Kawasaki Disease Clinical Trial
Official title:
Safety and Vascular Remodelling After Bioresorbable Vascular Scaffold Implantation for Stenotic or Occluded Lesions in Children and Young Adults With Kawasaki Disease
To investigate the safety and long-term vascular remodeling after bioresorbable vascular
scaffold (BVS) implantation for stenotic or occluded lesion in children or young adults with
Kawasaki disease (KD).
Background: KD occurs worldwide, most prevalent in Japan and East Asian countries. Coronary
artery lesion is the predominant determinant of KD outcome in the long-term. Children with
KD with aneurysms at least 6 mm in maximal diameter had a greater than 50% chance of
developing a clinically significant stenotic lesion during follow-up. They are at risk of
myocardial infarction-related sudden death or congestive heart failure as young adults.
Bypass surgery could be the reasonable strategy but the long-term patency of the graft
remains unsatisfactory. Percutaneous angioplasty with drug-eluting stents (DES) implantation
is the alternative. However, metallic stenting remains problematic in several aspects mainly
due to the restriction of vessel expansive remodeling. The novel BVS has the potential to be
free from the limitation due to scaffold degradation.
we will conduct a single-center, single-group prospective study with safety and imaging endpoints. A total of 10 KD children or young adults with indication of revascularization are enrolled, and BVS will be implanted for stenotic or occluded lesions. QCA and optical coherence tomography (OCT) are used to evaluate the baseline lumen area, plaque characteristics, and BVS expansion or eccentricity after deployment. At 12 months, scaffold restenosis is evaluated by multislice computed tomography. At 30 months, patients will receive follow-up by angiography and OCT to evaluate lumen area, neoplaque characteristics, and side branch conditions. Otherwise, the composite endpoint including cardiac death, myocardial infarction, and ischaemia-driven target lesion revascularisation are assessed at 30 days, 6 and 9 months, and 1, 2, 3 years. ;
Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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