Kardiologie I, Universitätsmedizin Mainz, Mainz, Rheinland-Pfalz, Germany.
DZHK, Standort Rhein-Mainz, Universitätsmedizin Mainz, Mainz, Rheinland-Pfalz, Germany.
BMJ Open. 2020 Jun 16;10(6):e034264. doi: 10.1136/bmjopen-2019-034264.
To assess the impact of 'reverse T and Protrusion' (TAP) technique on the outcome after stenting of true bifurcation lesions of the left main (LM) or proximal epicardial vessels as compared with double kissing (DK)-crush technique.
50 consecutive patients with true coronary bifurcation lesion (Medina 1,1,1 or 0,1,1) of the LM or the proximal main vessels, requiring a two-stent technique as first-line strategy at University Medical Center Mainz, are randomised in a 1:1 ratio to reverse TAP or DK-crush stenting. As recommended by best clinical practice, final angiographic result is evaluated and optical coherence tomographic (OCT) intracoronary imaging is performed to assess and optimise the final result. The primary end point is defined as the percentage of stent expansion in the side branch. Secondary end points consist of angiographic and procedural success (assessed until patient's discharge), procedural parameters (procedural time, fluoroscopy time, use of devices, X-ray dose) and OCT parameters expressing expansion of the stents. Safety parameters include all adverse events up to 6 months after discharge. A clinical, angiographic and intracoronary imaging control at 6 months is planned.
The protocol complies with good clinical practice and the ethical principles described in the Declaration of Helsinki and is approved by the local ethics committee. The results of the trial will be published as original article(s) in medical journals and/or as presentation at congresses.
ClinicalTrials.gov Registry (NCT03714750).
评估“反向 T 和突出”(TAP)技术与双吻(DK)-压碎技术相比,对左主干(LM)或心外膜近端血管真性分叉病变支架置入术后结果的影响。
50 例连续的左主干或近端主血管真性冠状动脉分叉病变(Medina 1,1,1 或 0,1,1)患者,需要双支架技术作为一线策略,在美因茨大学医学中心随机分为 1:1 比例的反向 TAP 或 DK-压碎支架置入组。根据最佳临床实践建议,评估最终血管造影结果,并进行光学相干断层扫描(OCT)冠状动脉内成像,以评估和优化最终结果。主要终点定义为侧支支架扩张的百分比。次要终点包括血管造影和程序成功(直至患者出院评估)、程序参数(程序时间、透视时间、器械使用、X 射线剂量)和表示支架扩张的 OCT 参数。安全参数包括出院后 6 个月内的所有不良事件。计划在 6 个月时进行临床、血管造影和冠状动脉内影像学随访。
该方案符合良好临床实践和赫尔辛基宣言中描述的伦理原则,并获得了当地伦理委员会的批准。试验结果将作为原始文章发表在医学期刊上,并/或以会议报告的形式发表。
ClinicalTrials.gov 注册号(NCT03714750)。