Bioresorbable Sirolimus-eluting scaffold in de Novo Coronary Artery Lesions
REC-CAGEFREE Ⅳ
A Bioresorbable Sirolimus-eluting scaffold Versus a Metallic Sirolimus-eluting Stent for the Treatment of de Novo Coronary Artery Lesions: a Randomized, Open-label, Non-inferiority Trial
1 other identifier
interventional
2,000
1 country
1
Brief Summary
Bioresorbable scaffold (BRS) was designed aiming to avoid the late adverse events associated with permanent metallic stents by providing temporary support to the vessel wall and promoting vessel remodeling, plaque reduction, and restoring vasomotion after its full absorption. As the first FDA-approved BRS, ABSORB BRS was associated with a significantly higher risk of late scaffold thrombosis compared with everolimus-eluting stent (EES). As a result, the ESC-EAPCI task force recommended that the current ABSORB BRS should not be preferred over conventional DES in clinical practice. To solve this dilemma, improved scaffold technology and optimal implantation techniques are necessary. The latest generation Firesorb BRS is a PLLA backbone scaffold system abluminally coated with poly(D, L-lactide) mixed with sirolimus using highly accurate and precise point spraying techniques. Compared to the ABSORB BRS, Firesorb features a thinner stent thickness (100-125 μm) while maintaining sufficient radial support, enabling faster degradation and a shorter duration of presence in the coronary. Additionally, inspired by the design of the Firehawk DES, its unique spot-coating process applies a single-sided coating layer exclusively to the stent's outer surface, enabling targeted drug release. Preclinical trials have demonstrated favorable performance for Firesorb, culminating in its approval by the National Medical Products Administration (NMPA) in 2024. Against these backgrounds, we have designed this trial to investigate whether the Firesorb BRS is non-inferior to the drug-eluting stent in terms of the Device-Oriented Composite Endpoint (DoCE) in patients undergoing percutaneous coronary intervention for de novo lesions.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for not_applicable
Started Dec 2025
Longer than P75 for not_applicable
1 active site
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
Click on a node to explore related trials.
Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
June 6, 2025
CompletedFirst Posted
Study publicly available on registry
June 15, 2025
CompletedStudy Start
First participant enrolled
December 20, 2025
CompletedPrimary Completion
Last participant's last visit for primary outcome
December 20, 2030
ExpectedStudy Completion
Last participant's last visit for all outcomes
December 20, 2073
February 13, 2026
February 1, 2026
5 years
June 6, 2025
February 10, 2026
Conditions
Keywords
Outcome Measures
Primary Outcomes (1)
Cumulative event rate of Device-oriented Composite Endpoint (DoCE)
DoCE is a composite clinical endpoint of cardiovascular death, target vessel myocardial infarction (TV-MI), and clinically and physiologically indicated target lesion revascularization (CPI-TLR).
36 months
Secondary Outcomes (13)
Cumulative event rate of Device-oriented Composite Endpoint (DoCE)
1, 12, and 60 months
Cumulative event rate of Patient-oriented composite endpoint (PoCE)
1, 12, 36, and 60 months
Cumulative event rate of Target vessel failure (TVF)
1, 12, 36, and 60 months
Cumulative event rate of All-cause death
1, 12, 36, and 60 months
Cumulative event rate of Cardiovascular death
1, 12, 36, and 60 months
- +8 more secondary outcomes
Study Arms (2)
Bioresorbable scaffold (BRS)
EXPERIMENTALDrug-eluting stents (DES)
ACTIVE COMPARATORInterventions
The Firesorb BRS (MicroPort Medical, Shanghai, China) is a balloon-expandable scaffold with a highly crystallized PLLA backbone, abluminally coated with a poly(D, L-lactide) (PDLLA) matrix incorporating sirolimus (4 μg/mm) through highly accurate and precise point spraying techniques. The scaffold thickness is 100 μm for devices with diameters of 2.5 and 2.75 mm, and 125 μm for those ranging from 3.0 to 4.0 mm in diameter. There are two radiopaque markers at each end of the scaffold, which can identify the position of the stent under X-ray monitoring and help to accurately locate the scaffold.
The Firehawk™ stent (MicroPort Medical, Shanghai, China) is a third-generation balloon-expandable L605 cobalt chromium stent with abluminal grooves containing a biodegradable polymer, which provides controlled release of the anti-proliferative medicinal substance sirolimus. The polymer is biodegradable, leaving only the metallic stent as a permanent implant. The stent is mounted on a rapid exchange delivery catheter system. The unique abluminal grooves are scored at the outer surface of the struts (total strut thickness: 86 μm), with an average sirolimus dosage of 3 µg/mm stent lengths.
Eligibility Criteria
You may qualify if:
- Patients with an indication for PCI due to acute or chronic coronary syndrome
- Patients who understand the study's objectives, voluntarily participate, sign the informed consent form, and are willing to undergo regular follow-up
- De novo lesion(s)
- Target vessel diameter of ≥ 2.5 mm to ≤ 4.00 mm, target lesion length ≤ 25 mm (visual estimation)
- Target lesion is NOT
- Severely calcified
- In-stent restenosis
- Diffused lesion requiring stent overlapping or more than one stent
- Located in the left main, aorto-ostial, proximal LAD/LCX/RCA involving vessel ostia (stent coverage required within 3 mm of vessel ostia), surgical graft, myocardial bridge, or chronic total occlusion
- Bifurcation requiring two stents or involving a side branch that is ≥ 2.5 mm in diameter
- Located in the target vessel with severe tortuosity
You may not qualify if:
- Age \< 18 years, or \> 75 years
- Patient is a woman who is pregnant or nursing
- Patients who have received any stent implantation in the target vessel within one year
- Patients required long-term oral anticoagulation
- Known non-adherence to antiplatelet therapy or not suitable for long-term antiplatelet therapy due to high bleeding risk
- Patients who are allergic to heparin, poly L-lactic acid (PLLA), sirolimus, antiplatelet drugs, or contrast
- Currently participating in another trial and not yet at its primary endpoint
- Patients whose life expectancy is less than 3 years
- Cardiogenic shock
Contact the study team to confirm eligibility.
Sponsors & Collaborators
- Xijing Hospitallead
Study Sites (1)
Xijing Hospital
Xi'an, Shannxi, 710032, China
MeSH Terms
Conditions
Condition Hierarchy (Ancestors)
Study Officials
- STUDY CHAIR
Ling Tao, M.D., Ph.D.
Xijing Hospital
- STUDY CHAIR
Patrick Serruys, M.D., Ph.D.
National University of Ireland, Galway
- STUDY CHAIR
Yoshinobu Onuma, M.D., Ph.D.
National University of Ireland, Galway
- STUDY CHAIR
Chao Gao, M.D., Ph.D.
The First Affiliated Hospital of USTC
Central Study Contacts
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- RANDOMIZED
- Masking
- SINGLE
- Who Masked
- OUTCOMES ASSESSOR
- Purpose
- TREATMENT
- Intervention Model
- PARALLEL
- Sponsor Type
- OTHER
- Responsible Party
- PRINCIPAL INVESTIGATOR
- PI Title
- Professor in Cardiology, Director of the Department of Cardiology
Study Record Dates
First Submitted
June 6, 2025
First Posted
June 15, 2025
Study Start
December 20, 2025
Primary Completion (Estimated)
December 20, 2030
Study Completion (Estimated)
December 20, 2073
Last Updated
February 13, 2026
Record last verified: 2026-02
Data Sharing
- IPD Sharing
- Will not share