IMPact on Revascularization Outcomes of IVUS Guided Treatment of Complex Lesions and Economic Impact

NCT ID: NCT04221815

Last Updated: 2025-09-12

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

3100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-10-14

Study Completion Date

2027-09-30

Brief Summary

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Intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) has been shown in clinical trials, registries, and meta-analyses to reduce recurrent events after PCI. This is accomplished by improving the angiographic result with lesion and vessel assessment to guide stent selection and implantation and intravascular imaging following stent implantation to ensure an adequate treatment endpoint has been achieved. Despite extensive literature supporting the use of IVUS in PCI, utilization remains low in the United States. An increasing number of high-risk or complex lesions are being treated with PCI and we hypothesize that the impact of IVUS in these complex lesions will be of increased importance in reducing clinical adverse events while remaining cost effective.

Detailed Description

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This is a prospective, single-blind clinical investigation randomizing subjects to IVUS-guided coronary stent implantation vs. angiography-guided coronary stent implantation in a 1:1 ratio.

The clinical investigation will be conducted at approximately 120 centers in the US, Canada, and Europe. Approximately 2,500-3,100 randomized subjects and up to 3 roll-in subjects per site will be enrolled in this study. Subjects participating in this clinical investigation will be followed for 2 years. The expected duration of enrollment is approximately 2.5 years. The total duration of the clinical investigation is expected to be approximately 4.5 years.

Conditions

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Atherosclerosis

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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IVUS guided PCI

Patients will receive a pre-PCI IVUS, IVUS guided stent sizing and optimization per study protocol, post-PCI IVUS

Group Type ACTIVE_COMPARATOR

Eagle Eye Platinum digital IVUS catheter with optional SyncVision

Intervention Type DEVICE

IVUS catheter

Resolute Onyx Drug Eluting Stent

Intervention Type DEVICE

Stent

Onyx Frontier Drug Eluting Stent

Intervention Type DEVICE

Stent

Onyx TruStar Drug Eluting Stent

Intervention Type DEVICE

Stent

Onyx TruCor Drug Eluting Stent

Intervention Type DEVICE

Stent

Angiographic-guided PCI

Patients will receive angiography guided PCI and angiographic optimization per local standard practice, as well as a post-PCI IVUS blinded to the investigator

Group Type PLACEBO_COMPARATOR

Resolute Onyx Drug Eluting Stent

Intervention Type DEVICE

Stent

Onyx Frontier Drug Eluting Stent

Intervention Type DEVICE

Stent

Onyx TruStar Drug Eluting Stent

Intervention Type DEVICE

Stent

Onyx TruCor Drug Eluting Stent

Intervention Type DEVICE

Stent

Interventions

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Eagle Eye Platinum digital IVUS catheter with optional SyncVision

IVUS catheter

Intervention Type DEVICE

Resolute Onyx Drug Eluting Stent

Stent

Intervention Type DEVICE

Onyx Frontier Drug Eluting Stent

Stent

Intervention Type DEVICE

Onyx TruStar Drug Eluting Stent

Stent

Intervention Type DEVICE

Onyx TruCor Drug Eluting Stent

Stent

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Age ≥ 18 years at screening
* PCI with stent implantation involving a high risk or complex lesion defined as involving at least one of the following characteristics:
* Chronic total occlusion
* In-stent restenosis
* Severe coronary artery calcification
* Long lesion (≥ 28 mm in length)
* Bifurcation lesion (Any Medina class that involves main branch disease with a side branch ≥2.0 mm)
* Stable angina, unstable angina, or non-ST Elevation myocardial infarction (NSTEMI), undergoing PCI of a single or multivessel coronary artery stenosis
* PCI performed with either angiography alone, or IVUS guidance used

Exclusion Criteria

* Subjects with acute ST elevation myocardial infarction (STEMI), or cardiogenic shock
* Use of fibrinolytic therapy within 24 hours of PCI
* Planned revascularization of a target vessel as a staged procedure
* Stent thrombosis
* Use of optical coherence tomography (OCT) during the index procedure
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Medstar Health Research Institute

