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Acute Coronary Syndromes (ACS)SAINT-IVUSNCT07512778

IVUS-Guided vs Angiography-Guided PCI in Acute Coronary Syndrome

A study testing IVUS-guided PCI and Angiography-guided PCI in people with Acute Coronary Syndromes (ACS), run by SUK MIN SEO at 1 site in South Korea.

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

Coronary artery disease is associated with substantial morbidity and mortality worldwide. Percutaneous coronary intervention (PCI) is a pivotal procedure for the treatment of coronary artery disease. Read more about this study

Who is it for?
Ages 19 to 90 years
Conditions the study is for
Acute Coronary Syndromes (ACS)
What is being tested?
IVUS-guided PCI and Angiography-guided PCI
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
1,500 participants
Where
1 siteSouth Korea
Study dates
13 Mar 2025to 31 Dec 2031
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 19 to 90 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients 19 years of age or older
  • Patients with unstable angina pectoris, and acute MI including NSTEMI or STEMI.
  • Coronary artery disease defined as >70% stenosis (reference vessel diameter 2.5 - 5.0 mm based on operator assessment) with identifiable culprit lesion indicated stent implantation
  • All lesions must be suitable for treatment with the Synergy stent system, or other Synergy platform iteration
  • The patient or guardian agrees to the study protocol and the schedule of clinical and angiographic follow-up, and provides informed, written consent, as approved by the appropriate Institutional Review Board/Ethical Committee of the respective clinical site.

Who cannot join

  • Age >90 years
  • Subject has known hypersensitivity or contraindication to device material and its degradants (everolimus, poly(L-lactide), poly(DL-lactide), lactide, lactic acid) and cobalt, chromium, nickel, platinum, tungsten, acrylic, and fluoro polymers that cannot be adequately premedicated.
  • Absolute contraindications or allergy that cannot be pre-medicated, to iodinated contrast or to antiplatelet drugs, including both aspirin and P2Y12 inhibitors
  • An elective surgical procedure is planned that would necessitate interruption of antiplatelet drugs within 6 m after the procedure.
  • Cardiogenic shock
  • Restenotic lesions
Show all 13Show fewer
  • Compromised left ventricular dysfunction (LVEF <30%)
  • At the time of screening, the subject has a malignancy that is not in remission
  • Non-cardiac co-morbidities with a life expectancy less than 1 year
  • Patients who are actively participating in another drug or device investigational study, which have not completed the primary endpoint follow-up period.
  • Subject belongs to a vulnerable population (per investigator's judgment) or subject unable to read or write
  • Concern for inability of the patient to comply with study procedures and/or follow-up (e.g., alcohol or drug abuse)
  • Pregnancy

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

SUK MIN SEO, Assisted Professor contact

82+010-9090-8491

ssm530@catholic.ac.kr

YUN JU KANG, RN,CRC contact

82+010-7358-5252

yunju423@naver.com

South Korea1 site, 1 recruiting
  • The Catholic University of Korea, Eunpyeong St. Mary's Hospital

    Seoul, Eunpyeong-gu, 03312

    SUK MIN SEO, Assisted Professor, 82+010-9090-8491, ssm530@catholic.ac.kr

    YUN JU KANG, 82+010-7358-5252, yunju423@naver.com

    Recruiting

Other trials in South Korea

About this study

Official title: Clinical Impact of Intravascular Ultrasound-guided vs. Angiography-guided Coronary Stenting in Patients With Acute Coronary Syndrome: Multicenter, Randomized Control Trial (SAINT-IVUS)

Coronary artery disease is associated with substantial morbidity and mortality worldwide. Percutaneous coronary intervention (PCI) is a pivotal procedure for the treatment of coronary artery disease. Although coronary angiography (CA) is the standard imaging modality used for coronary stent implantation, it provides only two-dimensional images of the coronary arteries. Intravascular ultrasound (IVUS) can provide additional information on plaque characteristics and vessel morphology, which may facilitate optimal stent sizing and procedural optimization. However, IVUS requires additional time and cost and may increase procedural complexity. Evidence regarding the clinical benefit of IVUS-guided PCI in patients with acute coronary syndrome (ACS) remains limited.

