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AzTrials

Vascular Access Site OcclusionDISCO COMPLEXNCT05490238

DIStal Versus COnventional Radial Access for COMPLEX Large-bore Percutaneous Coronary Intervention

A study testing Complex PCI with Ultimaster family drug-eluting stent (Terumo Corp., Japan) in people with Vascular Access Site Occlusion, run by IGLESIAS Juan Fernando at 9 sites in 5 countries.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The use of the distal radial artery has recently emerged as a promising alternative access route to further reduce the risk of radial artery occlusion (RAO) and has been endorsed by recent International Consensus documents. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Vascular Access Site Occlusion
What is being tested?
Complex PCI with Ultimaster family drug-eluting stent (Terumo Corp., Japan)
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
708 participants
Where
9 sitesin 5 countries
Study dates
31 Aug 2023to 1 Jun 2027
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age ≥18 years.
  • Patients presenting with CCS or ACS, including unstable angina or NSTEMI.
  • Patients planned for PCI of complex coronary lesions, such as CTO, left main coronary artery disease, heavily calcified lesions, complex bifurcations, or other complex coronary lesions in whom the operator anticipates that a 7F guiding catheter is indicated.
  • Patients able to provide written informed consent.

Who cannot join

  • Patients with acute ST-segment elevation myocardial infarction.
  • Patients with cardiogenic shock.
  • Patients on chronic hemodialysis.
  • Patients with contraindications to TRA, such as occlusive upper arm peripheral artery disease, or known anatomic variants prohibiting TRA on both sides.
  • Patients with medical conditions that may cause non-compliance with the study protocol and/or may confound the data interpretation.
  • Patients unable to provide written informed consent.

Trial locations and contacts

9 sites in 5 countries. Contact the study team or a site near you to ask about taking part.

Véronique Menoni contact

+41795530516

veronique.menoni@hug.ch

9 sites in 5 countries

Belgium4 sites, 4 recruiting
  • Clinique St. Joseph Arlon - Groupe Vivalia

    Arlon

    Giuseppe Colletti, MD

    Recruiting
  • CHU Saint-Pierre

    Brussels

    Panagiotis Xaplanteris, MD

    Recruiting
  • CHU de Charleroi

    Charleroi

    Adel Aminian, MD

    Recruiting
  • Hôpital de La Louvière - Site Jolimont

    La Louvière

    Claudiu Ungureanu, MD

    Recruiting

Other trials in Belgium

Switzerland2 sites, 2 recruiting
  • Basel University Hospital

    Basel, Basel

    Gregor Leibundgut, MD

    Recruiting
  • Geneva University Hospitals

    Geneva, Canton of Geneva, 1205

    Maëlle Achard, RN, +41795533553, maelle.achard@hcuge.ch

    Sophie Degrauwe, MD

    Recruiting

Other trials in Switzerland

Germany1 site, 1 recruiting
  • Agaplesion Bethesda Krankenhaus Bergedorf

    Hamburg

    Karsten Schenke, MD, +40725541261, kardiologie.bkb@agaplesion.de

    Recruiting

Other trials in Germany

Greece1 site, 1 recruiting
  • Patras University Hospital

    Pátrai

    Grigorios Tsigkas, MD

    Recruiting

Other trials in Greece

Italy1 site, 1 recruiting
  • Humanitas Research Hospital

    Milan

    Gabriele L Gasparini, MD

    Recruiting

Other trials in Italy

About this study

Official title: DIStal Versus COnventional Radial Access for COMPLEX Large-bore Percutaneous Coronary Intervention (DISCO COMPLEX)

The use of the distal radial artery has recently emerged as a promising alternative access route to further reduce the risk of radial artery occlusion (RAO) and has been endorsed by recent International Consensus documents. The feasibility of a distal radial access (DRA) for coronary angiography and/or PCI has been demonstrated in several observational clinical registries and small-sized randomized clinical trials. In the recent prospective, multicenter, open label, randomized, controlled DIStal vs Conventional RADIAL access (DISCO RADIAL) trial, DRA was associated with low and similar rates of RAO at discharge when compared to conventional TRA among patients undergoing coronary angiography and/or PCI. There is however limited evidence on the feasibility and safety of 7F DRA for PCI.