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Ron Waksman, MD

Role: PRINCIPAL_INVESTIGATOR

MedStar Health

Locations

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Northwest Medical Center

Tucson, Arizona, United States

Site Status

Central Arkansas Veterans Healthcare System

Little Rock, Arkansas, United States

Site Status

University of California San Deigo

La Jolla, California, United States

Site Status

San Francisco VA Health Care System

San Francisco, California, United States

Site Status

San Antonio Regional Hospital

Upland, California, United States

Site Status

Medstar Washington Hospital Center

Washington D.C., District of Columbia, United States

Site Status

Manatee Memorial Hospital

Bradenton, Florida, United States

Site Status

AdventHealth Orlando

Orlando, Florida, United States

Site Status

Ascension Sacred Heart

Pensacola, Florida, United States

Site Status

AdventHealth Sebring

Sebring, Florida, United States

Site Status

Tampa Cardiovascular/St. Joseph's Hospital

Tampa, Florida, United States

Site Status

Emory

Atlanta, Georgia, United States

Site Status

Atlanta VA Medical Center

Decatur, Georgia, United States

Site Status

Northeast Georgia Medical Center

Gainesville, Georgia, United States

Site Status

Rush University Medial Center

Chicago, Illinois, United States

Site Status

Riverside Medical Center

Kankakee, Illinois, United States

Site Status

Carle Foundation Hospital

Urbana, Illinois, United States

Site Status

MercyOne Iowa Heart Center

Des Moines, Iowa, United States

Site Status

MedStar Union Memorial Hospital

Baltimore, Maryland, United States

Site Status

MedStar Southern Maryland Hospital Center

Clinton, Maryland, United States

Site Status

Massachusetts General Hospital

Boston, Massachusetts, United States

Site Status

Brigham and Women's Hospital

Boston, Massachusetts, United States

Site Status

Baystate Medical Center

Springfield, Massachusetts, United States

Site Status

Ascension St. John

Dearborn, Michigan, United States

Site Status

St. Luke's Hospital of Duluth

Duluth, Minnesota, United States

Site Status

University of Minnesota

Minneapolis, Minnesota, United States

Site Status

Virtua Our Lady of Lourdes Hospital

Camden, New Jersey, United States

Site Status

AtlantiCare Regional Medical Center

Pomona, New Jersey, United States

Site Status

Northwell Health - South Shore University Hospital

Bay Shore, New York, United States

Site Status

NYU Langone Hospital

Brooklyn, New York, United States

Site Status

Northwell Health - North Shore University Hospital

Manhasset, New York, United States

Site Status

Northwell Health - Lennox Hill Hospital

New York, New York, United States

Site Status

St. Francis

Roslyn, New York, United States

Site Status

Good Samaritan University Hospital

West Islip, New York, United States

Site Status

University of North Carolina Rex Hospital

Raleigh, North Carolina, United States

Site Status

The Ohio State University Medical Center

Columbus, Ohio, United States

Site Status

Lehigh Valley Hospital

Allentown, Pennsylvania, United States

Site Status

Seton Medical Center Austin

Austin, Texas, United States

Site Status

Texas Tech University Health Sciences Center

El Paso, Texas, United States

Site Status

Carilion Clinic

Roanoke, Virginia, United States

Site Status

Nicosia General Hospital

Nicosia, , Cyprus

Site Status

Herz-und Diabeteszentrum NRW

Bad Oeynhausen, North Rhine-Westphalia, Germany

Site Status

St. Vinzenz Hospital

Cologne, North Rhine-Westphalia, Germany

Site Status

Segerberger Kliniken

Bad Segeberg, , Germany

Site Status

Helios Amper-Klinikum Dachau

Dachau, , Germany

Site Status

University Medical Center Hamburg-Eppendorf

Hamburg, , Germany

Site Status

Rheinland Klinikum

Neuss, , Germany

Site Status

University Medicine Rostock

Rostock, , Germany

Site Status

General Hospital of Athens Hippokration

Athens, , Greece

Site Status

The University General Hospital of Ioannina

Ioannina, , Greece

Site Status

Thriassion General Hospital

Magoula, , Greece

Site Status

Shamir Medical Center

Be’er Ya‘aqov, , Israel

Site Status

Meir Medical Center

Kfar Saba, , Israel

Site Status

University Hospital Careggi

Florence, , Italy

Site Status

University of Messina

Messina, , Italy

Site Status

Sahlgrenska University Hospital

Gothenburg, , Sweden

Site Status

Skane University Hospital

Lund, , Sweden

Site Status

Danderyd University Hospital

Stockholm, , Sweden

Site Status

Freeman Hospital

Newcastle upon Tyne, Tyne and Wear, United Kingdom

Site Status

Leeds General Infirmary

Leeds, West Yorkshire, United Kingdom

Site Status

Imperial College Healthcare

London, , United Kingdom

Site Status

Countries

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United States Cyprus Germany Greece Israel Italy Sweden United Kingdom

References

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Shlofmitz E, Torguson R, Mintz GS, Zhang C, Sharp A, Hodgson JM, Shah B, Kumar G, Singh J, Inderbitzen B, Weintraub WS, Garcia-Garcia HM, Di Mario C, Waksman R. The IMPact on Revascularization Outcomes of intraVascular ultrasound-guided treatment of complex lesions and Economic impact (IMPROVE) trial: Study design and rationale. Am Heart J. 2020 Oct;228:65-71. doi: 10.1016/j.ahj.2020.08.002. Epub 2020 Aug 8.

Reference Type DERIVED
PMID: 32866927 (View on PubMed)

Other Identifiers

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IMPROVE

Identifier Type: -

Identifier Source: org_study_id

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