The OCTOBER Trial - European Trial on Optical Coherence Tomography Optimized Bifurcation Event Reduction (OCTOBER)

NCT ID: NCT03171311

Last Updated: 2023-06-22

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

ACTIVE_NOT_RECRUITING

Clinical Phase

NA

Total Enrollment

1201 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-07-05

Study Completion Date

2029-05-31

Brief Summary

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The purpose is to compare median two-year clinical outcome after OCT guided vs. standard guided revascularization of patients requiring complex bifurcation stent implantation

Detailed Description

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Coronary bifurcation lesions with stenosis in a large side branch may require complex stent implantation techniques with an elevated risk of suboptimal treatment results. Intra vascular optical coherence tomography (OCT) enables improved procedural control of correctable factors and may lead to optimized implantation results.

It is unknown if routine, systematic use of OCT scans during complex bifurcation stenting improves clinical outcome but present available evidence indicates advantages of OCT guidance that could translate into improved clinical outcome.

Hypothesis: Systematic OCT guided revascularization of patients with bifurcation lesions requiring complex stent implantation provides superior two-year clinical outcome compared to standard revascularization by PCI.

Methods: Investigator initiated and investigator sponsored, randomized (1:1), controlled, prospective, multicenter, superiority trial. Randomization is stratified for 1) Left main or non-Left main artery disease, and 2) up-front planned one-stent technique with kissing balloon inflation, or a two-stent technique.

Systematic OCT guidance is detailed for five complex stent implantation techniques. Standard treatment is angiographic based with optional use of intravascular ultrasound (IVUS).

Conditions

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Ischaemic Heart Disease Ischemic Heart Disease

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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Angiographic guided PCI

Angiographic guided PCI is revascularization by percutaneous coronary intervention (PCI) and optional use of intravascular ultrasound (IVUS).

Group Type ACTIVE_COMPARATOR

Angiographic guided PCI

Intervention Type PROCEDURE

Angiographic guided PCI is percutaneous coronary intervention performed by standard angiographic guided techniques

OCT guided PCI

OCT guided PCI is percutaneous coronary intervention (PCI) guided by systematic use of intravascular optical coherence tomography (OCT)

Group Type EXPERIMENTAL

OCT guided PCI

Intervention Type PROCEDURE

OCT guided PCI is percutaneous coronary intervention (PCI) guided by intra vascular optical coherence tomography (OCT) scans

Interventions

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Angiographic guided PCI

Angiographic guided PCI is percutaneous coronary intervention performed by standard angiographic guided techniques

Intervention Type PROCEDURE

OCT guided PCI

OCT guided PCI is percutaneous coronary intervention (PCI) guided by intra vascular optical coherence tomography (OCT) scans

Intervention Type PROCEDURE

Other Intervention Names

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PCI, percutaneous transluminal coronary angioplasty (PTCA) OCT

Eligibility Criteria

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Inclusion Criteria

* Stable angina pectoris, unstable angina pectoris, clinically stable non-STEMI.
* Age ≥18 yrs.
* Abel to provide written Informed consent and willing to comply with the specified follow-up contacts.


* Native coronary bifurcation de novo lesion
* More than 50% diameter stenosis in the main vessel (MV)
* More than 50% diameter stenosis in the side branch (SB) within 5 mm of the ostium.
* Reference size at least 2.75 mm in the main vessel (MV) and ≥2.5 mm in the SB.


Functional significance of the main vessel lesion or documented ischemia of the main vessel territory or other objective documentation of lesion significance. Objective evidence of ischemia is required for all treated lesions except for lesions with more than 80% diameter stenosis that may be considered significant.


Indication for two-stent technique or one-stent technique with kissing balloon inflation

Exclusion Criteria

* STEMI within 72 hours
* Cardiogenic shock
* Prior coronary artery bypass grafting (CABG) or planned CABG
* Renal failure with glomerular filtration rate (GFR) \<50 mL/min per 1.73 m2
* Active bleeding or coagulopathy
* Life expectancy \< 2 years
* Ejection fraction \< 30%
* New York Heart Association (NYHA) class \> II
* Relevant allergies (aspirin, clopidogrel, ticagrelor, contrast compounds, everolimus).


