Plain English Summary
Background and study aims
Coronary angiograms are performed to examine the condition of the arteries that supply blood to the heart muscle. Coronary angioplasty involves the widening of the heart arteries with a balloon, often followed by the placement of a metal mesh-like structure called a stent. Traditionally these have been performed by passing a narrow tube called a catheter through a sheath inserted into an artery in the groin called the femoral artery. There has been a rapidly growing trend to perform these procedures through an artery in the wrist called the radial artery. The radial route has the advantage of lower complications and patients are often able to move earlier following their procedures. The radial artery however is smaller than the femoral, it is also more muscular and prone to spasm. To help prevent this, radial sheaths can be coated with a slippery substance. In the past a small number of patients have reported a skin reaction at the puncture site (thought to be from this coating), a couple of weeks or so after their procedure. The manufacturers of the sheath have made changes to their product. The aim of this is to eliminate or reduce the chance of this reaction occurring. Subsequently the study team would now like to follow the patients after their procedure to confirm that their skin puncture heals satisfactorily. Other routine information about the performance of the sheath will also be collected such as whether the procedure could be completed as planned.
Who can participate?
Patients aged over 18 admitted to the study hospital for a planned radial coronary procedure
What does the study involve?
Participants undergo their procedure as normal. Before they go home, a member of the study team provides them with some additional and contact information. If they experience any problems with their puncture site, they are encouraged to contact the study team. If they do not experience a problem they are contacted at around 28 days to confirm the absence of problems.
What are the possible risks and benefits of participating?
There are no direct benefits to participants. Personal results are not used in any way without their permission. The overall anonymous group results of the study may be directly used to inform the manufacturer of the optimal design of their product. There are no additional risks in taking part in the study. The risks are the same as those explained by the doctor when they were asked to consent for the procedure.
Where is the study run from?
Liverpool Heart and Chest Hospital NHS Foundation Trust (UK)
When is the study starting and how long is it expected to run for?
October 2013 to April 2014
Who is funding the study?
Cook Medical (USA)
Who is the main contact for the study?
1. Mrs Christine Mars
Christine.Mars@lhch.nhs.uk
2. Dr Rod Stables
Rod.Stables@lhch.nhs.uk
Trial website
Contact information
Type
Scientific
Primary contact
Mrs Christine Mars
ORCID ID
Contact details
Research Nurse
Liverpool Heart and Chest Hospital NHS Foundation Trust
Thomas Drive
Liverpool
L14 3PE
United Kingdom
+44 (0)151 600 1158
Christine.Mars@lhch.nhs.uk
Additional identifiers
EudraCT number
ClinicalTrials.gov number
Protocol/serial number
801
Study information
Scientific title
A prospective, single centre registry study recruiting consecutive patients to examine the safety, efficacy and subsequent incidence of cutaneous reaction with use of the Cook Flexor Radial Introducer Set
Acronym
SACRED
Study hypothesis
Observational study to describe the incidence of granuloma reactions observed after use of the study sheath device for radial access for coronary diagnostic and interventional procedures.
Ethics approval
National Research Ethics Service (NRES) Committee North West - Liverpool Central; 12/01/2010; ref: 09/H1005/72
Study design
Observational prospective single-centre registry study
Primary study design
Observational
Secondary study design
Single-centre
Trial setting
Hospitals
Trial type
Diagnostic
Patient information sheet
Not available in web format, please use the contact details to request a patient information sheet
Condition
Cutaneous granuloma formation following the use of radial introducer sheaths used in coronary angiography and angioplasty procedures
Intervention
Patients will be provided with some additional information prior to discharge. What they might expect with normal healing will be explained to them. Patients will be encouraged to contact the study team via email or dedicated phone line with voice messaging facilities. Such patients will be invited to return to the study centre for clinical review to allow formal assessment of the puncture site for the primary outcome measure. All other patients will be contacted by telephone, text or email at 28 days (+ 7 days) to confirm the absence of problems. Patients will equivocal responses will be invited for clinical assessment.
It is important to note that the sheath being studied is currently in use in all patients undergoing coronary angiography or angioplasty via the radial artery at the study centre. In participating in the study, patients are not being asked to trial a new or different sheath from any other patient.
Intervention type
Device
Phase
Not Applicable
Drug names
Primary outcome measures
The incidence of granuloma formation by 28 days defined as an indurated, erythematous lesion, at least 3mm in its longest diameter, not related to haematoma
Secondary outcome measures
1. The rate of successful insertion of the study sheath device
2. The rate of successful completion of the coronary procedure through the initial sheath device
3. The incidence of administration of intra-arterial vasodilator agents for the management of coronary artery spasm (routine administration is not practice at the study centre)
The rate of other vascular complications
1. Small haematoma ≤ 3cm diameter
2. Large haematoma > 3cm diameter
3. The incidence of blood transfusion related to access site complications
4. The incidence of surgical or other interventional procedures for the management of vascular access complications
5. Delayed discharge necessitating an unplanned night or more in hospital related to vascular access complications
All secondary outcome measures are recorded following the index procedure and prior to hospital discharge.
Overall trial start date
09/10/2013
Overall trial end date
30/04/2014
Reason abandoned
Eligibility
Participant inclusion criteria
1. Patients admitted for cardiac procedures with planned radial access
2. Patients under the care of a participating consultant
Participant type
Patient
Age group
Adult
Gender
Both
Target number of participants
415 including 2-3% failure rate
Participant exclusion criteria
1. Patients under 18 years of age
2. Patients unable to give informed consent
3. Patients who feel unable or unwilling to return to the study centre for outcome measure assessment
4. Patients who have had previous procedures through the same radial access site
5. Emergency or high risk procedures with survival doubt
6. Where there is a known sensitivity to the study device
Recruitment start date
09/10/2013
Recruitment end date
06/03/2014
Locations
Countries of recruitment
United Kingdom
Trial participating centre
Liverpool Heart and Chest Hospital NHS Foundation Trust
Liverpool
L14 3PE
United Kingdom
Sponsor information
Organisation
Liverpool Heart and Chest Hospital NHS Foundation Trust (UK)
Sponsor details
c/o Dr Margarita Perez-Casal
Thomas Drive
Liverpool
L14 3PE
United Kingdom
+44 (0)151 600 1616
Margarita.Perez-Casal@lhch.nhs.uk
Sponsor type
Hospital/treatment centre
Website
Funders
Funder type
Industry
Funder name
Cook Medical
Alternative name(s)
Funding Body Type
private sector organisation
Funding Body Subtype
corporate
Location
United States of America
Results and Publications
Publication and dissemination plan
Not provided at time of registration
Intention to publish date
Participant level data
Not provided at time of registration
Results - basic reporting
Publication summary