Ling Tao
Xi'an, Shannxi, 710032, China
NCT Number: NCT06373120
In patients with complex coronary artery disease (CAD), determining the optimal revascularization strategy (percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) remains a challenge. These high-risk patients pose an extreme surgical risk. However, with the development of new interventional techniques and materials, PCI is a good alternative to CABG and is referred to as complex high-risk indicated PCI (CHIP).
During CHIP, hemodynamics can deteriorate because of temporary complete coronary occlusion or profound myocardial ischemia. This could result in loss of cardiac output and hemodynamics collapse. Mechanical support during CHIP facilitates native cardiac function by achieving a stable hemodynamic state to withstand repetitive derangements such as ischemia caused by prolonged and repeated balloon inflations, and resume original cardiac function immediately postprocedure or shortly thereafter.
There are several mechanical circulatory support (MCS) systems available, i.e., intra-aortic balloon counterpulsation (IABP), Impella, TandemHeart, and veno-arterial extracorporeal membrane oxygenation (VA-ECMO). These MCS have been widely studied in patients with acute myocardial infarction (MI) complicated by cardiogenic shock and showed conflicting results. However, studies regarding the use of MCS in the setting of CHIP are much less abundant and no randomized study has compared Impella with VA-ECMO in CHIP patients.
The aim of the study is to evaluate the effectiveness of interventional ventricular assist system (CorVad) compared to the venoarterial extracorporeal membrane oxygenation (VA-ECMO) system in providing circulatory support for complicated and high-risk patient with indications for PCI.
This study is active but is not currently recruiting participants.
Notify Me18 year–90 year
All sexes
Interventional
Not applicable
Xi'an, Shannxi, 710032, China
Healthy volunteers accepted: No
Only the study team can determine whether someone qualifies for participation.
Inclusion criteria
Image inclusion criteria
Complex PCI maneuvers are defined as:
Exclusion criteria
The microaxial flow pump (The CorVad percutaneous ventricular assist system device) is a microaxial rotary blood pump that expels blood from the left ventricle into the ascending aorta, thus unloading the left ventricle. The CorVad system device can be introduced through a femoral percutaneous approach (14Fr) and can deliver an output of up to 4-6 L/min.
Veno-arterial extracorporeal Membrane Oxygenation (VA-ECMO) is a device originally created to replace heart and lung function. Venous deoxygenated blood is mechanically suctioned from a large central vein through a venous cannula by a centrifugal pump. It is then oxygenated, warmed, and restored into systemic circulation through an arterial cannula.
Time frame: 1 month
Major adverse event is a composite endpoint, defined as all-cause death, stroke, myocardial infarction, revascularization, cardiovascular hospitalization, MCS-ARC defined bleeding types 3, 4, or 5, acute kidney injury, serious device-related adverse events, cardiopulmonary resuscitation
Time frame: 1, 3, 12, 24, 36, and 60 months
Time frame: 1, 3, 12, 24, 36, and 60 months
Time frame: 1, 3, 12, 24, 36, and 60 months
Time frame: 1, 3, 12, 24, 36, and 60 months
Time frame: 1, 3, 12, 24, 36, and 60 months
Rehospitalization due to cardiovascular reasons
Time frame: 1 month
Bleeding is defined by the "Updated definitions of adverse events for trials and registries of mechanical circulatory support: A consensus statement of the mechanical circulatory support academic research consortium" (MRC-ARC)
Time frame: 1 month
Time frame: 1 month
Including but not limited to cardiac structural impairment, severe limb ischemia (pale, pulseless, and necrotic), infection, aortic and aortic valve impairment, hemolysis, peri-procedural complications that cause death, permanent/severe disability to the subject, or significantly prolonged hospital stay or need for surgical intervention
Time frame: 1 month
Time frame: 1 month
Time frame: 1 month
Time frame: 1 month
Time frame: 1 month
Hemodynamic disorder is defined as average arterial pressure (MAP) below 60 mmHg for more than 10 minutes with the requirement of additional vasoactive medications
Time frame: 1 month
Transfusion rate is defined as patients who had transfusion / all enrolled patients.
