View clinical trials related to Coronary Occlusion.
Filter by:A coronary chronic total occlusion refers to the long term complete blockage of a blood vessel supplying the heart. Exercise is beneficial for patients with heart problems, including people with narrowed blood vessels. However, exercise has not previously been tested in patients with a completely blocked blood vessel. Therefore, the aim of this study is to evaluate exercise testing in participants with a coronary chronic total occlusion, and to see if the physiological changes that occur are reproducible when participants are re-tested. Secondly, the study will see if sustained exercise is safe in this population. Participants will make 3 visits to our Laboratory. During the first two visits participants will complete symptom limited exercise tests using a stationary bike for approximately 8-12 minutes. The bikes' resistance will gradually increase until participants choose to stop or the researcher ends the test. Participants will wear a mask that collects exhaled breath for testing, and will be connected to an electrocardiogram (heart trace monitor), and blood pressure cuff for monitoring throughout the test. During visits one and three patients will also have blood taken pre and post exercise. Researchers will analyse how the amount of oxygen consumed with increasing exercise relates to the participants' heart rate. A plateau in these measures would indicate a change in the heart's blood supply resulting in reduced function. The participants' third visit will involve cycling under the same conditions as previous visits. However, during this test participants will be asked to cycle continuously for 20 minutes at a resistance set by the researchers. This level of resistance is determined from the results of the first test, as the point at which changes in blood flow and heart function occurred. In the last five minutes of the test patients will have an echocardiogram (heart scan), to look at the heart function.
The objective of this research study is to test the accuracy of preexisting criteria versus expert interpretation for the diagnosis of acute coronary occlusion (major heart attack due to a completely blocked blood vessel). If our hypothesis proves to be true, this would provide a significant improvement in the care for patients who present to the hospital with possible symptoms of coronary ischemia (symptoms due to lack of blood flow to the heart). The primary analysis will be designed as a multi-center, retrospective case-control study.
Rationale: Randomized trials could not yet establish favourable outcomes of CTO PCI on hard endpoints such as ejection fraction or mortality, when compared to optimal medical therapy. However, patients after CTO PCI appeared to be more frequently free of angina complaints, but the aetiology behind this is not fully understood. The investigators hypothesize that PCI of the CTO in patients preselected with an ischemic threshold (>12.5%) on cardiac imaging leads to a reduction of the ischemic burden and therefore an increased benefit on functional outcomes. Objective: Primary objective is to determine whether PCI of the CTO will yield a higher reduction of ischemia assessed by exercise myocardial perfusion SPECT-CT from baseline to 6-month follow-up compared to a control group. Secondary objectives are 1) to evaluate the effect of PCI of the CTO on improvement in functional status, infarct size and left ventricular function from baseline to follow-up compared to the control group; 2) to study the association between ischemia reduction and functional outcome and left ventricular function; 3) to assess the influence of the collateral flow index on the ischemic burden (reduction), functional status, infarct size and left ventricular (contractile) function (hibernation). Study design: open multicentre randomized trial Study population: 82 patients eligible for CTO PCI Intervention: CTO PCI Primary endpoint: ischemic burden assessed with exercise myocardial perfusion SPECT-CT from baseline to 6 months follow-up.
A Prospective, Multi-Center, Non-randomized, Single arm, Open label, Supplemental Study to Evaluate the Safety and Effectiveness of the NovaCross™ Micro-catheter in Facilitating Crossing Chronic Total Occlusion (CTO) Coronary Lesions
This study will include up to 60 eligible male and female subjects. The purpose of this trial is to evaluate the safety and effectiveness of the NovaCross™ micro-catheter when used to facilitate crossing of Chronic Total Occlusion (CTO) lesions in coronary arteries. The procedure will be conducted on consenting patients diagnosed with a CTO in a coronary vessel that requires revascularization after a previously failed attempt to cross or refractory to 10 minutes of conventional guidewire attempt. This study is an extension study of Nitiloop's Pivotal study.
This study evaluates effectiveness and safety of DESyne X2 in Routine Clinical Practice.
Proximal RCA occlusions were very often found among men with fatal pre-hospital MI; whereas left-sided coronary occlusions were significantly more frequent in hospital-admitted survivors of MI. Left-sided coronary occlusions may be associated with a more favorable pre-hospital phase of acute MI compared to proximal RCA occlusions. Proximal RCA occlusion increases the risk of arrhythmia and shock leading to increase the mortality. Sinus bradycardia and cardiogenic shock accounts for the majorities of the mortalities of RCA occlusion
The aim of this study is to investigate the role of functional evaluation for predicting clinical outcome in patients with coronary chronic total occlusion (CTO) undergoing percutaneous coronary intervention (PCI), and to evaluate the clinical evidence for the using of fractional flow reserve (FFR), coronary flow reserve (CFR), index of myocardial resistance (IMR) and dynamic single photon emission computed tomography (D-SPECT) in these patients.
The purpose of the Surveillance is to know the frequency and status of adverse device effects and adverse events in order to assure the safety of the new medical device, and to collect efficacy and safety information for evaluating clinical use results.
Randomized registry for the study of CTO PCI as adjunction to optimal medical therapy.