Clinical Trial: Guidewire for Chronic Total Occlusion
Study Status: Completed
Recruit Status: Completed
Study Type: Interventional
Official Title: Multicenter Prospective Randomized Study of First-choice Guidewires in Percutaneous Coronary Intervention for Chronic Total Occlusion
Brief Summary: Under the circumstances that appropriate first-choice guidewires for percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) have yet to be established, the objective of this study is to determine appropriate first-choice guidewires. G-FORCE study is a prospective multicenter randomized study between normal (distal tip size 0.014 inch) and slender (distal tip size 0.010 inch or less) guidewires. Primary end point is lesion penetration rate of the first choice guidewire.
Detailed Summary:
Background. Although the success rate of PCI for CTO is yet to reach a satisfactory level, prognoses have been improved in successful cases. The greatest challenge is the passage of the guidewire and a variety of new approaches including a parallel wire technique and a retrograde approach have been reported. However, the fundamental question of what type of guidewire is the most appropriate as a first-choice guidewire has not been answered.Tapered guidewires have recently been reported to be useful for CTO lesions. In addition, a multicenter prospective registry indicates the effectiveness of 0.010-inch guidewires (PIKACHU registry, personal communication). Its mechanism is associated with micro-channels ranging from 100 to 300 μm in size in CTO lesions. If 250 μm micro-channels are present in 60% of CTO lesions, a 0.010-inch (equivalent to 250 μm) guidewire theoretically can pass through the lesion at the probability of 60%, and this assumption consists with the findings of the PIKACHU study. This idea also suggests that a 0.014-inch (350 μm) guidewire is unlikely to pass through lesions.
Based on the above, a hypothesis has been formulated that a guidewire with a small tip should be selected as a first-choice guidewire for CTO lesions. In this study, patients will be prospectively randomized to slender guidewires or standard 0.014-inch guidewires to determine appropriate first-choice guidewires.
Objective. To determine appropriate first-choice guidewires.
Design. Prospective multicenter randomized controlled trial
Methods. The first choice guidewire to treat CTO lesion was randomly assigned to normal group (distal tip size 0.014 inch) or slender group (distal tip size 0.010 inch or less). The primary pa
Sponsor: Tokai University
Current Primary Outcome: Lesion penetration rate of a first-choice guidewire [ Time Frame: 30 days ]
Original Primary Outcome: Lesion penetration rate of a first-choice guidewire [ Time Frame: The end of PCI ]
Current Secondary Outcome:
- Successful PCI rate [ Time Frame: 30 days ]
- Types of guidewires successfully passing through the lesion [ Time Frame: 30 days ]
- Major adverse cardio-cerebral events (MACCEs: total death, MI, stroke, and all revascularization procedures) [ Time Frame: 30 days ]
Original Secondary Outcome:
- Successful PCI rate [ Time Frame: the end of PCI ]
- Types of guidewires successfully passing through the lesion [ Time Frame: the end of PCI ]
- Major adverse cardio-cerebral events (MACCEs: total death, MI, stroke, and all revascularization procedures) [ Time Frame: 30 days ]
Information By: Tokai University
Dates:
Date Received: September 29, 2009
Date Started: October 2009
Date Completion:
Last Updated: May 1, 2015
Last Verified: May 2015
