Coronary Artery Disease Clinical Trial
Official title:
Trans-Radial Percutaneous Coronary Interventions Using a Sheathless Guiding Catheter-Based Approach
Background:
The transradial approach is increasingly used in percutaneous coronary intervention (PCI)
because of lower major access site complications, lower bleeding risk and earlier patient
mobilization. According to this trend, in the last couple of years at the University
Hospital of Geneva the investigators have changed their practice and currently the
transradial approach is the most frequently used for PCI. However, the small diameter of the
radial artery remains a major limitation of the technique, especially in women or for
complex PCI necessitating larger bore guiding catheters. This may be overcome with
sheathless guiding catheters (Asahi, Japan), allowing for a standard inner catheter diameter
(6-7 Fr), with an outer diameter equivalent to a standard 5 and 6 Fr introducer sheath.
Aim:
This study is aimed to compare the transradial approach for PCI with a sheathless guiding
catheter and with a standard guiding catheter in women and patients with complex lesion
necessitating large bore guiding catheters.
Material and methods:
This prospective study will consecutively randomize all women and all men with
bifurcation/ostial lesion of a major coronary vessel (i.e. ≈ 120/year) in whom a transradial
PCI is attempted. The procedures will be performed either with a standard 6 or 7Fr guiding
catheter or with the sheathless 6.5, 7.5 Fr catheters.
End-points:
Successful performance a transradial PCI in all consecutive patients which qualify according
to the inclusion criteria (technical feasibility). Establish the proportion of procedures
performed with no device-related complications (safety). Analyze in details the technical
aspects of the sheathless catheter (efficacy).
Sample size:
The investigators have planed to include in the study ≈ 250 patients in two years. After 1
year of enrollment the investigators will perform an interim analysis and the instigators
will decide at that moment, according to the observed end-points, if prolonging the study
would be of any scientific value. In this case another 100 patients will be further included
in the study.
Enrollment time:
The investigators will start the study as soon the local ethical committee will give us the
permission. The investigators plan to start the study in July 2010. The end is expected for
July 2012.
n/a
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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