Shockwave Intervention for Enhanced Wound Healing in No-touch Pedicle Saphenous Vein Graft Harvesting for Coronary Artery Bypass Grafting

NCT ID: NCT07068776

Last Updated: 2025-12-23

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

120 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-10-03

Study Completion Date

2029-01-31

Brief Summary

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The aim of this trial is to apply shockwaves to the leg wound after saphenous vein harvesting and closure in order to reduce the occurrence of postoperative wound healing complications following coronary artery bypass grafting using venous grafts.

Detailed Description

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Selection of suitable grafts for coronary artery bypass grafting (CABG) is one of the most critical decisions cardiac surgeons must make. There are two main techniques for harvesting graft vessels. The first is the skeletonized harvesting technique (ST), in which only the vessel itself is dissected and isolated before removal. The second method is the "no-touch" technique (NT), where the vessel is harvested along with surrounding tissue to minimize direct manipulation and potential microtrauma to the graft.

Saphenous vein grafts (SVG) are the most commonly used conduits in CABG and can be harvested using either technique. While the NT technique has demonstrated superior long-term patency and reduced atherosclerotic changes, it is associated with a significantly higher rate of wound healing complications, which are often more severe and can have a considerable impact on patient quality of life.

Shockwave therapy (SWT) has been shown to accelerate wound healing. The SHIELDS-CABG trial employs a double-blinded, sham-controlled design to evaluate the efficacy of prophylactic SWT in reducing wound healing complications after NT saphenous vein harvesting in CABG patients. In this study, the intervention group receives SWT immediately after wound closure to enhance healing and prevent complications.

This is a prospective, single-center, single-blinded, randomized, sham-controlled trial conducted at the Department of Cardiac Surgery, Medical University of Innsbruck. Blinding is maintained intraoperatively and only applied after wound closure to avoid procedural bias. Half of the patients will receive SWT, while in the control group the device will be held over the wound for the same duration without delivering shockwaves. A double-blind design is not feasible, as the operating staff can hear the characteristic sound of the device during SWT application.

Conditions

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Coronary Arterial Disease (CAD)

Keywords

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Coronary artery bypass grafting Saphenous vein graft (SVG) No-touch vein harvesting Wound healing complications Shockwave therapy (SWT) Cardiac surgery

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

TRIPLE

Participants Caregivers Outcome Assessors

Study Groups

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Treatment group

Participants in this arm receive intraoperative shockwave therapy (SWT) applied to the leg wound after saphenous vein harvesting and wound closure. Shockwaves are administered during the reperfusion phase while the patient is still on cardiopulmonary bypass. The applicator is moved in circular motion over the wound using a sterile cover and ultrasound gel. The energy settings are 0.1 mJ/mm² at 5 Hz, with 25 impulses per centimeter of wound length. This intervention aims to reduce postoperative wound healing complications.

Group Type ACTIVE_COMPARATOR

Shockwave treatment

Intervention Type DEVICE

The shockwave device will be set to an energy flux density of 0.1 mJ/mm² at 5 Hz, with approximately 25 impulses per centimeter of wound length. This means that one centimeter of the wound will be treated for 5 seconds. The shockwave treatment will then be carried out, with each centimeter of the wound area treated for 5 seconds using gentle circular motions.

Sham group

Participants in this arm receive a sham treatment mimicking the active shockwave therapy. The applicator is moved over the leg wound in the same sterile manner using ultrasound gel and sterile cover, but no shockwaves are emitted. The procedure takes the same amount of time and follows the same protocol.

Group Type SHAM_COMPARATOR

Sham treatment

Intervention Type DEVICE

The applicator will not be connected to the shockwave device. The applicator treatment will then be carried out, with each centimeter of the wound area treated for 5 seconds using gentle circular motions.

Interventions

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Shockwave treatment

The shockwave device will be set to an energy flux density of 0.1 mJ/mm² at 5 Hz, with approximately 25 impulses per centimeter of wound length. This means that one centimeter of the wound will be treated for 5 seconds. The shockwave treatment will then be carried out, with each centimeter of the wound area treated for 5 seconds using gentle circular motions.

Intervention Type DEVICE

Sham treatment

The applicator will not be connected to the shockwave device. The applicator treatment will then be carried out, with each centimeter of the wound area treated for 5 seconds using gentle circular motions.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Male or female patients \> 18 years
* Isolated CABG procedure in the need of 2 or more venous grafts
* Elective or urgent cases
* Median sternotomy approach
* eGFR ≥ 15 ml/min
* Willing to participate in trial
* Able to provide informed consent

Exclusion Criteria

* History of venous stripping or ligation
* Uncontrolled Diabetes mellitus (HbA1c ≥ 9 %)
* Enrolled in other therapeutic or interventional trial
* Hemodynamically unstable
* Cardiogenic shock
* Any condition that seriously increases the risk of noncompliance or loss of follow-up
* Emergency case
* Salvage case
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Medical University Innsbruck

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Can Gollmann-Tepeköylü, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Department of Cardiac Surgery, Medical Univesity Innsbruck, Innsbruck, Austria

Locations

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Department of Cardiac Surgery, Medical University Innsbruck

Innsbruck, Tyrol, Austria

Site Status RECRUITING

Countries

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Austria

Central Contacts

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Clemens Engler, MD

Role: CONTACT

Phone: +43 512 504 83659

Email: [email protected]

Can Gollmann-Tepeköylü, MD, PhD

Role: CONTACT

Phone: +43 512 504 80466

Email: [email protected]

Facility Contacts

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Clemens Engler, MD, PhD

Role: primary

Other Identifiers

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1054/2025

Identifier Type: -

Identifier Source: org_study_id