DIStal Versus COnventional RADIAL Access for Coronary Angiography and Intervention

NCT ID: NCT04171570

Last Updated: 2022-05-24

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

COMPLETED

Clinical Phase

NA

Total Enrollment

1309 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-12-10

Study Completion Date

2021-12-28

Brief Summary

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The objective of this study is to demonstrate the superiority of Distal Radial Access (DTRA) to Conventional Transradial Access (CTRA) regarding forearm radial artery occlusion (RAO).

This trial plans to include 1300 patients in around 12 locations around the world (11 participating sites in Europe and 1 participating site in Japan).

Detailed Description

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DISCO RADIAL is a prospective, global, open label, multi-centre randomized controlled trial with plan to include approximately 1300 patients on who transradial coronary angiography and/or intervention is performed. The patients will be randomized in 1:1 ratio to either Distal Transradial Artery Access (DTRA) or Conventional Transradial Access (CTRA) arm. In both arms 6Fr Glidesheath Slender (GSS) will be used as access sheath.

The sponsor will work in accordance with standard operating procedures (SOP) and the Monitoring Plan in order to ensure adherence to the CIP and applicable regulations at the investigational sites.

The Monitoring Plan is built according to a risk-based monitoring approach and describes the level of source data verification to be performed by the monitors.

Risk-based monitoring approach uses all available means to supervise the trial (central monitoring, remote monitoring and on-site monitoring), focusing in critical data points and issues ensuring that adequate monitoring (central, remote and on-site) at each site is completed to ensure protection of the rights and safety of the subjects and the quality and integrity of the data collected and submitted.

The sponsor shall provide training and the necessary guidelines to assist each investigational site on the data collection in the eCRF. Each site is responsible to report the available data requested by the CIP. In order to ensure data quality and avoid missing information in the eCRF, edit checks are designed during database development. In addition, Sponsor's CRA and Data Management team will be responsible to review the data and raise queries accordingly into the eCRF. An audit trail logging all data entered and edited is available within the EDC system. All source documents are maintained in the hospital files ready for inspection by the Sponsor and regulatory authorities upon request. The Sponsor will inform the investigator of the time period for retaining these records as per applicable regulatory requirements.

The following analysis sets will be considered for the statistical analysis :

As Treated Population This population includes all patients who were treated and undergo the studied procedure. Patients will be assigned to the study treatement groups according to the actual received treatement.

Intention-To-Treat Population This population includes all patients who have been randomized to a treatement. Patients will be assigned to the study treatement groups according to the treatement to which they have been randomized.

Per-Protocol Population This population includes all patients who were treated and undergo the studied procedure, excluding all patients with major violations to the protocol (e.g. wrong inclusion, missing data, mis-randomization, crossover, drop off before discharge). Patients will be assigned to the study treatement groups according to the treatement to which they have been randomized. All the protocol deviations will be reported in statistical report.

Assuming a rate of forearm RAO of 1% in DTRA and 3.5% in CTRA based on on two-sided alpha = 0.050 and power = 80%, 1:1 randomization needs 551 patients for each group to detect statistically significant differences in forearm RAO proportions. Then, given the crossover rate of 10% and the drop out rate of 5% for both group, at least 648 patients needs for each group to maintain proper statistical power. In total 1300 subjects will be randomized.

The primary endpoint analysis will be performed on ITT (Intention-To-Treat) population, by using two-sided superiority test with alpha = 0.05. Due to the short observation period (3 days ±2), a low number of missing data is expected. However, in case it exceeds 15-20%, missing, unused or spurious data will be considered using a tipping point analysis for each population. The comparaison in RAO rates between treatment groups will be tested by Chi-squared tests or Fisher's exact test, as appropriate. Odd-Ratio with IC95% will be calculated. Logistic regression analyses will be used to test the tendency.

Conditions

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Coronary Disease

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Randomization to distal transradial access or conventional transradial access. Both techniques are standard of care.
Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Distal Transradial Access

Distal Transradial Access

Group Type OTHER

Coronary angiography and or Percutaneous coronary Intervention

Intervention Type PROCEDURE

Radial access punture site

Conventional Transradial Access

Conventional Transradial Access

Group Type OTHER

Coronary angiography and or Percutaneous coronary Intervention

Intervention Type PROCEDURE

Radial access punture site

Interventions

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Coronary angiography and or Percutaneous coronary Intervention

Radial access punture site

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Patient is at least 18 years of age.
* Patient has provided written informed consent.
* Patient is undergoing diagnostic coronary angiography and/or PCI.
* Patient is willing to comply with all protocol-required evaluations during the hospitalization.
* Patient is suitable for both DTRA and CTRA using 6Fr GSS.

