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Trial registered on ANZCTR
Registration number
ACTRN12621000697886
Ethics application status
Approved
Date submitted
12/04/2021
Date registered
7/06/2021
Date last updated
9/11/2022
Date data sharing statement initially provided
7/06/2021
Date results provided
9/11/2022
Type of registration
Prospectively registered
Titles & IDs
Public title
Intravascular Lithotripsy Catheter Balloon for Calcified Coronary Artery Pilot Study
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Scientific title
Pilot Study of Incidence of Major Adverse Cardiac Events and Effectiveness of Stent Delivery after Intravascular Lithotripsy Catheter Balloon for Calcified Coronary Artery in Adults
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Secondary ID [1]
303935
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Calcified coronary artery
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Condition category
Condition code
Cardiovascular
319275
319275
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0
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Coronary heart disease
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Intravascular Lithotripsy (IVL) is a technique based on lithotripsy, an established treatment strategy for renal calcification, in which multiple lithotripsy emitters mounted on a traditional balloon catheter platform create diffusive pulsatile mechanical energy to disrupt calcium within the vessel wall at low inflation pressures.
For coronary artery calcification, the recent Disrupt CAD III study reported high rates of device success, safety and performance of coronary IVL in vessel preparation of calcified stenotic coronary lesions prior to stent implantation.
The Shockwave Medical (Santa Clara, CA, USA) IVL system and coronary IVL catheter consist of a fluid-filled balloon angioplasty catheter and guidewire. Lithotripsy emitters are housed in the 12mm balloon segment. Each catheter is single use and can deliver a total of 80 IVL pulses.
All participants will have the procedure completed by a cardiologist with minimum 5 years experience in other forms of percutaneous coronary intervention who is trained in using the Shockwave IVL. A single IVL intervention will be undertaken in the Mackay Base Hospital Cardiac Catheterisation laboratory. The IVL catheter will be inserted and delivered over guidewire. Atherectomy devices and cutting/scoring balloons will not be used. The IVL balloon will be inflated to 4 atm and 10 IVL pulses will be delivered followed by inflation of the balloon to 6 atm. This will be continued until the balloon has expanded to full capacity, whereby the stent can be implanted. Procedure duration is anticipated to be a mean (+/- SD) of 70 (+/- 30) mins. Patient medical records will be used to monitor adherence to the intervention and patient outcomes.
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Intervention code [1]
320243
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Treatment: Devices
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Incidence of major adverse cardiac events (MACE) as assessed by patient medical records.
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Assessment method [1]
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Timepoint [1]
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Within 30 days of procedure
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Primary outcome [2]
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Procedural success defined as stent delivery with a residual stenosis <50% as determined by CT coronary angiography (CTCA) and without in-hospital MACE.
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Assessment method [2]
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Timepoint [2]
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Upon discharge from hospital.
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Secondary outcome [1]
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Ability to deliver the IVL catheter across the target lesion determined via intravascular ultrasound (IVUS) and optical coherence tomography (OCT).
