Radial Vs. State-Of-The-Art Femoral Access for Bleeding and Access Site Complication Reduction in Cardiac Catheterization (REBIRTH)

NCT ID: NCT04077762

Last Updated: 2025-01-24

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

RECRUITING

Clinical Phase

NA

Total Enrollment

3266 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-11-15

Study Completion Date

2028-08-19

Brief Summary

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This is a phase IV, prospective, open label, randomized-controlled study that will compare radial access with state-of-the-art femoral access in patients without ST-segment elevation acute myocardial infarction undergoing cardiac catheterization. Subjects will be randomized 1:1 into 2 treatment groups: radial access and state-of-the-art femoral access. Randomization will be performed in blocks of 50 per site. Similarly, a second sub-randomization will be performed in the femoral access group into use of 18 vs 21 gauge needles, also in a 1:1 fashion.

Detailed Description

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Conditions

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Patient Satisfaction Vascular Access Complication

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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Radial access

Radial access for cardiac catheterization. Radial access will be performed using ultrasound guidance and a micropuncture needle or catheter-over-needle system, as per the local standard of care.

Group Type ACTIVE_COMPARATOR

Radial Access

Intervention Type PROCEDURE

Radial Access

State-of-the-art femoral access

Femoral access for cardiac catheterization. Femoral access will be obtained using state-of-the-art techniques (ultrasound and fluoroscopic guidance for arterial puncture, immediate femoral angiography after obtaining access and use of a vascular closure device whenever possible).

Group Type ACTIVE_COMPARATOR

State-of-the-art femoral access with 18 gauge needle

Intervention Type PROCEDURE

State-of-the-art femoral access with 18 gauge needle

State-of-the-art femoral access with 21 gauge needle

Intervention Type PROCEDURE

State-of-the-art femoral access with 21 gauge needle. For patients randomized to micropuncture (21G) the micropuncture wire must be advanced under fluoroscopy to avoid inadvertent wiring of side-branches.

Interventions

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Radial Access

Radial Access

Intervention Type PROCEDURE

State-of-the-art femoral access with 18 gauge needle

State-of-the-art femoral access with 18 gauge needle

Intervention Type PROCEDURE

State-of-the-art femoral access with 21 gauge needle

State-of-the-art femoral access with 21 gauge needle. For patients randomized to micropuncture (21G) the micropuncture wire must be advanced under fluoroscopy to avoid inadvertent wiring of side-branches.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Age 18 years and older
* Undergoing diagnostic angiography for ischemic symptoms with possible PCI, or undergoing planned urgent or elective PCI
* Has provided informed consent and agrees to participate
* Patients must be equally eligible to undergo cardiac catheterization via radial or femoral access

Exclusion Criteria

* Primary PCI for STEMI
* Planned right heart catheterization
* Valvular heart disease requiring valve surgery within 30 days after the index procedure
* Hemodialysis access (arteriovenous fistula or graft) in the arm to be used for PCI in case of assignment to radial approach (the opposite arm may be used for radial access if a dialysis graft is present in one)
* Peripheral arterial disease prohibiting vascular access
* Presence of bilateral internal mammary artery coronary bypass grafts
* International normalized ratio ≥1.5 while treated with oral vitamin K antagonists (i.e. warfarin) Receipt of oral factor Xa or IIa inhibitors ≤24 h before procedure
* Planned staged PCI within 30 days after index procedure.
* Any planned surgeries within 30 days after index procedure
* Planned dual arterial access (for example for chronic total occlusion PCI)
* Coexisting conditions that limit life expectancy to less than 30 days
* Positive pregnancy test
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Minneapolis Heart Institute Foundation

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Emmanouil Brilakis, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Minneapolis Heart Institute Foundation

Locations

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San Francisco VA Medical Center

San Francisco, California, United States

Site Status RECRUITING

Mayo Clinic Florida

Jacksonville, Florida, United States

Site Status RECRUITING

Joseph Maxwell Cleland Atlanta VA Medical Center

Decatur, Georgia, United States

Site Status RECRUITING

Henry Ford Hospital

Detroit, Michigan, United States

Site Status NOT_YET_RECRUITING

Minneapolis Heart Institute Foundation

Minneapolis, Minnesota, United States

Site Status RECRUITING

Oklahoma Heart Hospital

Oklahoma City, Oklahoma, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Bavana Rangan, BDS, MPH, CCRP

Role: CONTACT

612-863-3852

Olga Mastrodemos

Role: CONTACT

Facility Contacts

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Jeffrey Zimmet, MD, PhD

Role: primary

415-221-4810

Kendrick Shunk, MD, PhD

Role: backup

Federico Simon

Role: primary

904-953-4205

Abdallah El Sabbagh, MD

Role: backup

Nikki Leslie, RN

Role: primary

404-321-6111

Kreton Mavromatis, MD

Role: backup

Michelle Butcher, RN

Role: primary

313-916-7614

Khaldoon Alaswad, MD

Role: backup

Bavana Rangan, BDS, MPH, CCRP

Role: primary

612-863-3852

Julia Myers, RN

Role: primary

405-608-1284

Mazen Abu-Fadel, MD

Role: backup

References

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Flumignan RL, Trevisani VF, Lopes RD, Baptista-Silva JC, Flumignan CD, Nakano LC. Ultrasound guidance for arterial (other than femoral) catheterisation in adults. Cochrane Database Syst Rev. 2021 Oct 12;10(10):CD013585. doi: 10.1002/14651858.CD013585.pub2.

Reference Type DERIVED
PMID: 34637140 (View on PubMed)

Other Identifiers

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REBIRTH

Identifier Type: -

Identifier Source: org_study_id

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