Very Long Versus Overlapping Stents in Long Coronary Lesions

The Young Investigator Group of Cardiovascular Research

Status: Withdrawn

Conditions: Coronary Artery Disease; Chronic Coronary Syndrome; Drug Eluting Stents

Treatments: Device: Percutaneous Coronary Intervention and Stent Implantation

Study type: Interventional

Funder types: NETWORK

Identifiers

NCT04738344

YIG0122001

Details and patient eligibility

About

This study is performed to compare the angiographic and clinical outcomes of the use of single long stent versus overlapping stents in the treatment of long coronary lesions in patients with chronic coronary syndrome.

Full description

Percutaneous coronary intervention (PCI) in diffuse coronary artery disease is still considered a big obstacle for interventional cardiologists. Very long coronary lesions are usually found, and implantation of a single stent was a great problem forcing the operator to do overlapping of several stents.

Recently, new stent designs with increasing length are developed and emerging as a great tool for the percutaneous treatment of long lesions. Nowadays, stents up to 60 mm are available to be used in these cases reducing stent overlap.

Intravascular ultrasound (IVUS)-guided percutaneous coronary intervention has been shown in clinical trials, registries, and meta-analyses to be associated with a reduction in clinical events after percutaneous coronary intervention; however, IVUS utilization during percutaneous coronary intervention remains low in the United States and worldwide. The impact of IVUS in these complex lesions may be associated with a lower rate of clinical adverse events in comparison with angiography alone.

The study will be conducted on forty patients with chronic stable angina on maximal medical treatment who are going to have elective coronary angiography and elective PCI and having one long coronary lesion that is more than 40 mm in length, they will be randomized into either treatment of the lesion with a single very long stent (more than 40 mm in length) or with more than one overlapping stents in 1:1 randomization. Control angiography and IVUS will be done to the 2 groups after 6 months and the major cardiovascular outcomes will be addressed at 1,3 and 6 months follow-up periods.

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients > 18 years of age
• Single vessel disease and undergoing PCI for significant long lesion.
• Chronic stable angina on maximal medical treatment.

Exclusion criteria

• Patients presenting with acute coronary syndromes.
• Patients having two or more vessel disease on coronary angiography.
• Previous myocardial infarction.
• Previous vascularization either by PCI or bypass grafting.
• Very low ejection fraction less than 35%.
• Renally impaired patients with Creatinine clearance less than 50 ml/min.
• Contraindication to dual antiplatelet drug therapy.
• Contraindication to coronary angiography.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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0 participants in 2 patient groups

Percutaneous coronary intervention and stent implantation using one long stent

Experimental group

Description:

Long coronary lesions will be treated percutaneously with a single long stent (more than 40 mm in length) and intravascular ultrasonography (IVUS) will be done immediately after stent deployment to record the baseline picture

Treatment:

Device: Percutaneous Coronary Intervention and Stent Implantation

Percutaneous coronary intervention and stent implantation using more than one overlapping stents

Experimental group

Description:

Long coronary lesions will be treated with more than one overlapping stents and intravascular ultrasonography (IVUS) will be done immediately after stent deployment to record the baseline picture

Treatment:

Device: Percutaneous Coronary Intervention and Stent Implantation