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CompletedNCT04538534Updated Feb 8, 2022

Nicardipine to Avoid Spasm in Trans Radial Percutaneous Coronary Intervention

A Phase 3 interventional study of Nicardipine in Spasm Artery, sponsored by Pr. Semir Nouira. Completed at 1 site in Tunisia. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2022-02-08.

Sponsored by Pr. Semir Nouira · Phase 3, Interventional, and Prevention

Phase
Phase 3
Study type
Interventional
Enrollment
1,500
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

Radial artery is the recommended route for percutaneous coronary intervention for it significantly reduces net adverse clinical events compared to the femoral approach. The success of the radial approach is therefore of a paramount importance. However, radial artery spasm (RAS) remains one of the major limitations of transradial approach (TRA) and the most frequent cause of TRA failure. Several recommendations has been issued to improve success rate when using the radial route.

In the Tunisian difficult economic context, the use of low end equipment, the unavailability of nitroglycerine and calcium antagonist verapamil, has led to the general feeling that RAS and TRA failure has subsequently increased.

The standard and only used protocol by the Tunisian interventional cardiologist, consists of administrating 1 mg isosorbide dinitrate through the arterial sheath immediately after radial arterial puncture, therefore limiting the options to prevent RAS.

Nicardipine is the only injectable calcium antagonist available in Tunisia. Its spasmolytic action on radial artery has been well demonstrated when used in CABG. However, it has been very poorly investigated in trans radial percutaneous coronary intervention.

Investigators believe that the concomitant use of nicardipine with isorbide might significantly reduce RAS and TRA failure when compared to isosorbide dinitrate only.

02

Conditions studied

  • Spasm Artery

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Keywords

  • radial artery spasm
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • All patients scheduled for coronary intervention will be eligible for screening (coronarography or coronary angioplasty).
  • Participant is willing and is able to give informed consent for participating in the trial.
  • Male or Female, aged 18 years or above.

Exclusion criteria

Exclusion Criteria:

  • Planned femoral approach because no radial pulse was perceived
  • Cardiogenic shock
  • Coronary intervention for ST elevation myocardial infarction during the night shift.
04

Study design

Phase
Phase 3
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
1,500 participants (actual)

Study arms

  • Experimental
    nicardipine and isosorbide dinitrate

    A Cocktail of 1 mg of Isosorbide Dinitrate associated to 1 mg of nicardipine will be put in a syringe than diluted in saline serum to have a volume of 3cc. The obtained solution will be administered in an intra-arterial fashion via the trans-radial sheath after randomization.

    Drug: Nicardipine

  • Active comparator
    isosorbide dinitrate

    Isosorbide Dinitrate: 1 mg will be diluted in saline solution as to have a 3cc volume The obtained solution will be administered in an intra-arterial fashion via the trans-radial sheath after randomization

    Drug: Nicardipine

Interventions

  • DrugNicardipine

    To compare the association of nicardipine and isosorbide dinitrate vs isosorbide dinitrate alone on the rate of occurrence of radial artery spasm

    Also known as: Loxen

05

What researchers measure

Primary outcomes

  1. Number of Participants in which radial artery spasm occurred

    Significant limitation of the catheter movement perceived by the operator together with mild to severe pain in the forearm of the patient or the need of repeating vasodilator administration

    Time frame: 24 hours

Secondary outcomes

  1. Number of Participants in which severe radial artery spasm occurred

    Complete catheter blockage \[i.e., the catheter cannot be moved back or forth\], severe pain with need for morphine or midazolam injections, crossover to the contralateral radial or femoral artery

    Time frame: 24 hours

06

Study locations

1 site
  • CHU Fattouma Bourguiba
    Monastir, 5000, Tunisia
07

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT04538534
Lead sponsor
Pr. Semir Nouira
Responsible party
Pr. Semir Nouira (MD, University of Monastir) — Sponsor-investigator
First posted
Sep 4, 2020
Start date
Nov 1, 2020
Primary completion
Feb 1, 2022
Completion
Feb 1, 2022
Last update
Feb 8, 2022

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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