Safety and Efficacy Study of Hybrid Revascularization in Multivessel Coronary Artery Disease

NCT ID: NCT01035567

Last Updated: 2013-12-03

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2/PHASE3

Total Enrollment

200 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-11-30

Study Completion Date

2013-10-31

Brief Summary

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The purpose of the study is to assess the safety and efficacy of hybrid revascularization in comparison with coronary artery bypass grafting among patients with multivessel coronary artery disease.

Detailed Description

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Conditions

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Heart Disease Myocardial Ischaemia Coronary Disease Coronary Artery Disease

Keywords

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Multivessel coronary artery disease Hybrid revascularization Coronary Artery Bypass Grafting Percutaneous Coronary Interventions Drug eluting stents

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Hybrid revascularization

Group Type ACTIVE_COMPARATOR

Hybrid revascularization

Intervention Type PROCEDURE

First stage: implantation of the internal mammary artery into LAD in MIDCAB/TECAB procedure Second stage: PCI with drug eluting stents in other coronary arteries qualified for revascularization within 36 hours after surgery

Coronary Artery Bypass Grafting

Group Type ACTIVE_COMPARATOR

Coronary Artery Bypass Grafting

Intervention Type PROCEDURE

Coronary artery bypass grafting with sternotomy on or off the pump at discretion of the operator.

Interventions

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Hybrid revascularization

First stage: implantation of the internal mammary artery into LAD in MIDCAB/TECAB procedure Second stage: PCI with drug eluting stents in other coronary arteries qualified for revascularization within 36 hours after surgery

Intervention Type PROCEDURE

Coronary Artery Bypass Grafting

Coronary artery bypass grafting with sternotomy on or off the pump at discretion of the operator.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Age 18 or more
* Angiographically confirmed multivessel CAD with involved LAD and critical (\>70%)lesion in at least one (apart LAD) major epicardial vessel amenable to both PCI and CABG
* Indication for revascularization based upon symptoms of angina and/or objective evidence of myocardial ischaemia
* Patient is willing to comply with all follow-up visits
* Patient signed an Informed Consent

Exclusion Criteria

* Severe congestive heart failure (class III or IV according to NYHA, or pulmonary edema, cardiogenic shock) at the time of enrollment
* Prior surgery with the opening of pericardium or pleura
* Prior stroke (within 6 months)or more than 6 months if there are substantial neurological defects
* Prior history of significant bleeding (within previous 6 months) that might be expected to occur during PCI/CABG related anticoagulation
* One or more chronic total occlusions in major coronary territories
* Left main stenosis (at least 50% diameter stenosis)
* Acute ST-elevation MI within 72 hours prior to enrollment requiring revascularization
* Planned simultaneous surgical procedure unrelated to coronary revascularization (e.g. valve repair/replacement, aneurysmectomy, carotid endarterectomy or carotid stenting)
* Contraindication to either CABG, MIDCAB or PCI/DES because of a coexisting clinical condition
* Significant leukopenia, neutropenia, thrombocytopenia, anemia, or known bleeding diathesis.
* Intolerance or contraindication to aspirin or both clopidogrel and ticlopidine
* Extra-cardiac illness that is expected to limit survival to less than 5 years e.g. oxygen-dependent chronic obstructive pulmonary disease, active hepatitis or significant hepatic failure, severe renal disease
* Suspected pregnancy. A pregnancy test will be administered prerandomization to all women of child-bearing age
* Concurrent enrollment in another clinical trial
* Patient inaccessible for follow-up visits required by protocol
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ministry of Science and Higher Education, Poland

OTHER_GOV

Sponsor Role collaborator

Silesian Centre for Heart Diseases

OTHER

Sponsor Role lead

Responsible Party

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Marian Zembala

MD, PhD, Head of the Cardiosurgery and Transplantology Department

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Marian Zembala, PhD

Role: PRINCIPAL_INVESTIGATOR

Silesian Center for Heart Disease

Mariusz Gasior, PhD

Role: STUDY_CHAIR

Silesian Center for Heart Disease

Locations

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Department of Cardiosurgery and Transplatology, Silesian Medical University, Silesian Center for Heart Disease

Zabrze, , Poland

Site Status

Third Department of Cardiology, Silesian Medical University, Silesian Center for Heart Disease

Zabrze, , Poland

Site Status

Countries

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Poland

References

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Riess FC, Schofer J, Kremer P, Riess AG, Bergmann H, Moshar S, Mathey D, Bleese N. Beating heart operations including hybrid revascularization: initial experiences. Ann Thorac Surg. 1998 Sep;66(3):1076-81. doi: 10.1016/s0003-4975(98)00714-0.

Reference Type BACKGROUND
PMID: 9769007 (View on PubMed)

Wittwer T, Cremer J, Klima U, Wahlers T, Haverich A. Myocardial "hybrid" revascularization: intermediate results of an alternative approach to multivessel coronary artery disease. J Thorac Cardiovasc Surg. 1999 Oct;118(4):766-7. doi: 10.1016/S0022-5223(99)70035-8. No abstract available.

Reference Type BACKGROUND
PMID: 10504652 (View on PubMed)

Cisowski M, Morawski W, Drzewiecki J, Kruczak W, Toczek K, Bis J, Bochenek A. Integrated minimally invasive direct coronary artery bypass grafting and angioplasty for coronary artery revascularization. Eur J Cardiothorac Surg. 2002 Aug;22(2):261-5. doi: 10.1016/s1010-7940(02)00262-2.

Reference Type BACKGROUND
PMID: 12142196 (View on PubMed)

Stahl KD, Boyd WD, Vassiliades TA, Karamanoukian HL. Hybrid robotic coronary artery surgery and angioplasty in multivessel coronary artery disease. Ann Thorac Surg. 2002 Oct;74(4):S1358-62. doi: 10.1016/s0003-4975(02)03889-4.

Reference Type BACKGROUND
PMID: 12400817 (View on PubMed)

Tajstra M, Hrapkowicz T, Hawranek M, Filipiak K, Gierlotka M, Zembala M, Gasior M, Zembala MO; POL-MIDES Study Investigators. Hybrid Coronary Revascularization in Selected Patients With Multivessel Disease: 5-Year Clinical Outcomes of the Prospective Randomized Pilot Study. JACC Cardiovasc Interv. 2018 May 14;11(9):847-852. doi: 10.1016/j.jcin.2018.01.271. Epub 2018 Apr 18.

Reference Type DERIVED
PMID: 29680218 (View on PubMed)

Gasior M, Zembala MO, Tajstra M, Filipiak K, Gierlotka M, Hrapkowicz T, Hawranek M, Polonski L, Zembala M; POL-MIDES (HYBRID) Study Investigators. Hybrid revascularization for multivessel coronary artery disease. JACC Cardiovasc Interv. 2014 Nov;7(11):1277-83. doi: 10.1016/j.jcin.2014.05.025. Epub 2014 Nov 17.

Reference Type DERIVED
PMID: 25459040 (View on PubMed)

Zembala M, Tajstra M, Zembala M, Filipiak K, Knapik P, Hrapkowicz T, Gierlotka M, Hawranek M, Polonski L, Gasior M. Prospective randomised pilOt study evaLuating the safety and efficacy of hybrid revascularisation in MultI-vessel coronary artery DisEaSe (POLMIDES) - study design. Kardiol Pol. 2011;69(5):460-6.

Reference Type DERIVED
PMID: 21594832 (View on PubMed)

Other Identifiers

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N R13 008406/2009

Identifier Type: -

Identifier Source: org_study_id