Thrombus Aspiration for OcLuded Coronary Artery Enhanced With Distal Injection Of Abciximab

NCT ID: NCT01383785

Last Updated: 2012-02-22

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

UNKNOWN

Clinical Phase

PHASE4

Total Enrollment

186 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-11-30

Study Completion Date

2012-12-31

Brief Summary

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Aims: (to prove that) The distal injection of IIb IIIa platelet receptor blocker to the thrombus occlusion is better than normal injection during primary percutaneous intervention (PCI) for the treatment of acute myocardial infarction. Using this modification of injection method the investigators can achieve less microvascular damage and a reduction of the infarct size with a significant improvement of the outcome at six months.

Detailed Description

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There are some evidence about the utilization of aspiration catheter (Indication class IIb with level of evidence B in European Guidelines) and intravenous abciximab (indication Class IIa an level of evidence A in European Guidelines) in primary PTCA. Direct intracoronary injection of abciximab get smaller infarct size than intravenous injection. The hypothesis of our study are that direct distal injection of abciximab by aspiration catheter will be better than proximal intracoronary injection with reduction in infarct size and microvascular damage quantified by Magnetic resonance (MR) and 6 months mortality.

Conditions

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Myocardial Infarction Occlusive Thrombus

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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GROUP A

Intracoronary full bolus dose of abciximab proximal to thrombus occlusion

Group Type ACTIVE_COMPARATOR

Intracoronary direct injection

Intervention Type OTHER

Abciximab bolus dosage: 0,125 mg/kg.

Group A: Intracoronary full bolus dose of abciximab proximal to thrombus occlusion. The investigators inject the bolus of abciximab by catheter guide before cross the occlusion. This in the normal way in study' laboratory.

GROUP B

Half bolus of intracoronary abciximab proximal to thrombus occlusion and the other half distal by aspiration catheter

Group Type EXPERIMENTAL

Intracoronary and distal injection by aspiration device

Intervention Type OTHER

Abciximab bolus dosage: 0,125 mg/kg.

Group B: Half bolus of intracoronary abciximab proximal to thrombus occlusion and the other half distal by aspiration catheter. The investigators inject half of the dose like group A and the other half like group C.

GROUP C

Distal injection to thrombus occlusion of total bolus dose of abciximab by aspiration catheter

Group Type EXPERIMENTAL

Intracoronary distal injection by aspiration catheter device

Intervention Type OTHER

Abciximab bolus dosage: 0,125 mg/kg.

Group C: Distal injection to thrombus occlusion of total bolus dose of abciximab by aspiration catheter. The investigators inject the bolus after cross the occlusion using an aspiration catheter.

Interventions

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Intracoronary direct injection

Abciximab bolus dosage: 0,125 mg/kg.

Group A: Intracoronary full bolus dose of abciximab proximal to thrombus occlusion. The investigators inject the bolus of abciximab by catheter guide before cross the occlusion. This in the normal way in study' laboratory.

Intervention Type OTHER

Intracoronary and distal injection by aspiration device

Abciximab bolus dosage: 0,125 mg/kg.

Group B: Half bolus of intracoronary abciximab proximal to thrombus occlusion and the other half distal by aspiration catheter. The investigators inject half of the dose like group A and the other half like group C.

Intervention Type OTHER

Intracoronary distal injection by aspiration catheter device

Abciximab bolus dosage: 0,125 mg/kg.

Group C: Distal injection to thrombus occlusion of total bolus dose of abciximab by aspiration catheter. The investigators inject the bolus after cross the occlusion using an aspiration catheter.

Intervention Type OTHER

Other Intervention Names

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Abciximab, thrombus aspiration catheter Abciximab, thrombus aspiration catheter Abciximab, thrombus aspiration catheter

Eligibility Criteria

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Inclusion Criteria

* Myocardial infarction patients between 3 and 12 hours after symptoms onset

Exclusion Criteria

* Hemodynamic instability
* TIMI flow 2 or 3
* Life expectance less than 6 months
* Contraindication to AAS, clopidogrel or abciximab
* Severe tortuosity of occluded vessel
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hospital Virgen de la Salud

OTHER

Sponsor Role lead

Responsible Party

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J.Moreu

Director catheterization laboratory

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Jose Moreu, Phd,MD

Role: PRINCIPAL_INVESTIGATOR

Hospital Virgen de la Salud. Toledo. Spain

Luis Rodriguez-Padial, Phd MD

Role: STUDY_DIRECTOR

Hospital Virgen de la Salud

Locations

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Hospital Virgen de la Salud

Toledo, Toledo, Spain

Site Status RECRUITING

Countries

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Spain

Central Contacts

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Jose Moreu, MD,PhD

Role: CONTACT

+34 925 269 188

Fernando Pajin, MD

Role: CONTACT

+34 925 269 188

Facility Contacts

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Jose Moreu, pHD,md

Role: primary

+34 925 269 188

References

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Van de Werf F, Bax J, Betriu A, Blomstrom-Lundqvist C, Crea F, Falk V, Filippatos G, Fox K, Huber K, Kastrati A, Rosengren A, Steg PG, Tubaro M, Verheugt F, Weidinger F, Weis M; ESC Committee for Practice Guidelines (CPG). Management of acute myocardial infarction in patients presenting with persistent ST-segment elevation: the Task Force on the Management of ST-Segment Elevation Acute Myocardial Infarction of the European Society of Cardiology. Eur Heart J. 2008 Dec;29(23):2909-45. doi: 10.1093/eurheartj/ehn416. Epub 2008 Nov 12. No abstract available.

Reference Type BACKGROUND
PMID: 19004841 (View on PubMed)

Svilaas T, Vlaar PJ, van der Horst IC, Diercks GF, de Smet BJ, van den Heuvel AF, Anthonio RL, Jessurun GA, Tan ES, Suurmeijer AJ, Zijlstra F. Thrombus aspiration during primary percutaneous coronary intervention. N Engl J Med. 2008 Feb 7;358(6):557-67. doi: 10.1056/NEJMoa0706416.

Reference Type BACKGROUND
PMID: 18256391 (View on PubMed)

Vetrovec GW. Improving reperfusion in patients with myocardial infarction. N Engl J Med. 2008 Feb 7;358(6):634-7. doi: 10.1056/NEJMe0708910. No abstract available.

Reference Type BACKGROUND
PMID: 18256399 (View on PubMed)

Thiele H, Schindler K, Friedenberger J, Eitel I, Furnau G, Grebe E, Erbs S, Linke A, Mobius-Winkler S, Kivelitz D, Schuler G. Intracoronary compared with intravenous bolus abciximab application in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention: the randomized Leipzig immediate percutaneous coronary intervention abciximab IV versus IC in ST-elevation myocardial infarction trial. Circulation. 2008 Jul 1;118(1):49-57. doi: 10.1161/CIRCULATIONAHA.107.747642. Epub 2008 Jun 16.

Reference Type BACKGROUND
PMID: 18559698 (View on PubMed)

Nijveldt R, Beek AM, Hirsch A, Stoel MG, Hofman MB, Umans VA, Algra PR, Twisk JW, van Rossum AC. Functional recovery after acute myocardial infarction: comparison between angiography, electrocardiography, and cardiovascular magnetic resonance measures of microvascular injury. J Am Coll Cardiol. 2008 Jul 15;52(3):181-9. doi: 10.1016/j.jacc.2008.04.006.

Reference Type BACKGROUND
PMID: 18617066 (View on PubMed)

Other Identifiers

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PI-2008/52

Identifier Type: -

Identifier Source: org_study_id

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