Time frame: 1 month
Time frame: 3, 12, 24, 36, and 60 months
Major adverse event is a composite endpoint, defined as all-cause death, stroke, myocardial infarction, revascularization, cardiovascular hospitalization, MCS-ARC defined bleeding types 3, 4, or 5, acute kidney injury, serious device-related adverse events, cardiopulmonary resuscitation
Time frame: 1, 3, 12, 24, 36, and 60 months
Major Adverse Cardiovascular and Cerebrovascular Events is a composite endpoint, defined as all-cause death, stroke, myocardial infarction, revascularization, cardiovascular hospitalization
Time frame: 1, 3, 12, 24, 36, and 60 months
Device-related composite endpoint (DoCE), defined as: cardiac death, target-vessel myocardial infarction (TV-MI), clinically and physiologically driven target lesion revascularization (CPI-TLR)
Time frame: 1, 3, 12, 24, 36, and 60 months
Patient-related composite endpoint (PoCE), defined as: all-cause death, any stroke, any myocardial infarction, and any revascularization
Time frame: 1, 3, 12, 24, 36, and 60 months
Net adverse clinical events, defined as: PoCE + MCS-ARC defined type 3, 4, 5 bleeding
Time frame: 1, 3, 12, 24, 36, and 60 months
Time frame: 1, 3, 12, 24, 36, and 60 months
Time frame: 1, 3, 12, 24, 36, and 60 months
Time frame: 1, 3, 12, 24, 36, and 60 months
Time frame: 1, 3, 12, 24, 36, and 60 months
Time frame: 1, 3, 12, 24, 36, and 60 months
Time frame: 1, 3, 12, 24, 36, and 60 months
Time frame: 1, 3, 12, 24, 36, and 60 months
Time frame: 1, 3, 12, 24, 36, and 60 months
Time frame: 1 month
Time frame: 1 month
Puncture complications: Vascular complications or percutaneous vascular suture failure
Time frame: 1 month
Aortic valve injury is defined as the occurrence of moderate and severe aortic valve regurgitation in patients with no pre-operative aortic valve regurgitation or mild regurgitation
Time frame: 1 month
Active infection refers to an infection accompanied by clinical evidence, including pain, fever, or imaging findings consistent with infection, and requires the use of antimicrobial drugs for treatment. The definition of infection requires positive culture results from the site or organ of infection, unless there is strong clinical evidence indicating the presence of infection and the need for treatment.
Time frame: assessed at index PCI procedure
Setup time is defined as the time from starting vessel puncture to the time providing cardiac support by the device
Time frame: 1 month
Complete revascularization is defined as the residual SYNTAX score ≤ 8 points
Time frame: 1, 12, 24, 36, and 60 months
Time frame: 1, 12, 24, 36, and 60 months
Time frame: 1, 12, 36, and 60 months
The SAQ is a 19-item self-administered disease-specific patient-reported outcome measure with 5 domains: physical limitation, angina stability, angina frequency, treatment satisfaction, and disease perception and/or quality of life. It was to identify a conceptual framework with which to elicit the important manifestations of coronary disease from the patient perspective. All SAQ domain scores and the summary score range from 0 to 100 points, with higher scores indicating less angina, fewer functional limitations, and better quality of life.
Time frame: 1, 12, 36, and 60 months
The KCCQ is a self-administered, 23-item questionnaire that quantifies physical limitations, symptoms, self-efficacy, social interference and quality of life. KCCQ scores range from 0 to 100, with higher scores indicating fewer symptoms and physical limitations.
Time frame: 1, 12, 36, and 60 months
The EQ-5D is a standardized instrument for use as a measure of health outcome which can be divided into two parts: the EQ-5D health description system and the EQ-vas. EQ-5D-5L questionnaire is a five-item scale assessing five separate dimensions of health: (mobility, self-care, usual activities, pain/discomfort and anxiety/depression). Each dimension has to be answered on a five-level scale (no problems, slight problems, moderate problems, severe problems and extreme problems). The EQ-VAS is a 20 cm long vertical visual scale. A score of 100 at the top represents "best perceived health status" and a score of 0 at the bottom represents "worst perceived health status".
Time frame: 1 month
Time frame: 1, 3, 12, 24, 36, and 60 months
Shenzhen Core Medical Technology CO.,LTD.
Industry
Interventional Ventricular Assist System for PCI in Complicated and High-risk Patient: a Prospective, Multicenter, Randomized Trial
Acronym: REC-CHIPMCS
OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.
View the official ClinicalTrials.gov record (opens in a new tab)This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.
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