Coronary artery disease is caused by narrowing of the artery lumen. Treatment with Percutaneous Coronary Intervention (PCI) may be needed. This is a minimally invasive procedure used to treat narrowed or blocked coronary arteries. Sometimes a stent is placed to keep the artery open. If the lesions in the coronary artery are calcified, this may cause difficulties for successful stent placement. The calcified plaques can be fractured via intravascular lithotripsy (IVL) with devices like ShockWave IVL and ShockFast IVL. The aim of this study is to compare the this relatively new ShockFast IVl with the more widely used ShockWave IVL.
Coronary calcified lesions have evolved as one of the most challenging indications for coronary percutaneous interventions (PCI). Different dedicated devices have been recently introduced into the market to improve procedural success in this challenging PCI population. Shockwave Intravascular Lithotripsy, (Shockwave IVL), Shockwave Medical, SC, CA, USA, was the first intracoronary device that used sonic pressure to fracture intracoronary calcium. The device safety and efficacy has been proved in a series of clinical trials. ShockFast intravascular lithotripsy (ShockFast IVL), Shunmei medical, Shenzhen, China, is a new dedicated device to treat intracoronary calcium that makes use of sonic pressure waves to fracture calcified plaques. ShockFast IVL has recently obtained CE mark approval for this indication. The aim of this study is to compare this new lithotripsy device (ShockFast IVL) with the existing and widely used lithotripsy device that uses the same principle of action, the Shockwave IVL, Shockwave Medical, SC, CA, USA.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
120
Treatment of subjects with coronary calcified lesions with an interventional procedure that utilizes a fluid-filled catheter connected to an energy source that generates mechanistically tuned ultrasonic acoustic pressure waves - or Shockwaves - for modification, fracture, and fragmentation of vascular calcification.
Treatment of subjects with coronary calcified lesions with an interventional procedure using a dedicated device to treat coronary calcified lesions by offering precise control of sonic pressure waves for safe fracture calcium deposits within the artery walls, thus maintaining vessel flexibility and promoting smoother stent placement. The ShockFast device has an improved crossing profile and 2 lengths of the catheter: 12 and also 15mm compared to ShockWave which has only 1 length.
Infirmerie Protestante de Lyon
Lyon, France
Centre Cardiologique du Nord
Paris, France
Centre Hospitalier de Valenciennes
Valenciennes, France
Medical University of Silesia
Katowice, Poland
University Hospital Krakow
Krakow, Poland
Miedziowe Centrum Zdrowia
Lubin, Poland
Regional Specialist Hospital
Wroclaw, Poland
La Paz University Hospital
Madrid, Spain
La Princesa Univeristy Hospital
Madrid, Spain
Virgen Arrixaca University Clinical Hospital
Murcia, Spain
...and 1 more locations
Stent area post PCI measured at the minimal lumen area during initial procedure, evaluated by OCT
Time frame: Hospitalisation (during procedure)
Target lesion failure defined as cardiac death, target-vessel myocardial infarction and target-lesion revascularisation at discharge and 30 days
Time frame: 30 day follow-up
Angiographic success
* Defined as a successful stent delivery with diameter of stenosis post PCI of \<50% without severe dissection (type D-F), perforation, abrupt vessel closure or persistent less than Thrombolysis in Myocardial Infarction (TIMI)-3 flow. * By collecting data through angiography and imaging: * Minimal lumen area post stenting * Residual area of stenosis * Residual diameter of stenosis \<30% * Residual diameter of stenosis \<50% * Optical Coherence Tomography (OCT) measured under expansion (\<80% of the reference lumen area) * Post-IVL acute area gain (measured at the minimum lumen area post IVL) * Number of visible calcium cracks post IVL * Severe coronary dissection post IVL (type C-F)
Time frame: Hospitalisation (during procedure)
Device success
Defined as success of the device to cross and fully expand
Time frame: Hospitalisation (during procedure)
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