Extracorporeal Shockwave Therapy for the Treatment of Refractory Angina Pectoris
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Purpose
Low intensity shockwaves have been proven in animal studies to induce local growth of new blood vessels from existing ones.
The hypothesis of this study is that shockwave therapy could improve the symptoms of patients with refractory angina not amenable to revascularization with angioplasty or bypass surgery.
| Condition | Intervention | Phase |
|---|---|---|
|
Refractory Angina Pectoris |
Device: Cardiac Extracorporeal Shockwave Therapy generator (Cardiospec) Device: Placebo |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver) Primary Purpose: Treatment |
| Official Title: | Randomized, Placebo Controlled, Double Blind Clinical Trial Evaluating the Treatment of Patients With Refractory Angina Pectoris With Low Intensity Extracorporeal Shockwave Therapy Device |
- Total Exercise Time [ Time Frame: 6 months ] [ Designated as safety issue: No ]
- Change in SPECT [ Time Frame: 6 months ] [ Designated as safety issue: No ]
- Change in AP-CCS [ Time Frame: 6 months ] [ Designated as safety issue: No ]
| Enrollment: | 28 |
| Study Start Date: | January 2007 |
| Study Completion Date: | November 2012 |
| Primary Completion Date: | June 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: A
A - Treatment group. Patients in this group receive actual shockwave therapy.
|
Device: Cardiac Extracorporeal Shockwave Therapy generator (Cardiospec)
Energy Density - 0.09 mJ/mm2
Other Names:
|
|
Placebo Comparator: B
Placebo group. This group of patients undergo the same procedure as the treatment group, however shockwaves are not delivered to the heart.
|
Device: Placebo
Placebo
|
Detailed Description:
Low intensity shockwaves (1/10 the ones used in Lithotripsy) are delivered to myocardial ischemic tissue. Shockwaves are created by a special generator and are focused using a shockwave applicator device. The treatment is guided by standard echocardiography equipment. The shockwaves are delivered in synchronization with Patient R-wave to avoid arrhythmias. The treatment is painless.
At first, the patient undergoes stress- SPECT testing to identify the ischemic areas. Following that, the same area is localized by the ultra-sound device and the shockwaves are focused to the ischemic area. Several treatments are required for optimal results.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Diagnosed with chronic stable angina pectoris.
- Documented myocardial segments with reversible ischemia
- AP CCS class of III-IV.
- Stable dosage of medication used to treat angina for at least 6 weeks prior to enrollment.
- Exercise tolerance time < 10 min (modified Bruce)
- Two ETT tests results (within two weeks) averaging no more than 25% of their mean
- Documented epicardial coronary artery disease not amenable to angioplasty or CABG.
- Signed an IRB approved informed consent form.
- Life expectancy of >12 months.
Exclusion Criteria:
- Intraventricular thrombus
- Malignancy in the area of treatment
- Severe COPD
- No smoking during the study procedure
- MI less <3 months prior to treatment
- Severe Valvular disease
- Child bearing potential
Contacts and Locations| Israel | |
| Hadassah-Hebrew University Medical Center | |
| Jerusalem, Israel | |
| Principal Investigator: | David Leibowitz, MD | Hadassah Medical Organization |
More Information
No publications provided
| Responsible Party: | Medispec |
| ClinicalTrials.gov Identifier: | NCT00662727 History of Changes |
| Other Study ID Numbers: | ESMR-RCT-IL |
| Study First Received: | April 14, 2008 |
| Last Updated: | February 17, 2013 |
| Health Authority: | Israel: Ethics Commission |
Keywords provided by Medispec:
|
Extracorporeal Shockwave Therapy Myocardial Ischemia Refractory Angina |
Additional relevant MeSH terms:
|
Angina Pectoris Myocardial Ischemia Heart Diseases Cardiovascular Diseases |
Vascular Diseases Chest Pain Pain Signs and Symptoms |
ClinicalTrials.gov processed this record on June 18, 2013