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- Klinische proef NCT06507449
De invloed van het modificeren van sterk verkalkte coronaire laesies op de coronaire microcirculatie
This is a prospective, single-center, three-arm study to evaluate the impact of severely calcified coronary lesions treatment on microvascular circulation. We will enroll 30 conveniently sampled subjects assigned to one of three therapeutical methods lithotripsy, super-high pressure balloon, and orbital atherectomy prior to implantation of drug-eluting stents (DES).
Studie Overzicht
Toestand
Conditie
Gedetailleerde beschrijving
This prospective, non-randomized, single-center study includes subjects who meet all of the inclusion and none of the exclusion criteria and sign the ICF. 30 patients with severe coronary stenosis will be enrolled. The severity will be assessed by Optical Coherence Tomography (OCT) based on the degree of calcification in the coronary lesion as defined by this protocol. Subjects will be assigned to one of three arms (lithotripsy, super-high pressure balloon or orbital atherectomy) followed by an implantation of drug-eluting stents (DES). The aposition and expansion of DES will be evaluated using OCT . Patients will be followed through discharge, 30 days and 12 months.
Studietype
Inschrijving (Geschat)
Fase
- Niet toepasbaar
Contacten en locaties
Studie Locaties
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-
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Katowice, Polen, 40-081
- Upper Silesian Medical Centre
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Beschrijving
Inclusion Criteria:
- Subjects with native coronary artery disease (including stable or unstable angina and NSTEMI) suitable for PCI.
- The lesion must be crossable with the study guide wire.
- The target vessel reference diameter must be ≥ 2.5mm and ≤ 4.0 mm.
- The target lesion must have evidence of severe calcium deposit at the lesion site based on the protocol criterion.
- Subject or legally authorized representative, signs a written Informed Consent form to participate in the study, prior to any study-mandated procedures.
- Male or female, age above or equal to 18 years at the time of signing informed consent.
Further inclusion criteria may apply
Exclusion Criteria:
- Inability to understand the study or a history of non-compliance with medical advice.
- Unwilling or unable to sign the Informed Consent Form (ICF).
- History of any cognitive or mental health status that would interfere with trial participation.
- Male or female, age under 18 years at the time of signing informed consent.
- Female subjects who are pregnant or planning to become pregnant within the study period.
- Subject has a known sensitivity to contrast media, which cannot be adequately pre-medicated.
- Subject has evidence of an active infection on the day of the procedure requiring oral or intravenous antibiotics.
- Limited long term prognosis due to other conditions.
- Subjects in cardiogenic shock or with decompensated heart failure (NYHA class IV).
- Subject diagnosed with chronic kidney disease stage 4 or greater (eGFR <30).
- Most recent left ventricular ejection fraction ≤ 20%.
- Subject is an acceptable candidate for coronary artery bypass surgery.
- The target vessel reference diameter is under 2.0 mm.
- Target lesion is located in or supplied by an arterial or venous bypass graft.
- The target vessel has angiographically visible or suspected thrombus.
- The target lesion is in an in-stent restenosis.
- Subject has received a heart transplant.
- Subject has major valve disease and underwent intervention within 30 days prior to randomization.
Further exclusion criteria may apply
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Niet-gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Enkel
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
|
Experimenteel: High-pressure non-compliant balloon
The SIS Medical OPN NC® super high-pressure coronary balloon will be used for balloon angioplasty vessel preparation prior to implantation of a drug-eluting stent. |
Calcified lesion preparation using high-pressure non-compliant balloon before implantation of a drug-eluting stent Optical coherence tomography assessment of coronary arteries. A coronary thermodilution system used for evaluate differences between the impact of calcified lesion preparation methods on coronary microvascular function. |
|
Experimenteel: Orbital atherectomy
The Diamondback 360® Coronary Orbital Atherectomy System (OAS) will be used for orbital atherectomy (OA) vessel preparation prior to implantation of a drug-eluting stent. |
Optical coherence tomography assessment of coronary arteries. A coronary thermodilution system used for evaluate differences between the impact of calcified lesion preparation methods on coronary microvascular function. Calcified lesion preparation using orbital atherectomy before implantation of a drug-eluting stent |
|
Experimenteel: Lithotripsy
