Super High-pressure Balloon Versus Intravascular Lithotripsy to Prepare Severely Calcified Coronary Lesions

NCT ID: NCT07093788

Last Updated: 2025-12-09

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

78 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-09-01

Study Completion Date

2027-06-30

Brief Summary

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this trial aimed to evaluate the stent expansion through optical coherence tomography (OCT) among individuals underwent different preparation techniques ,then comparing the efficacy and safety of super high-pressure balloon to IVL in severely calcified lesions

Detailed Description

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Calcified lesions posed a significant challenge in percutaneous coronary intervention (PCI). The existence of calcified plaque increased the difficulty of optimal stent expansion and the risk of target lesion failure(TLF). Consequently, optimizing the preparation techniques for calcified lesions before stent implantation has assumed growing importance.

As a kind of novel double-layered balloon, super high-pressure balloon can expand uniformly under extreme pressure. Previous studies have demonstrated that super high-pressure balloon perform non-inferiorly or superiorly to other strategies in terms of final stent expansion.

Through triggering localized pulsatile sonic pressure, intravascular lithotripsy(IVL) cracked intimal and medial calcium plaque within the artery. In present series of studies(DISRUPT), the optimized preparation of calcified lesions with IVL has been proved to be safe and effective. According to guidelines and clinical practice, IVL is applicable to different types of severe calcification lesions, including concentric and eccentric calcifications. However, considering its technological and economic costs, finding other preparation techniques non-inferiority to IVL was essential. In clinical practice, super high-pressure balloon had shown considerable effects of preparation for calcified lesions. However, study focused on the comparison of super high-pressure balloon with IVL for severe calcified lesions was limited.

In summary, this randomized trial aimed to evaluate the stent expansion through optical coherence tomography (OCT) among individuals underwent different preparation techniques ,then comparing the efficacy and safety of super high-pressure balloon to IVL in severely calcified lesions

Conditions

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PCI Coronary Arterial Disease (CAD) Calcified Coronary Lesions

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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Super high-pressure balloon

Patients underwent OCT-guided PCI were treated with super high-pressure balloon for lesion preparation.

Group Type EXPERIMENTAL

super high-pressure balloon

Intervention Type DEVICE

preparation strategy for calcified lesions after unsatisfactory dilation

Intravascular lithotripsy (IVL)

Patients underwent OCT-guided PCI were treated with Intravascular lithotripsy (IVL) for lesion preparation.

Group Type EXPERIMENTAL

intravascular lithotripsy (IVL)

Intervention Type DEVICE

preparation strategy for calcified lesions after unsatisfactory dilation

Interventions

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super high-pressure balloon

preparation strategy for calcified lesions after unsatisfactory dilation

Intervention Type DEVICE

intravascular lithotripsy (IVL)

preparation strategy for calcified lesions after unsatisfactory dilation

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Age \> 18 years and \< 80 years
* Presented as asymptomatic angina, stable angina, unstable angina, prior myocardial infarction (MI), or non-ST-elevation myocardial infarction (NSTEMI).
* Have an indication for drug-eluting stent (DES) implantation
* Denovo coronary artery calcified lesions
* Target lesion diameter stenosis ≥ 70%, or target lesion diameter stenosis between ≥ 50% and \< 70%, accompanied by evidence of myocardial ischemia(such as fractional flow reserve (FFR) ≤ 0.80 or minimal lumen area (MLA) ≤ 4.0 mm²).
* Reference vessel diameter of the target vessel between 2.5 mm - 4.5 mm
* Maximum calcium arc within the lesion ≥ 270⁰ assessed by optical coherence tomography (OCT)
* Unsatisfactory lesion preparation with non-compliant balloon, defined as baseline diameter stenosis reduction of \< 30% under maximal inflation pressure.
* Provision of written informed consent

