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Идёт набор NCT05704296

Saphenous Vein as Y-composite Versus Aortocoronary Conduit for CABG

Без фазы С лечением Coronary Artery Disease

Ориентир для пациента и семьи

Простыми словами

Автоматическая сводка по структурированным данным реестра. Она помогает сориентироваться, но не заменяет официальный протокол или оценку врача.

Что изучают
В протоколе указаны: Y-composite grafting, Aortocoronary grafting.
Кому может быть актуально
Состояния в реестре: Coronary Artery Disease. Базовые параметры: от 19 лет · Все.
Что важно проверить
Возраст, диагноз и пол — только базовые ориентиры. Предыдущее лечение, анализы и другие обязательные условия указаны ниже в критериях участия.
Где проводится
South Korea
Следующий шаг
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Официальное название

Comparison Between the Saphenous Vein as Y-composite Graft Based on the Left Internal Thoracic Artery Versus Aortocoronary Conduit for Coronary Artery Bypass Grafting: A Prospective Randomized Controlled Trial

Обзор

Left internal thoracic artery (LITA) has been acknowledged as the first graft of choice for coronary artery bypass grafting (CABG). However, it is still not conclusive which one is the best second graft of choice among right internal thoracic artery, radial artery, right gastroepiploic artery, saphenous vein, and etc., as well as its configuration for CABG. In our institution, saphenous vein has been primarily used for the second graft and we have harvested it with 'No touch technique'. We have been demonstrated the excellent long-term patency of this 'No touch saphenous vein' in many studies. However, it is still unknown which configuration is the better strategy for the saphenous vein as a Y-composite graft based on the left internal thoracic artery versus an aortocoronary conduit. Thus, we aimed to evaluate morphologic change of saphenous vein graft by 1-year intravascular ultrasound (IVUS) study and angiographic patency results between Y-composite graft and aortocoronary conduit.

Подробное описание

The enrolled patient underwent routine sternotomy, and left internal thoracic artery (LITA) and saphenous vein (SV) are harvested. After harvest, the patient is randomized to Y-composite group or aortocoronary group.

For Y-composite group, SV is anastomosed to LITA as Y-composite fashion. Then, LITA is anastomosed to left anterior descending artery. SV is anastomosed to the rest of the target vessels with sequential anastomosis technique (e.g. diagonal branch, obtuse marginal branch, posterolateral branch and posterior descending artery).

For aortocoronary group, LITA is anastomosed to left anterior descending artery. Then, SV is anastomosed to ascending aorta using proximal anastomosis assist device without clamping the aorta. SV is anastomosed to the rest of the target vessels with sequential anastomosis technique (e.g. diagonal branch, obtuse marginal branch, posterolateral branch and posteriori descending artery).

At 1-year follow-up, coronary angiography is performed to evaluate the patency of the saphenous vein graft. Clinical outcomes are also evaluated.

Вмешательства

  • Процедура Y-composite grafting
    Saphenous vein is used as a Y-composite graft during coronary artery bypass grafting
  • Процедура Aortocoronary grafting
    Saphenous vein is used as an aortocoronary graft during coronary artery bypass grafting

Первичные конечные точки

  • Graft patency [Срок оценки: at postoperative 1 year]
Вторичные конечные точки (5)
  • All-cause mortality [Срок оценки: at postoperative 1 year]
  • Cardiac death [Срок оценки: at postoperative 1 year]
  • Target vessel revascularization [Срок оценки: at postoperative 1 year]
  • Reintervention [Срок оценки: at postoperative 1 year]
  • Major Adverse Cardiac Events (MACEs) [Срок оценки: at postoperative 1 year]

Критерии участия

Критерии включения

  • A patient who is going to receive coronary artery bypass grafting
  • Older than 19 years
  • Coronary artery bypass grafting is going to be performed with left internal thoracic artery and saphenous vein graft

Критерии исключения

  • Other concomitant procedures (e.g. valve or aorta surgery) is planned
  • Patients with severe comorbidities which limit the life expectancy of them below 1 year (e.g. terminal cancer)
  • Patients whose left internal thoracic artery or saphenous vein is not available due to the low quality, severe injury, or absence of the graft
  • Patients whose ascending aorta is not suitable to aortocoronary anastomosis (e.g. ascending aorta aneurysm, porcelain aorta)
  • Emergency operation
  • Patients who have connective tissue disease
  • Reoperative coronary artery bypass grafting

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение
Рандомизированное
Модель
Параллельные группы
Маскирование
Открытое
Основная цель
Лечение

Центры проведения

South Korea · 1 центр
  • Seoul National University Hospital — Seoul

Идентификаторы

NCT: NCT05704296 · H-2211-023-1376

Первоисточники (государственные реестры)

Открыть это исследование на ClinicalTrials.gov ↗