Feasibility Study SA of the Supira System for HRPCI

The Feasibility Study SA is a prospective, single-arm, interventional multi-center study enrolling up to 100 treated subjects.

The Supira Catheter is a single-use percutaneous expandable blood pump designed to unload the left ventricle by actively transporting blood from the left ventricle into the aorta.

The Supira System is a temporary (≤ 4 hours) ventricular support device indicated for use during elective or urgent high-risk percutaneous coronary interventions (HRPCI) performed in hemodynamically stable patients with severe coronary artery disease when a heart team has determined HRPCI is the appropriate therapeutic option

To be eligible, subjects must meet ALL of the following inclusion criteria:

• Age ≥ 18 and ≤ 90 years
• Will undergo elective or urgent HRPCI, where hemodynamic support is needed, as determined by the institutional Heart Team
• Signed the informed consent

To be eligible, subjects must NOT meet ANY of the following exclusion criteria:

• Cardiogenic shock or acutely decompensated pre-existing chronic heart failure. Cardiogenic shock is defined as: systemic hypotension (systolic BP < 90 mmHg or the need for inotropes/pressors to maintain a systolic BP > 90 mmHg) plus one of the following: any requirement for inotropes/pressors prior to arrival at the catheterization laboratory, clinical evidence of end-organ hypoperfusion or use of intra-aortic balloon pump (IABP), or any other circulatory support device.
• Stroke within 6 months of the index procedure, or any prior stroke with permanent neurologic deficit
• Evidence of left ventricular thrombus
• Moderate or greater aortic valvular disease or regurgitation (≥ 2+ on a 4-grade scale as assessed on transthoracic echo cardiogram (TTE)
• Moderate or greater aortic stenosis (gradient >20 mmHg or valve area < 1.5 cm^2 as assessed on TTE)
• Previous aortic valve replacement or reconstruction
• Ascending or descending aortic dissection or aortic aneurysm > 4.5 cm
• Aortic and iliofemoral anatomical conditions that preclude safe delivery and placement of the device
• Presence of decompensated liver disease; severe liver dysfunction (Child class C)
• Patients requiring renal replacement therapy with dialysis
• Infection of the proposed procedural access site or systemic active infection requiring ongoing antibiotic therapy
• Current or history of heparin-induced thrombocytopenia (HIT)
• Known hypersensitivity to intravenous contrast agents that cannot be adequately pre-medicated or has known hypersensitivity to heparin, aspirin, ADP receptor inhibitors, or nitinol
• Known or suspected coagulopathy or abnormal coagulation parameters (defined as platelet count ≤ 100,000/mm³ or spontaneous INR ≥ 1.5 or known fibrinogen ≤ 1.5 g/L)
• Any condition or scheduled surgery that will require discontinuation of antiplatelet and/or anticoagulant therapy within 90 days of the index procedure
• Planned coronary intervention within 30 days post index procedure
• Breastfeeding or pregnant
• Currently participating in active follow-up phase of another clinical study of an investigational drug or device
• Active COVID-related infection or previously diagnosed with COVID-19 with sequelae that could confound endpoint assessments
• Subject has other medical, social, or psychological problems that, in the opinion of the Investigator, compromises the subject's ability to provide written informed consent and/or to comply with study procedures
• Considered to be part of a vulnerable population (defined as individuals with mental disability, impoverished persons, homeless persons, nomads, refugees and those permanently incapable of giving informed consent; vulnerable populations also may include members of a group with a hierarchical structure such as university students, subordinate hospital and laboratory personnel, employees of the Sponsor, members of the armed forces and persons kept in detention)