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Intravascular Ultrasound Guidance for Complex High-risk Indicated Procedures

Not Applicable
Active, not recruiting
Conditions
Complex Coronary Lesions
Interventions
Device: IVUS
Device: Angio
Registration Number
NCT04854070
Lead Sponsor
ECRI bv
Brief Summary

The IVUS CHIP trial is a post-marketing strategy study in which patients with complex coronary lesions, undergoing percutaneous coronary intervention (PCI), are treated either with intravascular ultrasound (IVUS) guided PCI or angiographic guided PCI .

The IVUS-guided PCI approach is indicated to reduce the frequency of target-lesion failure (cardiac death, target-vessel myocardial infarction, and clinically indicated target-lesion revascularization) in patients with complex coronary lesions undergoing PCI.

The objective of this study is to assess the superiority of an IVUS-guided approach versus an angio-guided approach in patients with complex coronary lesions undergoing PCI.

Detailed Description

During percutaneous coronary intervention (PCI) coronary arteries are visualized to guide placing the stent. In this study 2 currently utilized methods of visualizing coronary arteries during PCI are compared: intravascular ultrasound (IVUS) and angiographic guided PCI for patients with complex coronary lesions.The use of IVUS during PCI is suggested to give better results than angiographic guided PCI.

The IVUS-CHIP trial is a randomized, controlled, multicenter, international, post-marketing study. A total of 2020 patients, in 7 European countries and approximately 40 hospitals, will be included, randomized in a 1:1 fashion to IVUS-guided PCI versus angio-guided PCI, and followed up for at least 2 years.

The IVUS-CHIP is an event-driven study; primary analysis of the data will take place after 169 patients have experienced an event.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
2022
Inclusion Criteria

All of the following:

  1. The patient must be ≥18 years of age

  2. Patients with an indication for PCI of at least one lesion satisfying any of the following criteria:

    1. Angiographic heavy calcification
    2. Ostial lesions
    3. True bifurcation lesions involving side-branches >2.5mm
    4. Left main lesions
    5. Chronic total occlusion
    6. In-stent restenosis
    7. Long-lesions (estimated stent length > 28mm) OR Patient with an indication for PCI for any lesion and in need for elective mechanical circulatory support assisted PCI
  3. Presenting with silent ischemia, stable angina, unstable angina or non-ST-elevation acute coronary syndrome (NSTE-ACS)

  4. All lesions must be suitable for treatment with the Synergy stent system, Synergy Megatron system, or other Synergy platform iteration

  5. The patient is willing and able to cooperate with study procedures and follow-up until study completion

  6. Subject is able to confirm understanding of risks, benefits and treatment alternatives and he/she provides informed consent prior to any protocol-related procedure, as approved by the appropriate Ethics Committee

Exclusion Criteria

Any of the following:

  1. ST-elevation myocardial infarction, cardiogenic shock
  2. Known untreated severe valvular heart disease
  3. IVUS is strictly required for pre-PCI lesion severity assessment
  4. Known contraindication or hypersensitivity to everolimus, platinum-chromium, or to anticoagulants
  5. Absolute contraindications or allergy that cannot be pre-medicated, to iodinated contrast or to antiplatelet drugs, including both aspirin and P2Y12 inhibitors
  6. Non-cardiac co-morbidities with a life expectancy less than 1 year
  7. Currently participating in another trial that is not yet at its primary endpoint. The patient is not allowed to participate in another investigational device or drug study until the trial primary endpoint time point is achieved and may only be enrolled once in the study
  8. Women of childbearing potential who do not have a negative pregnancy test within 7 days before the procedure and women who are breastfeeding
  9. Subject belongs to a vulnerable population (per investigator's judgment) or subject unable to read or write

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
IVUS-guided PCIIVUSMethod is already used in standard care, but in this trial compared to another method also already used in standard care
Angio-guided PCIAngioMethod is standard care
Primary Outcome Measures
NameTimeMethod
Target-vessel failure comparison of IVUS-guided PCI to angio-guided PCI in patients with complex coronary lesionsFrom date of randomization until the analysis cut-off date at approximately 15-18 months of median follow-up

Target-vessel failure is defined as a composite of cardiac death, target vessel myocardial infarction, or clinically indicated target-vessel revascularization