* Severe tortuosity around target bifurcation
* Chronic total occlusions
* Massive thrombus in Left main coronary artery
* Medina 0.0.1 lesions
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Abbott

INDUSTRY

Sponsor Role collaborator

Aarhus University Hospital Skejby

OTHER

Sponsor Role lead

Responsible Party

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Evald Hoej Christiansen

MD, phd

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Evald H Christiansen, MD, PhD

Role: STUDY_CHAIR

Aarhus University Hospital, Denmark

Locations

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Ziekenhuis Oost-Limburg (ZOL) Genk

Genk, , Belgium

Site Status

Leuven University Hospital

Leuven, , Belgium

Site Status

Aalborg University Hospital

Aalborg, , Denmark

Site Status

Aarhus University Hospital Skejby

Aarhus N, , Denmark

Site Status

Gentofte Hospital

Gentofte Municipality, , Denmark

Site Status

Rigshospitalet

København Ø, , Denmark

Site Status

Odense University Hospital

Odense, , Denmark

Site Status

Zealand University Hospital, Roskilde Sygehus

Roskilde, , Denmark

Site Status

Estonia Medical Centre

Tallinn, , Estonia

Site Status

Tampere University Hospital

Tampere, , Finland

Site Status

Vivantes Klinikum im Friedrichshain

Berlin, , Germany

Site Status

Universitäres Herzzentrum Hamburg

Hamburg, , Germany

Site Status

Cardiologicum Hamburg

Hamburg, , Germany

Site Status

Universitätsklinikum Schleswig-Holstein Campus Kiel

Kiel, , Germany

Site Status

University Hospital Galway

Galway, , Ireland

Site Status

Azienda Ospedaliero-Universitaria di Ferrara

Ferrara, Cona, Italy

Site Status

Gemelli General Hospital, Catholic University of the Sacred Heart

Rome, , Italy

Site Status

Latvia Centre of Cardiology

Riga, , Latvia

Site Status

Northwest Hospital Alkmaar

Alkmaar, , Netherlands

Site Status

VU University Medical Center (VUMC)

Amsterdam, , Netherlands

Site Status

St Antonius Ziekenhuis

Nieuwegein, , Netherlands

Site Status

Hospital of Southern Norway, Arendal

Arendal, , Norway

Site Status

Haukeland University Hospital, Bergen

Bergen, , Norway

Site Status

Oslo University Hospital, Rikshospitalet

Oslo, , Norway

Site Status

Oslo University Hospital - Ullevål

Oslo, , Norway

Site Status

Trondheim University Hospital

Trondheim, , Norway

Site Status

Medical University of Warsaw

Warsaw, , Poland

Site Status

Karolinska University Hospital Huddinge

Huddinge, Stockholm County, Sweden

Site Status

Sahlgrenska University Hospital

Gothenburg, , Sweden

Site Status

Örebro University Hospital

Örebro, , Sweden

Site Status

Södersjukhuset

Stockholm, , Sweden

Site Status

Belfast Health and Social Care Trust

Belfast, , United Kingdom

Site Status

Royal Bournemouth Hospital

Bournemouth, , United Kingdom

Site Status

Sussex Cardiac Centre

Brighton, , United Kingdom

Site Status

Golden Jubilee Hospital

Glasgow, , United Kingdom

Site Status

St George's Hospital

London, , United Kingdom

Site Status

University Hospital South Manchester, Wythenshawe Hospital

Manchester, , United Kingdom

Site Status

Morriston Hospital

Swansea, , United Kingdom

Site Status

Countries

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Belgium Denmark Estonia Finland Germany Ireland Italy Latvia Netherlands Norway Poland Sweden United Kingdom

References

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Holm NR, Andreasen LN, Neghabat O, Laanmets P, Kumsars I, Bennett J, Olsen NT, Odenstedt J, Hoffmann P, Dens J, Chowdhary S, O'Kane P, Bulow Rasmussen SH, Heigert M, Havndrup O, Van Kuijk JP, Biscaglia S, Mogensen LJH, Henareh L, Burzotta F, H Eek C, Mylotte D, Llinas MS, Koltowski L, Knaapen P, Calic S, Witt N, Santos-Pardo I, Watkins S, Lonborg J, Kristensen AT, Jensen LO, Calais F, Cockburn J, McNeice A, Kajander OA, Heestermans T, Kische S, Eftekhari A, Spratt JC, Christiansen EH; OCTOBER Trial Group. OCT or Angiography Guidance for PCI in Complex Bifurcation Lesions. N Engl J Med. 2023 Oct 19;389(16):1477-1487. doi: 10.1056/NEJMoa2307770. Epub 2023 Aug 27.

Reference Type DERIVED
PMID: 37634149 (View on PubMed)

Holm NR, Andreasen LN, Walsh S, Kajander OA, Witt N, Eek C, Knaapen P, Koltowski L, Gutierrez-Chico JL, Burzotta F, Kockman J, Ormiston J, Santos-Pardo I, Laanmets P, Mylotte D, Madsen M, Hjort J, Kumsars I, Ramunddal T, Christiansen EH. Rational and design of the European randomized Optical Coherence Tomography Optimized Bifurcation Event Reduction Trial (OCTOBER). Am Heart J. 2018 Nov;205:97-109. doi: 10.1016/j.ahj.2018.08.003. Epub 2018 Aug 16.

Reference Type DERIVED
PMID: 30205242 (View on PubMed)

Other Identifiers

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1-10-72-161-16

Identifier Type: -

Identifier Source: org_study_id

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