The Shockwave® Medical system will be used for intravascular lithotripsy (IVL) vessel preparation prior to implantation of a drug-eluting stent. |
Optical coherence tomography assessment of coronary arteries. A coronary thermodilution system used for evaluate differences between the impact of calcified lesion preparation methods on coronary microvascular function. Calcified lesion preparation using lithotripsy before implantation of a drug-eluting stent |
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Coronary Flow Reserve (CFR)
Tijdsspanne: Intraprocedural
|
Determination of a difference between Coronary Flow Reserve (CFR) at the beginning and at the end of the procedure using CoroFlow™ Cardiovascular System. |
Intraprocedural
|
|
Index of Microcirculatory Resistance (IMR)
Tijdsspanne: Intraprocedural
|
Determination of a difference between Index of Microcirculatory Resistance (IMR) at the beginning and at the end of the procedure using CoroFlow™ Cardiovascular System. |
Intraprocedural
|
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Stent expansion
Tijdsspanne: Intraprocedural
|
Stent expansion (%) evaluated by optical coherence tomography. |
Intraprocedural
|
|
Acceptable stent expansion
Tijdsspanne: Intraprocedural
|
Acceptable stent expansion (cut-off value defined as >80%) evaluated by optical coherence tomography. |
Intraprocedural
|
|
Optimal stent expansion
Tijdsspanne: Intraprocedural
|
Optimal stent expansion (cut-off value defined as >90%) evaluated by optical coherence tomography. |
Intraprocedural
|
|
Minimal lumen diameter (MLD) difference
Tijdsspanne: Intraprocedural
|
Determination of a difference between quantitative OCT measured minimal lumen diameter (MLD) at the beginning and at the end of the procedure. |
Intraprocedural
|
|
Procedural Success
Tijdsspanne: Up to 3 years
|
Procedural success - defined as successful stent delivery and angiographic in-vessel residual stenosis <30%, and with the absence of any of the following: stent loss, coronary artery dissection, coronary artery perforation, PCI no reflow phenomenon or MACCE (defined as a composite of cardiovascular death, myocardial infarction at the targeted vessel, targeted coronary vessel revascularization (PCI or CABG), TIA or stroke). |
Up to 3 years
|
|
Strategy Success
Tijdsspanne: Intraprocedural
|
Strategy success - defined as procedural success without crossover to alternative treatment. |
Intraprocedural
|
Andere uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
The proportion of subjects that experience Major Adverse Cardiovascular and Cerebrovascular Events (MACCE)
Tijdsspanne: Up to 3 years
|
30-day and 1 year MACCE defined as a composite of cardiovascular death, myocardial infarction at the targeted vessel, targeted coronary vessel revascularization (PCI or CABG), TIA or stroke. |
Up to 3 years
|
|
The proportion of subjects that experience Target Vessel Revascularization (TVR)
Tijdsspanne: Up to 3 years
|
30-day and 1 year Target Vessel Revascularization (TVR) - defined as any repeat revascularization at the target vessel (inclusive of the target lesion) and target vessel collaterals after the completion of the procedure. |
Up to 3 years
|
|
The proportion of subjects that experience Target Lesion Revascularization (TLR)
Tijdsspanne: Up to 3 years
|
30-day and 1 year Target Lesion Revascularization (TLR) - defined as repeat intervention PCI or surgery within the index procedure stent or 5mm proximal or distal to the stent. |
Up to 3 years
|
|
Myocardial infarction (MI) rate at 30-day and 1 year
Tijdsspanne: Up to 3 years
|
The proportion of subjects that experience a Myocardial Infarction (MI) at 30-day and 1 year. |
Up to 3 years
|
Medewerkers en onderzoekers
Sponsor
Medewerkers
Onderzoekers
- Hoofdonderzoeker: Paweł Gąsior, MD, PhD, Division of Cardiology and Structural Heart Diseases, Medical University of Silesia
Studie record data
Bestudeer belangrijke data
Studie start (Werkelijk)
Primaire voltooiing (Geschat)
Studie voltooiing (Geschat)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
- Pijn
- Neurologische manifestaties
- Vaatziekten
- Hart-en vaatziekten
- Pathologische processen
- Hartziekten
- Infarct
- Necrose
- Arteriosclerose
- Arteriële occlusieve ziekten
- Hart-en vaatziekte
- Myocardinfarct
- Ischemie
- Pijn op de borst
- Angina pectoris
- Pathologische aandoeningen, tekenen en symptomen
- Tekenen en symptomen
- Niet-ST verhoogd myocardinfarct
- Coronaire hartziekte
- Myocardiale ischemie
- Angina, instabiel
- Onderzoekstechnieken
- Therapeutica
- Diagnostische technieken en procedures
- Diagnose
- Chirurgische procedures, operatief
- Tomografie
- Diagnostische beeldvorming
- Tomografie, optisch
- Optische beeldvorming
- Ultrasone chirurgische procedures
- Tomografie, optische samenhang
- Lithotripsie
Andere studie-ID-nummers
- BNW/NWN/0052/KB1/4/24
Plan Individuele Deelnemersgegevens (IPD)
Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?
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