Standby Cannulated ECMO for High-Risk Percutaneous Coronary Intervention (ECMO-READY)
Standby Cannulated ECMO Versus Prophylactic ECMO In Patients Undergoing High-Risk Percutaneous Coronary Intervention
The goal of this multicenter, randomized trial is to compare standby cannulated ECMO versus prophylactic ECMO in patients undergoing high-risk percutaneous coronary intervention (PCI). The main question it aims to answer is :
• If standby cannulated ECMO as compared with prophylactic ECMO will improve the outcomes in patients undergoing high-risk PCI
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Xiaotong Hou, MD
- Phone Number: 010-64456631
- Email: xt.hou@ccmu.edu.cn
Study Locations
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Beijing Municipality
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Beijing, Beijing Municipality, China, 100029
- Recruiting
- Beijing Anzhen Hospital
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Contact:
- Liangshan Wang, MD
- Phone Number: 86-13811363372
- Email: wangliangshanbam@sina.com
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Clinicians decide to perform PCI during ECMO support.
- Age of ≥18
- Patient presents with a compromised ejection fraction of less than 35% or at risk of hemodynamic deterioration, or intervention on the last patent coronary conduit or an unprotected left main artery, or complex 3-vessel disease (SYNTAX score of ≥33)
- Informed consent
Exclusion Criteria:
- Subject in cardiogenic shock(need inotrope, pressor or mechanical support to maintain SBP >90mmHg)
- Presence of moderate to severe aortic insufficiency
- Severe peripheral vascular disease
- creatinine≥4mg/dL
- Liver dysfunction with elevation of liver enzymes and bilirubin levels to ≥ 3x ULN
- History of recent (within 1 month) stroke or TIA
- Abnormal coagulation(defined as platelet count ≤50000/mm3 or Fibrinogen ≤1.50g/L)
- Allergy or intolerance to heparin, aspirin, ADP receptor inhibitors, or documented heparin induced thrombocytopenia.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Standby cannulated ECMO
For standby cannulated ECMO procedures, femoral cannulas are inserted either by percutaneous approach or surgical approach.
The primed circuit is connected to the inserted ECMO cannulas, clamps are kept on circuit, and ECMO is on standby during PCI.
When PCI cause hemodynamic instability, clamps on circuit are removed, and VA-ECMO is initiated to maintain maintain adequate systemic pressure and perfusion.
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Femoral cannulas are inserted and connected to the primed circuit.
Clamps are kept on circuit, and ECMO is on standby during PCI.
ECMO is initiated if needed.
|
|
Active Comparator: Prophylactic ECMO
Prophylactic ECMO procedures are performed in the catheterization laboratory before PCI.
Femoral cannulas are inserted either by percutaneous approach or surgical approach.
Following cannula placement, VA-ECMO is initiated to maintain adequate systemic pressure and perfusion during PCI.
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Prophylactic ECMO procedures are performed in the catheterization laboratory before PCI.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Composite rate of 9 major adverse events
Time Frame: 30 days
|
included all-cause death, myocardial infraction, repeat revascularization, stroke, percutaneous coronary intervention failure, limb ischemia, major bleeding, vascular injury requiring intervention, and need for renal replacement therapy
|
30 days
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Duration of ECMO support
Time Frame: 30 days
|
Time on ECMO support
|
30 days
|
|
Length of hospital stay
Time Frame: 30 days
|
Time of hospitalization
|
30 days
|
|
Serum interleukin-6 concentration
Time Frame: 30 days
|
Highest level of IL-6 during concentration
|
30 days
|
|
Post-procedural hemoglobin decline
Time Frame: 30 days
|
The relative decrease in hemoglobin from the pre-procedural value to the nadir post-procedural value
|
30 days
|
|
Post-procedural platelet count decline
Time Frame: 30 days
|
The relative decrease in platelet count from the pre-procedural value to the nadir post-procedural value
|
30 days
|
|
RBC transfusion rate
Time Frame: 30 days
|
The percentage of patients who receive at least one unit of packed red blood cells
|
30 days
|
|
Hospitalization cost
Time Frame: 30 days
|
The total cost until the discharge from the hospital
|
30 days
|
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Use of intra-aortic balloon pump (IABP)
Time Frame: 30 days
|
Unplanned initiation of IABP after randomization
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30 days
|
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Each component of the composite major adverse events
Time Frame: 30 days
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The incidence of all-cause death, myocardial infraction, repeat revascularization, stroke, PCI failure, limb ischemia, major bleeding, vascular injury requiring intervention, or need for RRT
|
30 days
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Xiaotong Hou, MD, Beijing Anzhen Hospital
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
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
Other Study ID Numbers
Other Study ID Numbers
- KS2024014
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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