Baseline V-RESOLVE Score Guided Versus Angiography Guided Stent Implantation in Coronary Bifurcation Lesions (CIT-RESOLVE II)

NCT05503407 | Completed DMC

• 1 other identifier: 2020-1361
• Study Type: interventional
• Target: 1,104
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this study is to investigate whether baseline V-RESOLVE score guided intervention is associated with significant reduction of side branch occlusion rates compared to angiography guided intervention in patients with coronary bifurcation lesions.

Conditions

Coronary Artery Disease

Keywords

Percutaneous Coronary Intervention; Coronary Bifurcation Intervention

Outcome Measures

Primary Outcomes (1)

• side branch occlusion after main vessel stenting

  The primary endpoint is side branch occlusion, which is defined as any decrease in TIMI flow grade or absence of flow in side branch after main vessel stent well opposed.

  Immediately after the main vessel

Secondary Outcomes (2)

• The elevation of biomarkers of periprocedural myocardial injury [Creatine Kinase-Myocardial Band (CK-MB) and Troponin I].

  48h after Percutaneous Coronary Intervention (PCI)

• Major adverse cardiac events (MACE)

  12-month follow-up

Study Arms (2)

Baseline V-RESOLVE score-guided PCI

EXPERIMENTAL

Lesions with baseline V-RESOLVE \<14 scores would undergo either jailed wire technique or provisional two-stent strategy; Lesions with baseline V-RESOLVE ≥14 scores would undergo either jailed balloon technique or elective two-stent strategy.

Procedure: Baseline V-RESOLVE score-guided PCI

Angiography-guided PCI

PLACEBO COMPARATOR

The choice of interventional strategy was left to the discretion of experienced interventionists based on the coronary angiogram.

Procedure: Angiography-guided PCI

Interventions

Baseline V-RESOLVE score-guided PCI PROCEDURE

Jailed wire technique (JWT): Both main vessel (MV) and side branch (SB) are wired. The MV is stented with wire protection in SB. If suboptimal results exist, the SB would be rewired and a kissing balloon inflation (KBI) is undertaken. Jailed balloon technique: A monorail balloon is advanced into the SB. If there is TIMI flow grade decrease in the SB after MV stenting, the SB balloon is inflated to simulate attempt to reopen the SB. Provisional two-stent strategy: Lesion preparation and MV stenting are consistent with JWT. Provisional SB stenting could be undertaken when suboptimal results occur after SB rewiring and a KBI is undertaken. Elective two-stent strategy: Patients in this subgroup would undergo crush procedure or any other elective two-stent strategy which usually stenting SB before MV stenting.

Baseline V-RESOLVE score-guided PCI

Angiography-guided PCI PROCEDURE

The choice of interventional strategy was left to the discretion of experienced interventionists based on the coronary angiogram.

Angiography-guided PCI

Eligibility Criteria

• Age: 18 Years - 75 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Subject must be male or nonpregnant female ≥18 years of age and ≤75 years of age;
• Subject has symptomatic coronary artery disease with objective evidence of ischemia or silent ischemia;
• Subject is eligible for PCI;
• Subject (or legal guardian) understands the trial requirements and the treatment procedures and provides written informed consent before any trial-specific tests or procedures are performed;
• Subject is willing to comply with all protocol-required follow-up evaluation.
• Subjects have coronary bifurcation lesions requiring PCI with stent implantation according to clinical guidelines and/or the operator's judgement;
• Visually estimated reference vessel diameter (RVD) of target main vessel ≥2.5 mm and ≤4.0 mm;
• Visually estimated RVD of target side branch ≥ 2.0mm;
• Coronary anatomy is likely to allow delivery of a study device to the target lesion(s);

You may not qualify if:

• Subject has a known allergy to contrast (that cannot be adequately pre-medicated) and/or the trial stent system or protocol-required concomitant medications (e.g., stent alloy, stainless steel, sirolimus, everolimus or structurally related compounds, polymer or individual components, all P2Y12 inhibitors, or aspirin);
• Planned surgery within 6 months after the index procedure;
• Subject has one of the following (as assessed prior to the index procedure):
• Other serious medical illness (e.g., cancer, congestive heart failure) with estimated life expectancy of less than 12 months;
• Current problems with substance abuse (e.g., alcohol, cocaine, heroin, etc.);
• Planned procedure that may cause non-compliance with the protocol or confound data interpretation;
• Subject has a history of bleeding diathesis or coagulopathy or will refuse blood transfusions;
• Subject is participating in another investigational drug or device clinical trial that has not reached its primary endpoint;
• Subject intends to participate in another investigational drug or device clinical trial within 12 months after the index procedure;
• Subject with known intention to procreate within 12 months after the index procedure (women of child-bearing potential who are sexually active must agree to use a reliable method of contraception from the time of screening through 12 months after the index procedure);
• Subject is a woman who is pregnant or nursing (a pregnancy test must be performed within 7 days prior to the index procedure in women of child-bearing potential);
• Subject with left ventricular ejection fraction \< 35%;
• Subject has preoperative renal dysfunction: serum creatinine\>2.0mg/dl (176.82umol/L).
• Left main lesions;
• In case of acute myocardial infarction of which the culprit vessel located at the left anterior descending (LAD) artery, the bifurcation lesion (LAD/diagonal branch \[RVD\>2.5mm\]) which is proximal to occluded LAD segment should be excluded.

Sponsors & Collaborators

• China National Center for Cardiovascular Diseases: lead

Study Sites (1)

Fuwai Hospital

Beijing, Beijing Municipality, 100037, China

Location

MeSH Terms

Conditions

Coronary Artery Disease

Condition Hierarchy (Ancestors)

Coronary Disease; Myocardial Ischemia; Heart Diseases; Cardiovascular Diseases; Arteriosclerosis; Arterial Occlusive Diseases; Vascular Diseases

Study Officials

• Kefei Dou, MD, PhD

  Fuwai Hospital and National Center for Cardiovascular Diseases

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER GOV
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Study Record Dates

• First Submitted: August 14, 2022
• First Posted: August 16, 2022
• Study Start: January 1, 2017
• Primary Completion: April 30, 2023
• Study Completion: April 30, 2023
• Last Updated: June 13, 2023

Record last verified: 2023-06

Locations

CN (1)