational stent(s) at the intended target lesion (this includes successful delivery and deployment of multiple overlapping stents) and successful withdrawal of the stent delivery system with attainment of a final residual stenosis of less than 50% by visual estimation and without use of a device outside the assigned treatment strategy. Standard predilation catheters and post-dilation catheters (if applicable) may be used. | 1 day (At time of intervention) | 
| Clinical Procedure Success | Successful delivery and deployment of the investigational stent(s) at the intended target lesion (this includes successful delivery and deployment of multiple overlapping stents, if applicable) and successful withdrawal of the stent delivery system with attainment of a final residual stenosis of less than 50% of the target lesion as observed by visual estimate without using any adjunctive device* without the occurrence of ischemia-driven major adverse cardiac event (ID-MACE) during the hospital stay to a maximum of the first seven days post index procedure. | During the hospital stay to a maximum of the first seven days post index procedure | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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International, Multicenter, Observational registry, Orsiro Drug Eluting Stent (DES), Stenting, Treatment of Coronary Artery Disease, Coronary revascularization, Percutaneous Coronary Intervention (PCI), STEMI, NSTEMI, Ischemia, Angina, Subgroups, Acute Myocardial Infarction, Diabetes, Small Vessels, Chronic Total Occlusion (CTO)