Status:
RECRUITING
The Value of IVL Compared To OPN Non-Compliant Balloons for Treatment of RefractorY Coronary Lesions (VICTORY) Trial
Lead Sponsor:
Luzerner Kantonsspital
Collaborating Sponsors:
Hôpital Fribourgeois
Hamilton General Hospital
Conditions:
Coronary Disease
Coronary Artery Disease
Eligibility:
All Genders
18+ years
Phase:
NA
Brief Summary
Percutaneous coronary intervention (PCI) with drug-eluting stent (DES) implantation has become the dominant treatment strategy for patients with acute and chronic coronary artery disease (CAD) requiri...
Detailed Description
To evaluate final stent expansion following a strategy of lesion preparation with either the Shockwave C2 IVL™ Catheter (Shockwave Medical Inc. Santa Clara, CA, United States) or a super high-Pressure...
Eligibility Criteria
Inclusion
- Clinical inclusion criteria:
- Age ≥18 years and consentable;
- Acute or chronic coronary artery disease with ischemia related symptoms (e.g. angina) and/or evidence of myocardial ischemia (e.g. FFR/ iFR, CMR, SPECT or PET-CT);
- Angiographically-proven coronary artery disease;
- Lesions in non-target vessels requiring PCI may be treated either
- prior to the study procedure if the procedure was unsuccessful or complicated; or
- in the same session if feasible and safe for the patient, otherwise a staged PCI procedure for non-target vessels may be considered;
- Informed Consent signed by the subject.
- Angiographic inclusion criteria:
- Single de novo target lesion stenosis of protected LMCA, or LAD, RCA or LCX (or of their branches) with\*:
- Stenosis of ≥70%;
- Stenosis ≥50% and \<70% (visually assessed) with evidence of ischemia via positive stress test, or fractional flow reserve value ≤0.80, or iFR \<0.90 or IVUS minimum lumen area ≤4.0 mm²;
- The target vessel reference diameter must be ≥2.5 mm \& ≤4.5mm;
- AND AT LEAST ONE OF THE FOLLOWING CRITERIA:
- Evidence of calcification at the lesion site by angiography (Grade 3), with fluoroscopic radio-opacities noted without cardiac motion prior to contrast injection involving both sides of the arterial wall in at least one location and total length of calcium of at least 15 mm and extending partially into the target lesion,
- AND/ OR by OCT, with presence of ≥270° calcium;
- AND/ OR Prior attempt at PCI with inability to expand a balloon in target lesion.
- Annotation: Only one lesion and vessel per randomized patient may be treated according to protocol and considered for the purpose of this study. The lesion considered for the study should represent the most calcified one.
- The presence of any one of the following exclusion criteria will lead to the exclusion of the subject:
- Exclusion criteria:
- Patient experienced an acute STEMI or cardiogenic shock related to an acute MI within 2 days prior to index procedure;
- Any comorbidity or condition which may reduce compliance with this protocol, including follow-up calls/ visits (e.g. advanced dementia);
- Any medical, geographic, and/or social factor making study participation impractical or precluding required follow-up.
- Patient is pregnant or nursing (a negative pregnancy test is required for women of child-bearing potential within 7 days prior to enrollment);
- Unable to take a P2Y12 inhibitor (i.e. clopidogrel, prasugrel, or ticagrelor) for at least 6 months;
- Patient has an allergy to imaging contrast media which cannot be adequately pre-medicated;
- Renal failure with an eGFR \<30ml/min1.73m2;
- History of a stroke or transient ischemic attack (TIA) within 7 days, or any prior intracranial hemorrhage;
- Active peptic ulcer or upper gastrointestinal (GI) bleeding within 6 months;
- Untreated pre-procedural hemoglobin \<10g/dL or intention to refuse blood transfusions if one should become necessary;
- Patient has an allergy or intolerance to cobalt-chromium and/ or everolimus.
- Life expectancy of less than 1 year.
- Angiographic exclusion criteria:
- Anatomy where the device or OCT catheter are unlikely to be delivered due to tortuosity or other characteristics;
- Target lesion is in a coronary artery bypass graft;
- Target lesion is an in-stent restenosis (ISR);
- Flow limiting target vessel thrombus (evident on angiography or OCT);
- Definite or possible thrombus (by angiography or intravascular imaging) in the target vessel;
- Evidence of aneurysm in target vessel within 10 mm of the target lesion.
- Of note, only qualified physicians who are investigators or a sub-investigators for the trial will assess each individual´s eligibility criteria and take the final decision to include the subject in the trial (ICH GCP 4.3.1). This decision will be documented prior to the subject receiving the first intervention.
Exclusion
Key Trial Info
Start Date :
November 22 2022
Trial Type :
INTERVENTIONAL
Allocation :
ESTIMATED
End Date :
May 30 2028
Estimated Enrollment :
280 Patients enrolled
Trial Details
Trial ID
NCT05346068
Start Date
November 22 2022
End Date
May 30 2028
Last Update
June 18 2024
Active Locations (1)
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1
Luzerner Heart Centre
Lucerne, Switzerland, 6000