In a prospective, multicenter, observational study including 41 patients undergoing CTO PCI using a left DRA with a 7F GLIDESHEATH SLENDER® (Terumo Corp., Tokyo, Japan), technical success was achieved in 90.3% of patients and procedural success was achieved in 78.1% of patients. No post-procedural DRA RAO were detected by clinical assessment and Doppler ultrasound examination, and no radial artery occlusions at the site of the forearm were found. Doppler ultrasound imaging of the DRA at one month was available in 67.6% of patients, with only one case (4.3%) of DRA RAO. This proof-of-concept study demonstrates that DRA using a 7F GLIDESHEATH SLENDER® (Terumo Corp., Tokyo, Japan) for CTO PCI is feasible and associated with a high procedural success rate and low vascular access-site complication rates.

No randomized clinical trial to date has however compared the feasibility and safety of a 7F DRA versus 7F TRA for PCI of complex coronary lesions, such as chronic total occlusions (CTO), left main coronary artery disease, heavily calcified lesions, complex bifurcations, or other complex coronary lesions for whom the operator anticipates that a 7F guiding catheter is indicated.

Read the detailed description

The radial artery has become the standard vascular access site for most percutaneous coronary interventions (PCI) and is recommended by the most recent 2018 European Society of Cardiology/European Association for Cardio-Thoracic Surgery guidelines on myocardial revascularization, irrespective of clinical presentation. Patients undergoing PCI of complex coronary lesions, such as a chronic total occlusion (CTO), left main (LM) coronary artery disease, complex bifurcation lesions, or heavily calcified lesions, have however been either absent or under-represented in most trials supporting these guidelines.

The small size of the radial artery remains an important limitation for the use of large bore guiding catheters (>6 F), restricting thereby the treatment of highly complex lesions through the transradial approach. The 7F GLIDESHEATH SLENDER® (Terumo Corp., Tokyo, Japan) is a dedicated radial sheath with a thinner wall and hydrophilic coating. It combines an inner diameter compatible with any 7F guiding catheter and an outer diameter smaller than current 7F sheaths.

A prospective, multicenter, observational study including 60 patients demonstrates that a transradial access (TRA) using the 7F GLIDESHEATH SLENDER® (Terumo Corp., Tokyo, Japan) for complex coronary interventions is feasible and associated with a high rate of procedural success and a low rate of vascular complications.

In the Complex Large-Bore Radial Percutaneous Coronary Intervention (COLOR) randomized trial, 388 patients with planned PCI for complex coronary lesions were randomly allocated to a 7F TRA or 7F transfemoral access (TFA). Conventional TRA was associated with a significant reduction in clinically relevant access- site bleeding or vascular complications without affecting procedural success when compared to TFA among patients undergoing complex PCI with a 7F large bore access.

The use of the distal radial artery has recently emerged as a promising alternative access route to further reduce the risk of radial artery occlusion (RAO) and has been endorsed by recent International Consensus documents. The feasibility of a distal radial access (DRA) for coronary angiography and/or PCI has been demonstrated in several observational clinical registries and small-sized randomized clinical trials. In the recent prospective, multicenter, open label, randomized, controlled DIStal vs Conventional RADIAL access (DISCO RADIAL) trial, DRA was associated with low and similar rates of RAO at discharge when compared to conventional TRA among patients undergoing coronary angiography and/or PCI. There is however limited evidence on the feasibility and safety of 7F DRA for PCI. The potential advantages of DRA when compared to TRA are contrasted by a slightly smaller size of the distal radial artery potentially impacting on device selection and procedural planning and by its less predictable course, due to the pronounced tortuosity and angulation of the vessel, leading to an overall higher number of puncture attempts, a longer time to achieve arterial access and a higher rate of access failure. These limitations may preclude the use of DRA for PCI of complex coronary lesions when a large bore guiding catheter is needed. There is however limited evidence on the feasibility and safety of 7F DRA for PCI.

In a prospective, multicenter, observational study including 41 patients undergoing CTO PCI using a left DRA with a 7F GLIDESHEATH SLENDER® (Terumo Corp., Tokyo, Japan), technical success was achieved in 90.3% of patients and procedural success was achieved in 78.1% of patients. No post-procedural DRA RAO were detected by clinical assessment and Doppler ultrasound examination, and no radial artery occlusions at the site of the forearm were found. Doppler ultrasound imaging of the DRA at one month was available in 67.6% of patients, with only one case (4.3%) of DRA RAO. This proof-of-concept study demonstrates that DRA using a 7F GLIDESHEATH SLENDER® (Terumo Corp., Tokyo, Japan) for CTO PCI is feasible and associated with a high procedural success rate and low vascular access-site complication rates.