Exclusion Criteria

* Patient has a medical condition that may cause non-compliance with the protocol and/or confound the data interpretation.
* Patients on chronic hemodialysis.
* Patients presenting with ST-elevated myocardial infarction (STEMI).
* Patients have chronic total occlusion (CTO) lesions in coronary artery.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Cromsource

INDUSTRY

Sponsor Role collaborator

Terumo Europe N.V.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Adel Aminian, Dr.

Role: PRINCIPAL_INVESTIGATOR

Hôpital Civil Marie Curie

Locations

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Cliniques Universitaires Saint-Luc

Woluwe-Saint-Lambert, Brussels Capital, Belgium

Site Status

Hôpital Civil Marie Curie

Charleroi, Hainaut, Belgium

Site Status

CHU Jolimont

Haine-Saint-Paul, Hainaut, Belgium

Site Status

UZ Brussel

Brussels, , Belgium

Site Status

Plzen Medical University

Pilsen, , Czechia

Site Status

University Hospital Johannes Wesling Klinikum Minden

Minden, , Germany

Site Status

Bács-Kiskun Megyei Kórház

Kecskemét, , Hungary

Site Status

Sant'Eugenio Hospital

Roma, , Italy

Site Status

Istituto Clinico Humanitas

Rozzano, , Italy

Site Status

Shonan Kamakura General Hospital

Kanagawa, , Japan

Site Status

Isala Hospital

Zwolle, , Netherlands

Site Status

University Clinic of Cardiology, Skopje

Skopje, , North Macedonia

Site Status

HUG Geneva

Geneva, , Switzerland

Site Status

Kantonsspital Baselland Liestal

Liestal, , Switzerland

Site Status

Royal Stoke University Hospital

Stoke-on-Trent, , United Kingdom

Site Status

Sunderland Royal Hospital

Sunderland, , United Kingdom

Site Status

Countries

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Belgium Czechia Germany Hungary Italy Japan Netherlands North Macedonia Switzerland United Kingdom

References

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Kiemeneij F. Left distal transradial access in the anatomical snuffbox for coronary angiography (ldTRA) and interventions (ldTRI). EuroIntervention. 2017 Sep 20;13(7):851-857. doi: 10.4244/EIJ-D-17-00079.

Reference Type BACKGROUND
PMID: 28506941 (View on PubMed)

Corcos T. Distal radial access for coronary angiography and percutaneous coronary intervention: A state-of-the-art review. Catheter Cardiovasc Interv. 2019 Mar 1;93(4):639-644. doi: 10.1002/ccd.28016. Epub 2018 Dec 11.

Reference Type BACKGROUND
PMID: 30536709 (View on PubMed)

Sgueglia GA, Di Giorgio A, Gaspardone A, Babunashvili A. Anatomic Basis and Physiological Rationale of Distal Radial Artery Access for Percutaneous Coronary and Endovascular Procedures. JACC Cardiovasc Interv. 2018 Oct 22;11(20):2113-2119. doi: 10.1016/j.jcin.2018.04.045.

Reference Type BACKGROUND
PMID: 30336816 (View on PubMed)

Aminian A, Saito S, Takahashi A, Bernat I, Jobe RL, Kajiya T, Gilchrist IC, Louvard Y, Kiemeneij F, Van Royen N, Yamazaki S, Matsukage T, Rao SV. Comparison of a new slender 6 Fr sheath with a standard 5 Fr sheath for transradial coronary angiography and intervention: RAP and BEAT (Radial Artery Patency and Bleeding, Efficacy, Adverse evenT), a randomised multicentre trial. EuroIntervention. 2017 Aug 4;13(5):e549-e556. doi: 10.4244/EIJ-D-16-00816.

Reference Type BACKGROUND
PMID: 28218605 (View on PubMed)

Other Identifiers

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T133E3

Identifier Type: -

Identifier Source: org_study_id

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