IVUS-guided DES Implantation in Coronary Calcification

Nanjing First Hospital, Nanjing Medical University864 enrolled

Overview

Coronary calcified lesion is associated with a poor clinical outcome. Intravascular ultrasound (IVUS) provides anatomic information in detail about reference vessel dimensions and lesion characteristics including severity of diameter stenosis, lesion length, and morphology. Both randomized and observational studies have reported the clinical benefits of IVUS guidance for patients with chronic total occlusion (CTO), long lesions, acute coronary syndrome (ACS) with complex bifurcation lesions. Our previous ULTIMATE trial has demonstrated that IVUS-guided drug-eluting stent (DES) implantation significantly improved clinical outcome in all-comers, particularly for patients who had an IVUS-defined optimal procedure, compared with angiography guidance. However, the benefit of IVUS guidance in coronary severe calcification still remains unknown in the modern DES era.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

TRIPLE

Enrollment

864

Conditions

Coronary Artery Disease

Interventions

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Silent ischemia, stable or unstable angina, non-ST-segment elevation myocardial infarction \> 48 hours, or ST-segment elevation myocardial infarction \> 7 days; 2. De novo coronary lesion eligible for drug-eluting stent implantation; 3. Target lesion with severe calcification; Exclusion Criteria: 1. Age less than 18-year-old; 2. Comorbidity with a life expectancy \<12 months; 3. Intolerant of antithrombotic therapy; 4. Significant anemia, thrombocytopenia, or leucopenia; 5. History of major hemorrhage (intracranial, gastrointestinal, and so on); 6. Chronic total occlusion lesion not recanalized; 7. Scheduled major surgery in the next 12 months; 8. Left ventricular ejection fraction \< 25%; 9. Uremia dependent on dialysis treatment; 10. Previous drug-eluting stent implantation in target vessel;

Outcomes

Primary Outcomes

the rate of target-vessel failure at 12 months

the composite of cardiovascular death, target-vessel myocardial infarction, and clinically driven target-vessel revascularization

Time frame: 12 months after indexed procedure