No randomized clinical trial to date has however compared the feasibility and safety of a 7F DRA versus 7F TRA for PCI of complex coronary lesions, such as chronic total occlusions (CTO), left main coronary artery disease, heavily calcified lesions, complex bifurcations, or other complex coronary lesions for whom the operator anticipates that a 7F guiding catheter is indicated.

Being tested
Complex PCI with Ultimaster family drug-eluting stent (Terumo Corp., Japan)
Keywords
Radial artery access, Distal radial artery, Complex PCI

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Complex PCI with Ultimaster family drug-eluting stent (Terumo Corp., Japan)Procedure or surgery

    Large-bore radial access for complex PCI with Ultimaster family drug-eluting stent (Terumo Corp., Japan)

Study groups in NCT05490238
Study groupRoleWhat they receive
Distal radial accessExperimentalDistal radial access using 7Fr Glidesheath Slender sheath (Terumo Corp., Japan)
Receives: Procedure: Complex PCI with Ultimaster family drug-eluting stent (Terumo Corp., Japan)
Conventional radial accessActive comparatorConventional radial access using 7Fr Glidesheath Slender sheath (Terumo Corp., Japan)
Receives: Procedure: Complex PCI with Ultimaster family drug-eluting stent (Terumo Corp., Japan)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Incidence of forearm radial artery occlusion

    US Doppler

    Measured: At hospital discharge (assessed up to day 5)

Secondary outcomes (8)
  1. Incidence of vascular access site-related bleeding

    EASY criteria and BARC criteria

    Measured: At hospital discharge (assessed up to day 5)

  2. Incidence of vascular access site-related complication

    Clinical assessment

    Measured: At hospital discharge (assessed up to day 5)

  3. Incidence of radial artery spasm

    Angiographic assessment

    Measured: During intervention (up to day 1)

  4. Incidence of distal radial artery occlusion

    US Doppler

    Measured: At hospital discharge (assessed up to day 5)

  5. Total hemostasis time

    Clinical assessment

    Measured: At hospital discharge (assessed up to day 5)

  6. Incidence of vascular access site-related pain

    Visual Analogue Scale (VAS, 0-10, lower scores represent less pain)

    Measured: At hospital discharge (assessed up to day 5)

  7. Incidence of hand dysfunction

    Michigan Hand Outcomes Questionnaire (MHQ: 0-100, lower pain scores denote less pain, other high scores denote better hand performance) and QuickDASH Outcome Measure Questionnaire (0-100, lower scores indicate lower level of disability)

    Measured: At hospital discharge (assessed up to day 5) and at 1 year

  8. Rate of target lesion failure

    Composite of cardiac death, target vessel myocardial infarction, or clinically indicated target lesion revascularization.

    Measured: At 1 year

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted5 Aug 2022
  2. Study start31 Aug 2023
  3. Primary completion1 May 2027 (estimated)
  4. Study completion1 Jun 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
708 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05490238
Sponsor's protocol ID
2022-0729
Acronym
DISCO COMPLEX
Status last verified
Oct 2026
First submitted
1 Aug 2022
Last updated
15 Oct 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Individual participant data will be shared upon reasonable request to the principal investigator after publication of the study primary and secondary endpoints.

Publications

  • Iglesias JF, Leibundgut G, Heg D, Gasparini GL, Tsigkas G, Ungureanu C, Colletti G, Degrauwe S, Xaplanteris P, Schenke K, Achim A, van Leeuwen MA, Muresan M, Saito S, Sgueglia GA, Aminian A. Distal versus conventional radial large-bore access for percutaneous coronary intervention of complex coronary lesions: Rationale and design of the DISCO COMPLEX randomized superiority trial. Am Heart J. 2026 Feb;292:107291. doi: 10.1016/j.ahj.2025.107291. Epub 2025 Oct 18.

    PubMed 41115584

Questions about this trial

What is this clinical trial studying?

A study testing Complex PCI with Ultimaster family drug-eluting stent (Terumo Corp., Japan) in people with Vascular Access Site Occlusion, run by IGLESIAS Juan Fernando at 9 sites in 5 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 15 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 9 sites in Belgium, Switzerland, Germany, Greece, Italy. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Véronique Menoni (+41795530516, veronique.menoni@hug.ch), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Incidence of forearm radial artery occlusion (time frame: At hospital discharge (assessed up to day 5)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05490238, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Oct 2026.

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