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Five-year Patency of No-touch Saphenous Vein Grafts in On-pump Versus Clamp-less Off-pump Coronary Artery Bypass Surgery

Primary Purpose

Coronary Artery Stenoses

Status
Completed
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
The use of extracorporeal circulation
Sponsored by
Örebro County Council
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Coronary Artery Stenoses

Eligibility Criteria

55 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Patients were eligible if they:

    1. provided written informed consent;
    2. were >21 years of age;
    3. required isolated CABG with median sternotomy;
    4. had at least one of the following risk factors:

      1. had peripheral vascular disease (previous peripheral bypass, amputation or anklebranchial index <0.90),
      2. had cerebrovascular disease (history of stroke, transient ischemic attach or carotid stenosis ≥70%),
      3. had renal insufficiency (creatinine above upper limit of normal),
      4. were ≥70 years of age, or
      5. were between the ages of 60-69 with one of the following: i. had diabetes and taking an oral hypoglycemic agent and/or insulin, ii. required urgent revascularization (i.e., waiting in hospital for revascularization after an acute coronary syndrome), iii. were a recent smoker (within 1 year of randomization), or iv. had left ventricular ejection fraction ≤35%, OR
      6. were between the ages of 55-59 with two of the following: i. Diabetes and taking an oral hypoglycemic agent and/or insulin, ii. required urgent revascularization (i.e., waiting in hospital for revascularization after an acute coronary syndrome, iii. were a recent smoker (within 1 year of randomization), or iv. had a left ventricular ejection fraction ≤35%

Exclusion Criteria:

  • Patients were excluded if they:

    1. required a concomitant cardiac procedure associated with CABG;
    2. had a contraindication to off-pump or on-pump CABG (e.g., calcified aorta, intramuscular left anterior descending artery, calcified coronaries, small target vessels);
    3. had a concomitant life-threatening disease likely to limit life expectancy to less than 2 years;
    4. were previously enrollment in the CORONARY Trial;
    5. required emergency CABG surgery (i.e., immediate revascularization for hemodynamic instability); OR
    6. required a redo CABG.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Active Comparator

    No Intervention

    Arm Label

    On-Pump

    Off-Pump

    Arm Description

    Use of extracorporeal circulation

    Outcomes

    Primary Outcome Measures

    Graft patency
    Graft patency as assessed with computed tomography angiography

    Secondary Outcome Measures

    Full Information

    First Posted
    February 20, 2018
    Last Updated
    February 25, 2018
    Sponsor
    Örebro County Council
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    1. Study Identification

    Unique Protocol Identification Number
    NCT03447197
    Brief Title
    Five-year Patency of No-touch Saphenous Vein Grafts in On-pump Versus Clamp-less Off-pump Coronary Artery Bypass Surgery
    Official Title
    Five-year Patency of No-touch Saphenous Vein Grafts in On-pump Versus Clamp-less Off-pump Coronary Artery Bypass Surgery: A Sub-study of a Multicenter Randomized Controlled Trial
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    February 2018
    Overall Recruitment Status
    Completed
    Study Start Date
    September 1, 2015 (Actual)
    Primary Completion Date
    December 31, 2016 (Actual)
    Study Completion Date
    December 31, 2017 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Principal Investigator
    Name of the Sponsor
    Örebro County Council

    4. Oversight

    Studies a U.S. FDA-regulated Drug Product
    No
    Studies a U.S. FDA-regulated Device Product
    No
    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    Randomised controlled trials (RCTs) have shown high long-term patency for no-touch saphenous vein grafts (NTSVGs), comparable to the internal thoracic artery in on-pump coronary artery bypass grafting (CABG). RCTs on patency in NTSVGs in off-pump CABG have not been published yet. Orebro University Hospital participated in the CABG Off- or On-pump Revascularization study (CORONARY, ClinicalTrials.gov number, NCT00463294) and included fifty-six patients. Accordingly, this is a sub-study and the aim was to assess the midterm patency in NTSVGs in clamp-less off-pump versus on-pump CABG at five-year follow-up.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Coronary Artery Stenoses

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Not Applicable
    Interventional Study Model
    Parallel Assignment
    Masking
    Outcomes Assessor
    Allocation
    Randomized
    Enrollment
    59 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    On-Pump
    Arm Type
    Active Comparator
    Arm Description
    Use of extracorporeal circulation
    Arm Title
    Off-Pump
    Arm Type
    No Intervention
    Intervention Type
    Procedure
    Intervention Name(s)
    The use of extracorporeal circulation
    Intervention Description
    The use or not of extracorporeal circulation during the coronary artery bypass procedure.
    Primary Outcome Measure Information:
    Title
    Graft patency
    Description
    Graft patency as assessed with computed tomography angiography
    Time Frame
    Five years postoperatively

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    55 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Patients were eligible if they: provided written informed consent; were >21 years of age; required isolated CABG with median sternotomy; had at least one of the following risk factors: had peripheral vascular disease (previous peripheral bypass, amputation or anklebranchial index <0.90), had cerebrovascular disease (history of stroke, transient ischemic attach or carotid stenosis ≥70%), had renal insufficiency (creatinine above upper limit of normal), were ≥70 years of age, or were between the ages of 60-69 with one of the following: i. had diabetes and taking an oral hypoglycemic agent and/or insulin, ii. required urgent revascularization (i.e., waiting in hospital for revascularization after an acute coronary syndrome), iii. were a recent smoker (within 1 year of randomization), or iv. had left ventricular ejection fraction ≤35%, OR were between the ages of 55-59 with two of the following: i. Diabetes and taking an oral hypoglycemic agent and/or insulin, ii. required urgent revascularization (i.e., waiting in hospital for revascularization after an acute coronary syndrome, iii. were a recent smoker (within 1 year of randomization), or iv. had a left ventricular ejection fraction ≤35% Exclusion Criteria: Patients were excluded if they: required a concomitant cardiac procedure associated with CABG; had a contraindication to off-pump or on-pump CABG (e.g., calcified aorta, intramuscular left anterior descending artery, calcified coronaries, small target vessels); had a concomitant life-threatening disease likely to limit life expectancy to less than 2 years; were previously enrollment in the CORONARY Trial; required emergency CABG surgery (i.e., immediate revascularization for hemodynamic instability); OR required a redo CABG.

    12. IPD Sharing Statement

    Learn more about this trial

    Five-year Patency of No-touch Saphenous Vein Grafts in On-pump Versus Clamp-less Off-pump Coronary Artery Bypass Surgery

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