Exclusion Criteria

* Presented as acute ST-segment elevation myocardial infarction (STEMI), cardiogenic shock and multiple organ failure
* Presented as severe contrast agent allergy
* Intolerant to dual antiplatelet therapy (DAPT) and/or anticoagulation therapy
* Presented as active phase of autoimmune disease
* Calcified nodules or eccentric calcification lesions
* Failure to reach the target lesion with guidewires or catheters
* Complex coronary bifurcation lesions
* Target vessel thrombosis or aneurysm within 10 mm of the target lesion
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Nanjing First Hospital, Nanjing Medical University

OTHER

Sponsor Role lead

Responsible Party

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Ye-fei

chief physician

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Fei Ye, MD

Role: PRINCIPAL_INVESTIGATOR

The First Affiliated Hospital with Nanjing Medical University

Locations

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Lianyungang First People's Hospital

Lianyungang, Jiangsu, China

Site Status RECRUITING

Nanjing First Hospital

Nanjing, Jiangsu, China

Site Status RECRUITING

Yixing People's Hospital

Yixing, Jiangsu, China

Site Status RECRUITING

Countries

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China

Central Contacts

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Fei Ye, MD

Role: CONTACT

18951670287 ext. +86

Yi-fei Wang, MD

Role: CONTACT

18852577798 ext. +86

Facility Contacts

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De-lu Yin, MD

Role: primary

18961326475 ext. +86

Fei Ye, MD

Role: primary

18951670287 ext. +86

Yi-fei Wang, MD

Role: backup

18852577798 ext. +86

Liang Xu, MD

Role: primary

18861576565 ext. +86

Peng-fei Wei, MD

Role: backup

18761550965 ext. +86

References

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Cassese S, Simonetti F, Covarrubias HAA, Janisch M, Joner M, Kufner S, Lenz T, Pellegrini C, Rheude T, Sager H, Schunkert H, Starnecker F, Voll F, Xhepa E, Kastrati A, Kessler T. Intracoronary stenting and additional results achieved by shockWAVE coronary lithotripsy: design and rationale of ISAR-WAVE trial. Am Heart J. 2025 Apr;282:1-12. doi: 10.1016/j.ahj.2024.12.008. Epub 2024 Dec 20.

Reference Type BACKGROUND
PMID: 39710352 (View on PubMed)

Sagris M, Ktenopoulos N, Dimitriadis K, Papanikolaou A, Tzoumas A, Terentes-Printzios D, Synetos A, Soulaidopoulos S, Lichtenberg M, Korosoglou G, Honton B, Tousoulis D, Tsioufis C, Toutouzas K. Efficacy of intravascular lithotripsy (IVL) in coronary stenosis with severe calcification: A multicenter systematic review and meta-analysis. Catheter Cardiovasc Interv. 2024 Apr;103(5):710-721. doi: 10.1002/ccd.31006. Epub 2024 Mar 14.

Reference Type BACKGROUND
PMID: 38482928 (View on PubMed)

Rheude T, Rai H, Richardt G, Allali A, Abdel-Wahab M, Sulimov DS, Mashayekhi K, Ayoub M, Cuculi F, Bossard M, Kufner S, Xhepa E, Kastrati A, Fusaro M, Joner M, Byrne RA, Cassese S. Super high-pressure balloon versus scoring balloon to prepare severely calcified coronary lesions: the ISAR-CALC randomised trial. EuroIntervention. 2021 Aug 27;17(6):481-488. doi: 10.4244/EIJ-D-20-01000.

Reference Type BACKGROUND
PMID: 33258774 (View on PubMed)

Rheude T, Fitzgerald S, Allali A, Mashayekhi K, Gori T, Cuculi F, Kufner S, Hemetsberger R, Sulimov DS, Rai H, Ayoub M, Bossard M, Xhepa E, Fusaro M, Toelg R, Joner M, Byrne RA, Richardt G, Kastrati A, Cassese S, Abdel-Wahab M. Rotational Atherectomy or Balloon-Based Techniques to Prepare Severely Calcified Coronary Lesions. JACC Cardiovasc Interv. 2022 Sep 26;15(18):1864-1874. doi: 10.1016/j.jcin.2022.07.034.

Reference Type BACKGROUND
PMID: 36137691 (View on PubMed)

Other Identifiers

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KY20250425-03

Identifier Type: -

Identifier Source: org_study_id

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