The Oxford Optimisation of PCI Study (OXOPT-PCI Study) (OXOPT-PCI)
The OxOPT-PCI study addresses patients with coronary artery disease who are referred to the John Radcliffe Hospital because of the need for treatment with an intra-coronary stent (metal scaffold) for clinical reasons. Although, this has become a highly standardised procedure it is still challenging for the clinician to assess the final success of this procedure at the end of intervention with conventional methods. This shortcoming can potentially translate into a worse clinical outcome for approximately 10 percent of all patients treated with an intra-coronary stent for this type of disease.
This study (OxOPT-PCI) investigates if the use of blood flow measurements (namely measurement of fractional flow reserve (FFR)) and intravascular imaging (namely optical coherence tomography (OCT)) after the implantation of a stent can improve the treatment result for these patients. Both, FFR and OCT are being used already in daily clinical routing but their usefulness especially in combination is not clear. In order to standardise the optimisation procedure we developed a specific algorithm to make sure that all patients receive the same optimisation measures based on the assessment of FFR and OCT.
The benefit of this specific optimisation algorithm will be assessed by measuring 1) indices of coronary blood flow, 2) intravascular imaging at the end of the procedure, and 3) by contacting the patients 12 months after stenting to verify the clinical mid-term success.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
-
Oxford, United Kingdom, OX3 9DU
- Oxford University Hospital - NHS Trust
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- participant is willing and able to give informed consent for participation in the study
- angiogram shows haemodynamically relevant lesion suitable for PCI and suitable for the use of intravascular imaging (OCT)
Exclusion Criteria:
- patients in whom safety or clinical concerns preclude participation
- ST-segment elevation myocardial infarction
- presentation with cardiogenic shock
- revascularization by mean of balloon angioplasty without stenting
- contraindications to adenosine
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: NON_RANDOMIZED
- Interventional Model: PARALLEL
- Masking: NONE
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
EXPERIMENTAL: PCI optimisation
Post PCI FFR below 0.9
|
|
|
NO_INTERVENTION: No PCI optimisation
Post PCI FFR 0.9 or higher
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Final Fractional Flow Reserve (FFR) After Intracoronary Stenting
Time Frame: Immediately post-stenting for Group 1A and 1B, and post FFR/OCT-guided optimisation for Group 1A
|
After administration of intracoronary nitrates, FFR was measured under maximal hyperaemia, using intravenous adenosine (140 mg kg-1 min-1) as the ratio between distal coronary pressure (Pd) and aortic pressure (Pa)
|
Immediately post-stenting for Group 1A and 1B, and post FFR/OCT-guided optimisation for Group 1A
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Number of Participants With Stent-edge Dissection Assessed by OCT
Time Frame: During PCI procedure, OCT typically adds 5 minutes to the procedure
|
Defined as presence of a linear rim of tissue ≥200 μm in width and with clear separation from the vessel wall, or underlying plaque <5 mm from stent edges
|
During PCI procedure, OCT typically adds 5 minutes to the procedure
|
|
Number of Participants With Reference Lumen Narrowing (Geographical Miss) Assessed by OCT
Time Frame: During PCI procedure, OCT typically adds 5 minutes to the procedure
|
Defined as reference lumen area <4.5 mm2, with significant residual plaque within 10 mm of stent edges
|
During PCI procedure, OCT typically adds 5 minutes to the procedure
|
|
Number of Participants With Stent Malapposition Assessed by OCT
Time Frame: During PCI procedure, OCT typically adds 5 minutes to the procedure
|
Defined as stent-adjacent vessel lumen distance > 200 μm
|
During PCI procedure, OCT typically adds 5 minutes to the procedure
|
|
Number of Participants With Plaque/Thrombus Protrusion Assessed by OCT
Time Frame: During PCI procedure, OCT typically adds 5 minutes to the procedure
|
Defined as tissue prolapsing between stent struts extending inside a circular arc connecting adjacent struts or intraluminal mass ≥500 μm thick with no direct connection to the vessel wall, or highly backscattered luminal protrusion in continuity with the vessel wall, resulting in signal-free shadowing
|
During PCI procedure, OCT typically adds 5 minutes to the procedure
|
|
Number of Participants With Stent Under-expansion Assessed by OCT
Time Frame: During PCI procedure, OCT typically adds 5 minutes to the procedure
|
Defined as minimal stent area (MSA) < 70% of average reference lumen area and/or MSA < 4.5 mm2
|
During PCI procedure, OCT typically adds 5 minutes to the procedure
|
Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (ACTUAL)
Study Start
Primary Completion (ACTUAL)
Primary Completion
Study Completion (ACTUAL)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (ACTUAL)
First Posted
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 12005 (DAIDS-ES Registry)
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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