"Expert IVUS-Eye" vs. IVUS-guided Left Main Bifurcation PCI (EYE-IVUS LM)

July 14, 2026 updated by: Conrady Alexandra, Federal State Budgetary Institution, V. A. Almazov Federal North-West Medical Research Centre, of the Ministry of Health

"IVUS-Trained Eye" vs. Intravascular Ultrasound in Left Main Bifurcation Stenting: A Prospective Randomized Trial

This is a prospective, randomized, controlled trial comparing two strategies for optimizing stent implantation during bifurcation stenting of the left main coronary artery (LM): an intravascular ultrasound (IVUS)-guided approach versus a "IVUS-trained eye" approach based on angiographic assessment and operator experience. All patients receive the same stent brand and procedure steps to minimize variability. The primary objective is to compare the planimetric stent appearance between two strategies.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

Stenting of the left main coronary artery in bifurcation lesions remains one of the most technically demanding tasks in interventional cardiology. Stent implantation quality is directly linked to the risk of adverse outcomes. Minimal stent area (MSA), as measured by IVUS, is a key predictor of adverse clinical outcomes. In practice, however, many centers continue to rely on angiographic assessment alone when performing various left main bifurcation stenting techniques. Proponents of this approach cite extensive clinical experience, anatomical familiarity, and IVUS-informed intuition developed over time (a "trained eye"). To date, no randomized data exist comparing outcomes of left main stenting between an IVUS-guided approach and a visually/experience-guided approach. Investigators hypothesize that, when combined with mandatory bifurcation optimization steps (e.g., proximal optimization technique [POT], kissing balloon inflation [KBI]), an angiography-only approach performed by an IVUS-experienced physician is non-inferior to a standard IVUS-guided approach, as assessed by post-PCI IVUS stent planimetric characteristics.

Study Type

Interventional

Enrollment (Estimated)

50

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • Russia
      • Saint Petersburg, Russia
        • Recruiting
        • Federal State Budgetary Institution, V. A. Almazov Federal North-West Medical Research Centre, of the Ministry of Health
        • Contact:
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • De novo lesion in an unprotected left main coronary artery, indicated for bifurcational stenting (provisional or 2-stent)
  • Patient referred for elective or delayed (non-emergency) stenting
  • Technical feasibility of performing IVUS
  • Signed informed consent

Exclusion Criteria:

  • ST-elevation myocardial infarction (STEMI) within the preceding 72 hours
  • Cardiogenic shock
  • Isolated (non-bifurcation) left main lesion
  • Prior PCI in the target segment
  • Diameter of one of the left main main branches < 2 mm
  • Occlusion in the proximal segment of one of the main left main branches without the possibility of simultaneous recanalization
  • History of coronary artery bypass grafting (CABG)
  • Severe comorbidity with expected life expectancy < 1 year
  • Participation in another interventional study
  • Patient is a woman who is pregnant or nursing;
  • Female patient of childbearing potential, i.e. who are not surgically sterile or post-menopausal (defined as no menses for 2 years without an alternative cause);
  • IVUS is strictly required for pre-PCI lesion severity assessment
  • Patients unable to tolerate, obtain or comply with dual antiplatelet therapy for at least 6 months in stable patients and 1 year in ACS patients;
  • Known contraindication or hypersensitivity to everolimus, platinum-chromium, or to anticoagulants.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: IVUS-Guided Approach
Pre-procedural IVUS will be used to determine lesion characteristics and post-procedural IVUS to confirm correct implantation of stent.
Procedure: IVUS-Guided LM PCI

Coronary stent - single manufacturer and model ("Calypso", R-Vascular, Russia) used in all patients, to minimize variability related to stent design (strut thickness, cell design, expansion limits).

Procedure steps:

  • Baseline IVUS pullback - assessment of proximal and distal reference segments and lesion length
  • Stent selection based on IVUS data
  • Stent implantation
  • Mandatory optimization: kissing balloon dilation; proximal optimization
  • Final IVUS pullback to confirm result
Experimental: "Trained Eye" (Angiography-Guided) Approach
Stent sizing and procedural optimization guided by angiographic visual assessment and operator experience, with only IVUS assessment after intervention.
Procedure: "Trained Eye" (Angiography-Guided) LM PCI

Coronary stent - single manufacturer and model ("Calypso", R-Vascular, Russia) used in all patients, to minimize variability related to stent design (strut thickness, cell design, expansion limits).

Procedure steps:

  • Anatomical assessment based on visual angiographic evaluation
  • Stent and balloon selection at operator discretion
  • Stent implantation
  • Mandatory optimization (same steps: kissing balloon dilation, proximal optimization)
  • Final IVUS pullback performed only afterward, solely to assess planimetric result (not used to guide the procedure itself)

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Relative optimal LM stent expansion
Time Frame: Immediately post-procedure
Proportion of patients (%) achieving MSA ≥ 90% of the distal reference segment area according to IVUS, assessed after completion of all stenting and optimization steps
Immediately post-procedure
Absolute optimal LM stent expansion
Time Frame: Immediately post-procedure
Proportion of patients (%) achieving MSA ≥ 11.4 mm² in the left main coronary artery according to IVUS, assessed after completion of all stenting and optimization steps
Immediately post-procedure
Device-oriented Composite Endpoint (DoCE)
Time Frame: 1 year follow-up
Proportion of patients (%), achieving the device-oriented Composite Endpoint (DoCE) defined as the composite of: Cardiovascular death, target vessel MI, clinically indicated repeat revascularization of the target lesion at longest follow-up
1 year follow-up

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
All individual components of DoCE at all time points.
Time Frame: 1 year follow-up
Proportion of patients (%) achieving individual components of DoCE.
1 year follow-up

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Federal State Budgetary Institution, V. A. Almazov Federal North-West Medical Research Centre, of the Ministry of Health

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

July 1, 2026

Primary Completion (Estimated)

January 1, 2027

Study Completion (Estimated)

December 31, 2027

Study Registration Dates

First Submitted

July 7, 2026

First Submitted That Met QC Criteria

July 14, 2026

First Posted (Actual)

July 17, 2026

Study Record Updates

Last Update Posted (Actual)

July 17, 2026

Last Update Submitted That Met QC Criteria

July 14, 2026

Last Verified

July 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • EYE-IVUS LM Trial

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

Demographic, clinical, procedural and follow-up data. No personal data will be shared

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • SAP
  • ICF
  • CSR

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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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