Impact of Stepwise Pressure-Increasing NC Balloon Post-Dilation on Stent Expansion (SPND)
This is a prospective, single-center, single-arm exploratory observational study aiming to evaluate the impact of stepwise pressure-increasing non-compliant (NC) balloon post-dilation on stent expansion rate in patients undergoing single-stent implantation for coronary artery stenosis, with stent sizing guided by intravascular ultrasound-external elastic membrane (IVUS-EEM) measurement.
A total of 150 eligible patients will be enrolled at The First Hospital of Jilin University. All participants will receive standard single-stent implantation followed by multi-stage stepwise pressure-increasing NC balloon post-dilation under IVUS monitoring. The post-dilation protocol includes sequential inflation at nominal pressure, rated burst pressure, and 24 atm, with IVUS assessment performed after each stage. All treatment procedures are conducted in accordance with routine clinical practice; no additional randomization or mandatory intervention is applied beyond the standard of care. The study solely observes and records outcomes associated with this treatment strategy.
調査の概要
状態
状態
条件
条件
介入・治療
介入・治療
詳細な説明
Coronary atherosclerotic heart disease remains one of the leading causes of mortality and disability worldwide. Coronary stent implantation is a principal therapeutic strategy for coronary artery stenosis. The adequacy of stent expansion is a critical determinant of treatment efficacy; inadequate stent expansion may lead to stent malapposition, in-stent restenosis, stent thrombosis, and other adverse events that significantly compromise patient prognosis.
Intravascular ultrasound (IVUS), as an invasive vascular imaging modality, enables clear visualization of vessel wall architecture, plaque characteristics, and immediate post-stent implantation outcomes. Among its measurements, the external elastic membrane (EEM) cross-sectional area serves as a key reference for stent sizing, effectively overcoming the inherent limitation of conventional coronary angiography, which relies solely on luminal imaging for stent diameter selection.
Non-compliant (NC) balloon post-dilation is an essential step in optimizing stent implantation outcomes. Gradual incremental increases in balloon pressure may further promote adequate stent expansion and improve stent-vessel wall apposition. However, the specific impact of NC balloon post-dilation at different pressures and durations on stent expansion rate has not been systematically validated. To date, there remains a paucity of dedicated studies investigating the dynamic changes in stent expansion rate under a stepwise pressure-increasing protocol.
This study utilizes IVUS-EEM measurements to guide stent sizing and adopts a single-stent implantation strategy combined with multi-stage stepwise pressure-increasing NC balloon post-dilation. after stent deployment with norminal pressure, 12*10 atm, 18*10 atm and 24*10 atm NC balloon post-dilation. IVUS measurement will be made after each step and stent expansion and Minimal stent area will be documented.
Primary Endpoint. Minimum Stent Area (MSA)
IVUS-measured minimum lumen cross-sectional area within the stented segment post-procedure (after stent deployment with norminal pressure, 12*10 atm, 18*10 atm and 24*10 atm NC balloon post-dilation)
Secondary endpoints:
Stent Expansion Rate
IVUS-measured stent expansion rate immediately post-procedure (after stent deployment with norminal pressure, 12*10 atm, 18*10 atm and 24*10 atm NC balloon post-dilation), calculated as: (minimum stent cross-sectional area [MSA] measured by IVUS / manufacturer's nominal MSA) × 100%.
rates of stent edge dissection, hematoma, perforation.
研究の種類
研究の種類
入学 (推定)
入学
段階
段階
- 適用できない
連絡先と場所
研究連絡先
研究連絡先
- 名前:Mingyou Zhang, M.D.
- 電話番号:8613689842200
- メール:zmy@jlu.edu.cn
研究場所
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-
Jilin
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Changchun、Jilin、中国、130000
- 募集
- The First Hospital of Jilin University
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-
参加基準
適格基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- Age ≥18 years regardless of gender;
- Coronary angiography confirms single-vessel coronary artery stenosis ≥50%, meeting the indication for single-stent implantation;
- Preoperative IVUS examination can clearly visualize the vessel EEM, allowing for stent size measurement and assessment of stent expansion-related parameters;
- The patient voluntarily participates in this study and signs the informed consent form;
- No contraindications related to IVUS examination, stent implantation, or balloon angioplasty.
Exclusion Criteria:
- Hemodynamically unstable
- Presence of anatomical or pathological factors preventing IVUS catheter crossing.
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:なし
- 介入モデル:単一グループの割り当て
- マスキング:なし(オープンラベル)
アーム数
武器と介入
参加者グループ / アーム参加者グループ / アーム |
介入・治療介入・治療 |
|---|---|
|
実験的:Serial pressure dilation
After stent nominal pressure deployment stent will be postdilated at 12atm*10s, 18atm *10s, 24atm*10s.Final post-dilation will be attempted at 24 atm for up to 120 seconds, with the duration limited to the patient's maximum tolerated time if premature intolerance occurs.IVUS measurement will be done after each dilation for the MSA and stent expansion |
Coronary stent implantation followed by serial pressure post-dilation using non-compliant balloon under IVUS guidance |
この研究は何を測定していますか?
主要な結果の測定
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Minimum Stent Area (MSA)
時間枠:3 days
|
IVUS-measured minimum lumen cross-sectional area within the stented segment post-procedure (after stent deployment with norminal pressure, 12*10 atm, 18*10 atm and 24*10 atm NC balloon post-dilation), Final post-dilation will be attempted at 24 atm for up to 120 seconds, with the duration limited to the patient's maximum tolerated time if premature intolerance occurs. |
3 days
|
協力者と研究者
研究記録日
主要日程の研究
研究開始 (実際)
研究開始
一次修了 (推定)
一次修了
研究の完了 (推定)
研究の完了
試験登録日
最初に提出
最初に提出
QC基準を満たした最初の提出物
QC基準を満たした最初の提出物
最初の投稿 (実際)
最初の投稿
学習記録の更新
投稿された最後の更新 (実際)
投稿された最後の更新
QC基準を満たした最後の更新が送信されました
QC基準を満たした最後の更新が送信されました
最終確認日
最終確認日
詳しくは
本研究に関する用語
キーワード
その他の研究ID番号
その他の研究ID番号
- stepwise stent postdilation
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
米国で製造され、米国から輸出された製品。
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