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De invloed van het modificeren van sterk verkalkte coronaire laesies op de coronaire microcirculatie

10 november 2026 bijgewerkt door: Medical University of Silesia

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

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

Ingrijpend

Inschrijving (Geschat)

30

Fase

  • Niet toepasbaar

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studie Locaties

      • Katowice, Polen, 40-081
        • Upper Silesian Medical Centre

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

18 jaar en ouder (Volwassen, Oudere volwassene)

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Allemaal

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

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

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

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Onderzoekers

  • Hoofdonderzoeker: Paweł Gąsior, MD, PhD, Division of Cardiology and Structural Heart Diseases, Medical University of Silesia

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Werkelijk)

10 november 2026

Primaire voltooiing (Geschat)

1 augustus 2027

Studie voltooiing (Geschat)

1 december 2027

Studieregistratiedata

Eerst ingediend

12 juli 2024

Eerst ingediend dat voldeed aan de QC-criteria

12 juli 2024

Eerst geplaatst (Werkelijk)

18 juli 2024

Updates van studierecords

Laatste update geplaatst (Werkelijk)

12 november 2026

Laatste update ingediend die voldeed aan QC-criteria

10 november 2026

Laatst geverifieerd

1 november 2026

Meer informatie

Termen gerelateerd aan deze studie

Plan Individuele Deelnemersgegevens (IPD)

Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?

NEE

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Nee

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Ja

product vervaardigd in en geëxporteerd uit de V.S.

Ja

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