TARGET-PREMIER Trail in Evaluating the Safety and Efficacy of the Rapamycin Target Eluting Stent in CAS Treatment

Prior treatment

• Planned surgery within 6 months after index procedure.
• Known allergy to protocol-required concomitant medications such as aspirin, or clopidogrel, or heparin and the study stent components such as cobalt, nickel, chromium, rapamycin or similar drugs.
• Patient is participating in or plans to participate in any other investigational drug or device clinical trial that has not reached its primary endpoint.
• Patient has immunosuppressive or autoimmune disease, and is receiving or scheduled to immunosuppressive therapy.
• Women who are pregnant or breastfeeding (women of child-bearing potential must have a negative pregnancy test with on week before treatment.)
• Patient has received an organ transplant or is on a waiting list for an organ transplant.
• Patient is receiving or scheduled to receive chemotherapy or radiotherapy with 30 days before or any time after the baseline procedure.

Other illness

• Acute myocardial infarction with 1 week or enzyme levels (Creatinkinase or Troponin) demonstrating that either or both enzyme levels have not returned to normal limits at the time of the procedure.
• Patient has current unstable arrhythmias.
• Patient has a history of any coronary arteries brachytherapy.
• Patient has a history of bleeding diathesis, contraindication to dual antiplatelet therapy (DAPT).
• Other serious medical illness with life expectancy less than 1 year (e.g. cancer, congestive heart failure).
• Left main artery coronary disease.
• Three-vessel coronary artery disease.

Lab values

• Known congestive heart failure (NYHA III) or left ventricular ejection fraction (LVEF) \<30%
• Platelet count \<100,000 cells/mm3 or \>700,000 cells/mm3, white blood cell (WBC) count \<3,000 cells/mm3.
• Impaired renal function (serum creatinine \>2.0mg/dl) or patient on dialysis.

Other

• General Exclusion Criteria:
• Target vessel (including branches) PCI within 12 months of the baseline procedure.
• Cerebrovascular accident or transient ischemic attack within the past 6 months, or any permanent neurologic defect attribute to cerebral vascular accident (CVA).
• A
• Women who intend to become pregnant with 12 months after the baseline procedure (women of child-bearing potential who are sexually active must agree to use a reliable method of contraception from the time of screening through 12 months after the baseline procedure).
• Patient may not be obedient to the clinical investigation plan through the judgment by investigators.
  • Angiographic Inclusion Criteria:
• Target lesion is located in or supplied by an arterial or venous bypass graft.
• In-stent restenosis lesions.
• Patient has additional lesion(s) for which an intervention with 1 year after the index procedure would be required.

• Age ≥18 years.
• Patient with an indication for percutaneous coronary intervention (PCI) including silent ischemia (in absence of symptoms a positive functional study or a reversible change in the ECG consistent with ischemia), angina (stable or unstable).
• Subject acceptable candidate for coronary artery bypass surgery (CABG).
• Patient or legal guardian is willing and able to provide informed written consent and comply with follow-up visits and testing schedule.
  • Angiographic Inclusion Criteria:
• Treatment up to two target lesions with a maximum of two lesions per epicardial vessel. If there are two target lesions within the same epicardial vessel, the two target lesions must be at least 10mm apart per visual estimation.
• Target lesion(s) must be located in a native coronary artery with a visually estimated diameter stenosis ≥70%, TIMI 1, lesions length ≤36mm. Target vessel must be visually estimated diameter of ≥2.25mm to ≤4.0mm.
• Target lesion must be adequately covered with a single stent.
• Up to two target lesion needed treatment in one target vessel.
• One non-target lesion is allowed prior to enrollment if successful. It should be located at the distal end of the target lesion, and be at lease 10mm apart, when both are in the same epicardial vessel.