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Assessment method [1]
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Timepoint [1]
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Within the episode
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Secondary outcome [2]
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Delivery of lithotripsy without angiographic complications immediately after IVL
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Assessment method [2]
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Timepoint [2]
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Within the episode
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Eligibility
Key inclusion criteria
• Troponin must be less than or equal to the upper limit of lab normal value within 24 hours prior to the procedure or if troponin is elevated, concomitant CK must be normal
• The target vessel must have a TIMI flow 3 at baseline
• Patients with significant (> 50% diameter stenosis) native coronary artery disease including stable or unstable angina and silent ischemia, suitable for PCI
• Ability to tolerate dual antiplatelet agent (i.e. aspirin, clopidogrel, prasugrel, or ticagrelor for 1 year and single antiplatelet therapy for life
• Single lesion stenosis of protected LMCA, or LAD, RCA or LCX artery > 50% in a reference vessel of 2.5mm – 4.0 mm diameter and < 32 mm length
• Presence of calcification within the lesion on both sides of the vessel as assessed by angiography
• Planned treatment of single lesion in one vessel
• Ability to pass a 0.014’’ guide wire across the lesion
• Patient, or authorized representative, signs a written Informed Consent form to participate in the study, prior to any study-mandated procedures
• Patient is able and willing to comply with all assessments in the study
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
• Concomitant use of other techniques to deal CAC such as atherectomy and special balloons
• Severe renal failure
• Severe anaemia
• Previous PCI within 30 days of planned procedure
• Patients not suitable for consenting such as severe memory impairment
• Acute coronary syndrome within 1 month from planned procedure
• Severe Heart Failure (NYHA III or IV)
• Unable to tolerate dual antiplatelet agents (Aspirin + clopidogrel or ticargrelor or prasugrel) for 1 year for any reason
• Contrast allergy
• Active infection
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/07/2021
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Actual
2/08/2021
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Date of last participant enrolment
Anticipated
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Actual
14/12/2021
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Date of last data collection
Anticipated
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Actual
14/12/2021
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Sample size
Target
10
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Accrual to date
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Final
10
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Recruitment in Australia
Recruitment state(s)
QLD
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Recruitment hospital [1]
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Mackay Base Hospital - Mackay
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Recruitment postcode(s) [1]
33646
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4740 - Mackay
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Funding & Sponsors
Funding source category [1]
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Commercial sector/Industry
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Name [1]
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Shockwave Medical, Inc.
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Address [1]
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5403 Betsy Ross Dr., Santa Clara, CA 95054
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Country [1]
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United States of America
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Primary sponsor type
Hospital
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Name
Mackay Hospital and Health Service
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Address
Mackay Base Hospital 475 Bridge Rd, Mackay, QLD, 4740
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Country
Australia
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Secondary sponsor category [1]
309129
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None
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Name [1]
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Address [1]
309129
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Country [1]
309129
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
308295
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Townsville Hospital and Health Service Human Research Ethics Committee
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Ethics committee address [1]
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The Townsville Hospital, IMB 52, PO Box 670, Townsville QLD 4810
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Ethics committee country [1]
308295
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Australia
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Date submitted for ethics approval [1]
308295
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Approval date [1]
308295
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03/02/2021
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Ethics approval number [1]
308295
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Summary
Brief summary
Coronary calcification complicates the delivery and expansion of stents and is a risk factor for major adverse cardiovascular events such as cardiac death or myocardial infarction. Intravascular lithotripsy (IVL) provides a variation to currently available percutaneous coronary interventions by delivering an acoustic pressure wave within the balloon to modify calcium, and in doing so enhancing vessel accessibility and providing a better environment for stent deployment. IVL has shown safety and effectiveness in multicentre studies, and our study will confirm the benefits of IVL in the context of our local facility for optimising stent implantation in calcified coronary lesions.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Michael Zhang
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Address
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Mackay Base Hospital 475 Bridge Rd, Mackay, QLD, 4740
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Country
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Australia
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Phone
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+61 7 4885 7953
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Michael Zhang
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Address
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Mackay Base Hospital 475 Bridge Rd, Mackay, QLD, 4740
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Country
110215
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Australia
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Phone
110215
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+61 7 4885 7953
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Matthew Hiskens
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Address
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Mackay Base Hospital 475 Bridge Rd, Mackay, QLD, 4740
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Country
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Australia
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Phone
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+61 7 4885 6793
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Fax
110216
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
All IPD that underlie results in a publication.
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When will data be available (start and end dates)?
From January 1, 2022 with no end date.
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Available to whom?
Public accessibility.
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Available for what types of analyses?
Analysis will be undertaken by research team.
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How or where can data be obtained?
By emailing the principal investigator
[email protected]
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
11351
Study protocol
381789-(Uploaded-12-04-2021-15-22-57)-Study-related document.docx
11352
Informed consent form
381789-(Uploaded-12-04-2021-15-22-28)-Study-related document.docx
11353
Ethical approval
381789-(Uploaded-12-04-2021-15-22-00)-Study-related document.pdf
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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