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ROtational Atherectomy, Lithotripsy or LasER for the Treatment of CAlcified STEnosis

Not Applicable
Conditions
Coronary Artery Disease
Registration Number
NCT04181268
Lead Sponsor
Hospital Universitario La Paz
Brief Summary

Some data exist about the efficacy and safety of rotational atherectomy, intravascular lithotripsy and excimer laser to modify calcified plaques.

However there is no direct randomized comparison between these three tools in this scenario.

The aim of this pilot randomized trial is to compare the safety and efficacy of these three techniques during PCI of moderate to severe calcified lesions.

Detailed Description

Some data exist about the efficacy and safety of rotational atherectomy, intravascular lithotripsy and excimer laser to modify calcified plaques.

However there is no direct randomized comparison between these three tools in this scenario.

The aim of this pilot randomized trial is to compare the safety and efficacy of these three techniques during PCI of moderate to severe calcified lesions.

The primary endpoint will be the percentage of stent expansion measured with optical coherence tomography. Between secondary endpoints we will analyze the strategy success (defined as successful stent delivery and expansion with \<20% residual stenosis and TIMI 3 flow without crossover or stent failure) and presentation of clinical adverse at 1 year follow-up .

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
150
Inclusion Criteria
  • Patients >18 years.
  • Stenosis ≥70% in a coronary artery with a diameter ≥2,5 y ≤4 mm.
  • Moderate to severe angiographic calcification
  • Stable coronary artery disease or NSTEMI.
  • Native coronary vessel or bypass graft.
Exclusion Criteria
  • Knwon allergies to aspirin or P2y12 inhibitors.
  • STEMI.
  • Cardiogenic shock at the time of PCI.
  • Treated lesion in a bifurcation with side branch diameter > 2mm.
  • Absence of informed consent.
  • Impossibility for 1year follow up.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
Percentage of stent expansion by optical coherence tomographyAt the end of percutaneous coronary intervention

We will analyze with optical coherence tomography the percentage of stent expansion (defined as the minimal stent area divided by the mean of the proximal and distal reference lumen areas).

Secondary Outcome Measures
NameTimeMethod
Strategy success rateAt the end of percutaneous coronary intervention

Successful stent delivery and expansion with \<20% residual stenosis and TIMI3 flow without crossover or stent failure.

Successful stent delivery and expansion with \<20% residual stenosis and TIMI3 flow without crossover or stent failure.

Successful stent delivery and expansion with residual stenosis \<20% and TIMI 3 without crossover

Trial Locations

Locations (1)

La Paz University Hospital

🇪🇸

Madrid, Spain

La Paz University Hospital
🇪🇸Madrid, Spain

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