WEDGES: Coronary Lesion Preparation With Enhanced Dilatation for Good Expansion of Stent: Assessment of a New Scoring Balloon by Quantitative Stent Enhanced Visualization (WEDGES)
WEDGES: a Prospective, Multi-center Randomized Trial for the Evaluation of Coronary Lesion Preparation With Enhanced Dilatation for Good Expansion of Stent: Assessment of a New Scoring Balloon by Quantitative Stent Enhanced Visualization
Stent under-expansion during percutaneous coronary intervention (PCI) is one of the suboptimal results associated with a higher risk of restenosis and thrombosis. In order to obtain an optimal stent expansion, especially in lesions with calcific or fibrotic plaque, the appropriate lesion preparation before stent implantation is a crucial phase.
For this, different devices are used in everyday practices, including non-compliant balloon (NC), scoring / cutting balloons or rotational atherectomy; however, their effectiveness depends on the experience and skill of the operator. The purpose of this study is to assess the feasibility, efficacy and safety of a novel scoring balloon intended to treat calcific or fibrotic plaque of a coronary lesion
調査の概要
研究の種類
入学 (予想される)
段階
- 適用できない
連絡先と場所
研究連絡先
- 名前:Stéphane Carlier
- 電話番号:0032475812765
- メール:stephane.carlier@umons.ac.be
研究連絡先のバックアップ
- 名前:Chadi Ghafari
- メール:chadi.ghafari@umons.ac.be
研究場所
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Genk、ベルギー、3600
- 募集
- UZ Genk
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コンタクト:
- Jo Dens
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Ghent、ベルギー、9000
- 募集
- UZ Ghent
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コンタクト:
- Peter Kayaert
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La Louvière、ベルギー、7100
- 募集
- CHU Jolimont
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コンタクト:
- Claudiu Ungureanu
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Liège、ベルギー、4000
- 募集
- CHU Liège
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コンタクト:
- Lancelotti
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Mons、ベルギー、7000
- 募集
- CHU Ambroise Paré
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コンタクト:
- Stéphane Carlier
- メール:stephane.carlier@umons.ac.be
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参加基準
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:
- Patient written consent is given A de novo lesion
- Mild to moderate burden of calcifications detected on two orthogonal views using normal radiation power
Exclusion Criteria:
Exclusion criteria patient-related:
- Patient <18 years old
- Pregnant female
- Contraindication to dual antiplatelet therapy
- Thrombocytopenia <100 000
- Major surgical intervention planned
Exclusion criteria lesion-related:
- Significant left main lesion
- Bifurcating lesion with a significant side branch to be treated
- Lesion length > 25 mm
- Chronic total occlusion
- Lesion with heavy calcifications where a rotational atherectomy or lithotripsy should be planned
- Lesion in a graft
- In-stent restenosis lesion
- Lesion responsible of a STEMI
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:ランダム化
- 介入モデル:並列代入
- マスキング:ダブル
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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アクティブコンパレータ:Conventional balloon predilation
the target lesion can be prepared according to standard clinical practice using SC balloons sized 0.8-1:1.
Stenting using a drug-eluting stent (DES) is performed and the inflation pressure for delivery is noted, as well as the expected balloon diameter at that pressure.
2 enhanced stent imaging acquisitions (StentBoost or equivalent depending on the X-ray system used), are acquired in 2 orthogonal views.
Post dilatation can be performed at operator discretion followed by a final acquisition of 2 similar orthogonal views with enhanced stent imaging.
Intravascular imaging is left to the operator's discretion and is encouraged
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Conventional balloon
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実験的:Scoring balloon predilation
the target lesion must be prepared with a scoring balloon (SC) inflated 3 times at nominal pressure.
To allow the scoring balloon to cross the lesion, it might be necessary to predilate with a small compliant balloon.
The size of the scoring balloon to be used for is based on the size of the vessel.
Stenting using a DES is performed and the inflation pressure for delivery is noted, as well as the expected balloon diameter at that pressure.
2 enhanced stent imaging acquisitions (StentBoost or equivalent depending on the X-ray system used), are acquired in 2 orthogonal views.
Post dilatation can be performed at operator discretion followed by a final acquisition of 2 similar orthogonal views with enhanced stent imaging.
Intravascular imaging is left to the operator's discretion and is encouraged
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Scoring balloon
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Stent expansion in calcified lesions assessed by stent diameter calculation using quantitative and intravascular analysis after lesion preparation using a scoring balloon is superior to conventional lesion preparation
時間枠:Intravascular ultrasound (IVUS) or quantitative analysis is directly done after procedure
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The measure of stent expansion in calcified coronary lesions as assessed by quantitative coronary angiography, enhanced stent imaging and intravascular ultrasound after lesion preparation using the novel scoring semi-compliant and noncompliant balloons are superior (p<0.05) to semi compliant and non-compliant balloons.
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Intravascular ultrasound (IVUS) or quantitative analysis is directly done after procedure
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二次結果の測定
結果測定 |
時間枠 |
|---|---|
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Rate of successful predilatation of calcified lesions of a scoring semi-compliant/non-compliant balloon and semi-compliant (SC)/ non-compliant (NC) balloon
時間枠:Directly after procedure
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Directly after procedure
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Rate of residual under-expansion of stent after post-dilatation with a non-compliant balloon
時間枠:Directly after procedure
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Directly after procedure
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Rate of procedural complication (composite of cardiac death, myocardial infarction, coronary artery perforation and cardiac tamponade) of a scoring balloon and a SC/NC balloon followed by stenting.
時間枠:1 month follow up
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1 month follow up
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協力者と研究者
スポンサー
捜査官
- スタディディレクター:Stéphane Carlier、University of Mons
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (予想される)
研究の完了 (予想される)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
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
詳しくは
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