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Two-stent vs Provisional Stenting Techniques for Patients With Complex Coronary Bifurcation Lesions

A Prospective, Multi-center, Randomized Trial Comparing Two-stent With Provisional Stenting Techniques for Patients With Complex Coronary Bifurcation Lesions

Status
Completed
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT02284750
Acronym
DEFINITION-II
Enrollment
660
Registered
2014-11-06
Start date
2015-12-31
Completion date
2019-12-31
Last updated
2019-12-16

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Coronary Artery Disease

Keywords

Bifurcation lesion, Percutaneous coronary intervention

Brief summary

The purpose of this study is to establish the optimal strategy for stenting in coronary bifurcation lesion.

Detailed description

The current study is designed as a multicenter, randomized and prospective study aiming to compare the effect of two-stenting and simple stenting techniques in patients with complex bifurcation lesions. Based on the previous studies, the rate of 1-year target lesion failure events was around 14% after PCI with provisional stenting. And our previous data showed that this event at 12-month after two-stenting procedure was 7%. Considering the lost to follow-up, it is anticipated that up to 660 patients will be enrolled in the trial. All patients will have repeat angiography at 13 months, with clinical follow-up to 5 years.

Interventions

PROCEDUREPercutaneous coronary intervention

Sponsors

Nanjing First Hospital, Nanjing Medical University
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Provision of informed consent prior to any study specific procedures; * Men and women 18 years and older;. * Established indication to PCI according to the guidelines of American Heart Association and American College of Cardiology; * Native coronary lesion suitable for drug-eluting stent placement; * True bifurcation lesions (Medina 0,1,1/1,1,1); * Reference vessel diameter in side branch ≥2.5mm by visual estimation; * Complex bifurcation lesions based on DEFINITION study.

Exclusion criteria

* Pregnancy and breast feeding mother; * Co-morbidity with an estimated life expectancy of \< 50 % at 12 months; * Scheduled major surgery in the next 12 months; * Inability to follow the protocol and comply with follow-up requirements or any other reason that the investigator feels would place the patient at increased risk; * Unable to provide written informed consent, or fail to follow the protocol; * Previous enrolment in coronary intervention device investigation during the study period; * Patient with STEMI within 24-hour from the onset of chest pain to admission; * Restenosis bifurcation lesions.

Design outcomes

Primary

MeasureTime frameDescription
Target lesion failure12 monthsCombined end point of: cardiac death, target-vessel myocardial infarction (MI), or target lesion revascularization (TLR).

Secondary

MeasureTime frame
Target-vessel myocardial infarction12 months
Target lesion revascularisation12 months
Target vessel revascularisation12 months
Stent thrombosis12 months
Cardiac death12 months

Other

MeasureTime frameDescription
Late lumen loss13 monthsThe late lumen loss was defined as the difference between post- and follow-up minimal lumen diameter (MLD)
In-stent restenosis13 monthsIn-stent restenosis was defined as ≥50% diameter stenosis at the follow-up angiogram.
Acute gainIntraoperativeThe acute gain was defined as the difference between post- and preprocedural minimal lumen diameter (MLD)

Countries

China

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 24, 2026