Secondary Outcome Measures
NameTimeMethod
Composite of cardiac death and target-vessel myocardial infarctionFrom date of randomization until the analysis cut-off date at approximately 15-18 months of median follow-up

Composite of cardiac death and target-vessel myocardial infarction

Composite of target-vessel myocardial infarction and clinically indicated target vessel revascularizationFrom date of randomization until the analysis cut-off date at approximately 15-18 months of median follow-up

Composite of target-vessel myocardial infarction and clinically indicated target vessel revascularization

Clinically-indicated target vessel revascularizationFrom date of randomization until the analysis cut-off date at approximately 15-18 months of median follow-up

Clinically-indiated target vessel revascularization is defined as any clinically-indicated repeat percutaneous intervention or surgical bypass of any segment of the target vessel

Cardiac deathFrom date of randomization until the analysis cut-off date at approximately 15-18 months of median follow-up

Cardiac death is defined as death resulting from cardiovascular causes

Target-Lesion Failure (TLF)From date of randomization until the analysis cut-off date at approximately 15-18 months of median follow-up

Target-Lesion Failure is defined as a composite of cardiac death, target vessel myocardial infarction, or clinically indicated target-lesion revascularization

Target-lesion revascularizationFrom date of randomization until the analysis cut-off date at approximately 15-18 months of median follow-up

Target-lesion revascularization is defined as any repeat percutaneous intervention of the target lesion or bypass surgery of the target vessel performed for restenosis or other complication of the target lesion

Trial Locations

Locations (36)

Noordwest Hospital Group

🇳🇱

Alkmaar, Netherlands

Ospedale degli infermi di Rivoli

🇮🇹

Rivoli, Italy

Catharina hospital

🇳🇱

Eindhoven, Netherlands

Erasmus University Medical Center

🇳🇱

Rotterdam, Netherlands

Humanitas Research Hospital

🇮🇹

Milan, Italy

Ospedale dell'Angelo

🇮🇹

Venezia, Italy

Heart Center Dresden

🇩🇪

Dresden, Germany

Charite Universitatsmedizin Berlin

🇩🇪

Berlin, Germany

OLVZ

🇧🇪

Aalst, Belgium

CHU

🇫🇷

Toulouse, France

University of Ferrara

🇮🇹

Ferrara, Italy

Bellvitge University Hospital

🇪🇸

Barcelona, Spain

Hospital Clinic de Barcelona

🇪🇸

Barcelona, Spain

Reina Sofia Hospital

🇪🇸

Córdoba, Spain

Royal Victoria Hospital

🇬🇧

Belfast, United Kingdom

St. George's University Hospital

🇬🇧

London, United Kingdom

Hopital Privé Jacques Cartier

🇫🇷

Massy, France

Centre Cardiologique du Nord Saint-Denis

🇫🇷

Saint-Denis, France

CHRU Tours - HopitalTrousseau

🇫🇷

Tours, France

Clinique Saint-Augustin

🇫🇷

Bordeaux, France

Cardiovascular Institute of Grenoble, GHM

🇫🇷

Grenoble, France

Segeberger Kliniken

🇩🇪

Bad Segeberg, Germany

Clinique Pasteur

🇫🇷

Toulouse, France

Universitätsklinikum Frankfurt

🇩🇪

Frankfurt, Germany

MediClin Heartcenter Lahr

🇩🇪

Lahr, Germany

University of Giessen

🇩🇪

Gießen, Germany

Albert Schweitzer hospital

🇳🇱

Dordrecht, Netherlands

VuMC

🇳🇱

Amsterdam, Netherlands

Golden Jubilee National Hospital

🇬🇧

Glasgow, United Kingdom

Hospital la Paz

🇪🇸

Madrid, Spain

La Princesa University Hospital

🇪🇸

Madrid, Spain

University Clinical Hospital of Valladolid

🇪🇸

Valladolid, Spain

John Radcliffe Hospital

🇬🇧

Oxford, United Kingdom

Marques de Valdecilla University Hospital

🇪🇸

Santander, Spain

University Hospital Gasthuisberg

🇧🇪

Leuven, Belgium

ZOL Sint-Jan

🇧🇪

Genk, Belgium

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