The Physiological Impact of CTO PCI on Coronary Pressure Measurements and Correlation in Donor Vessel

NCT ID: NCT02643940

Last Updated: 2022-01-11

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

Total Enrollment

42 participants

Study Classification

OBSERVATIONAL

Study Start Date

2015-10-01

Study Completion Date

2018-05-31

Brief Summary

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This study will be recording pressure wire readings from both blocked and narrowed arteries, to better guide treatment options; medications, stents or potentially bypass surgery, for patients with Chronic Total Occlusion (CTO).

Detailed Description

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The patients in this study are planned to have a Percutaneous Coronary Intervention (PCI) with recanalization of Chronic Total Occlusion (CTO) on clinical grounds alone.

This study will be recording pressure wire readings from both blocked and narrowed arteries, to better guide treatment option. To date there is no data available on instantaneous wave free ratio (iFR) measurement (a pressure derived assessment of flow limitation) in patients with blocked arteries.

Conditions

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Acute Coronary Syndrome Coronary Artery Disease

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Eligibility Criteria

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Inclusion Criteria

1. Age \>18 years of age
2. Stable angina / ischaemic symptoms
3. Evidence of viability and / or ischaemia in the chronic total occlusion (CTO) territory
4. Participant is willing and able to give informed consent for participation in the study
5. Presence of a chronic total occlusion (CTO) in RCA:

* Duration of the occlusion \> 3 months;
* Thrombolysis In Myocardial Infarction (TIMI) (50) coronary flow grade 0;
* Spontaneously visible collaterals, Rentrop classification grade 1 or 2 or 3 from contralateral donor artery
6. Presence of minor to intermediate coronary stenosis (1-70 %) in the contralateral donor artery
7. Eligible for PCI to a chronic total occlusion (CTO)

Exclusion Criteria

1. Previous CABG with patent grafts to the interrogated donor artery
2. Left main stenosis of \> 40 %
3. Presence of severe flow limiting stenosis in the contralateral donor artery (typically \> 70 % stenosis)
4. Haemodynamic instability at the time of intervention (heart rate \<40 beats per minute, systolic blood pressure \<90mmHg), balloon pump)
5. Significant contraindication to adenosine administration (e.g. heart block, severe asthma)
6. Contraindications to PCI
7. Severe hepatic or lung disease (chronic pulmonary obstructive disease)
8. Pregnancy
9. ACS within 48 hours of procedure
10. Severe valvular heart disease
11. Severe cardiomyopathy / Infiltrative heart disease
12. eGFR \< 40
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Mid and South Essex NHS Foundation Trust

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Thomas Keeble, MBBS MRCP

Role: PRINCIPAL_INVESTIGATOR

The Essex Cardiothoracic Centre

Locations

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The Essex Cardiothoracic Centre

Basildon, Essex, United Kingdom

Site Status

Countries

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United Kingdom

References

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Karamasis GV, Kalogeropoulos AS, Mohdnazri SR, Al-Janabi F, Jones R, Jagathesan R, Aggarwal RK, Clesham GJ, Tang KH, Kelly PA, Davies JR, Werner GS, Keeble TR. Serial Fractional Flow Reserve Measurements Post Coronary Chronic Total Occlusion Percutaneous Coronary Intervention. Circ Cardiovasc Interv. 2018 Nov;11(11):e006941. doi: 10.1161/CIRCINTERVENTIONS.118.006941.

Reference Type RESULT
PMID: 30571203 (View on PubMed)

Mohdnazri SR, Karamasis GV, Al-Janabi F, Cook CM, Hampton-Till J, Zhang J, Al-Lamee R, Dungu JN, Gedela S, Tang KH, Kelly PA, Davies JE, Davies JR, Keeble TR. The impact of coronary chronic total occlusion percutaneous coronary intervention upon donor vessel fractional flow reserve and instantaneous wave-free ratio: Implications for physiology-guided PCI in patients with CTO. Catheter Cardiovasc Interv. 2018 Sep 1;92(3):E139-E148. doi: 10.1002/ccd.27587. Epub 2018 Mar 22.

Reference Type RESULT
PMID: 29569332 (View on PubMed)

Other Identifiers

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B785

Identifier Type: -

Identifier Source: org_study_id

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