This study is a prospective, multicenter, randomized controlled trial designed to compare IVUS-guided PCI versus angiography-guided PCI in patients with ACS. A total of 1,500 participants will be randomized 1:1 to either the IVUS-guided group or the angiography-guided group. Participants will be recruited from 15 PCI centers in Korea. The primary outcome is target vessel failure at 2 years.

Read the detailed description

Coronary artery disease is a condition characterized by a high incidence and mortality rate globally. Percutaneous coronary intervention (PCI) stands as a pivotal procedure in the diagnosis and treatment of this disease. Although coronary angiography (CA) is the standard imaging used in coronary stent implantation, it has a limitation in that it only provides two-dimensional images of the coronary arteries. To overcome this limitation, intravascular ultrasound (IVUS) can be utilized, allowing for the visualization of three-dimensional images such as intravascular plaque and morphological characteristics within the vessel, thereby offering more detailed information essential for optimal stent placement. Theoretically, IVUS-guided drug-eluting stent insertion could bring about a reduction in major cardiac events in patients with complex lesions and those at high risk, but most studies have excluded patients with acute coronary syndrome (ACS). The utilization of IVUS demands additional costs and time and might escalate the risk of intravascular complications in certain circumstances. However, the use of IVUS can facilitate a more accurate evaluation of plaque properties and morphology, assisting in determining more effective treatment strategies, and potentially contributing to lowering the risk of major cardiac events in patients suffering from acute myocardial infarction.

The objective of this study is to observe and compare the clinical impact between IVUS-guided drug-eluting stent insertion and angiography-guided drug-eluting stent insertion in patients with ACS over a span of 24 months. To this end, the investigators have planned a prospective, multi-institutional, randomized controlled trial, setting the primary outcome measurement as the target vessel failure rate over two years. The study will encompass 1500 patients, who will be assigned randomly at a 1:1 ratio to either the IVUS-guided or angiography-guided groups. The study participants will be recruited from 15 leading domestic PCI centers.

This research intends to chart the future course of ACS treatment, aspiring to surmount the current limitations of the technologies being employed. It is anticipated that in patients with ACS, IVUS-guided stent insertion during drug-eluting stent implantation might present superior clinical long-term prognoses compared to simple angiography-guided insertion.

Being tested
IVUS-guided PCI, Angiography-guided PCI
Keywords
Intravascular Ultrasound, IVUS-guided PCI, Angiography-guided PCI
Medical subject headings
Acute Coronary Syndrome

What participants receive

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

  • IVUS-guided PCIProcedure or surgery

    Patients randomized to the IVUS-guided PCI arm will undergo percutaneous coronary intervention with intravascular ultrasound guidance. IVUS may be used before, during, and after PCI, and post-stent IVUS assessment will be mandatory. IVUS will be used to determine reference vessel dimensions, guide stent sizing and length selection, and optimize stent expansion and apposition according to predefined criteria. Optimization criteria include adequate stent expansion (minimal lumen area ≥90% of the average reference lumen area), absence of major malapposition, absence of major edge dissection, and absence of significant residual stenosis near the stent edges. If these criteria are not met, additional balloon dilation or stent implantation may be performed at the operator's discretion.

  • Angiography-guided PCIProcedure or surgery

    Patients randomized to the angiography-guided PCI arm will undergo percutaneous coronary intervention guided by conventional coronary angiography. Stent sizing, length selection, and procedural optimization will be performed according to standard angiographic assessment at the operator's discretion. Routine use of intravascular ultrasound will not be routinely performed in this group. However, IVUS may be used only in bailout situations if deemed necessary by the operator.

Study groups in NCT07512778
Study groupRoleWhat they receive
IVUS-guided PCIExperimentalPCI will be performed under IVUS guidance. Post-stent IVUS assessment is mandatory, and procedural optimization will be performed according to predefined IVUS criteria. Additional balloon dilation or stent implantation may be performed at the operator's discretion if optimization criteria are not met.
Receives: Procedure: IVUS-guided PCI
Angiography-guided PCIActive comparatorPCI will be performed under coronary angiography guidance. Routine IVUS use is not planned. IVUS may be used only for bailout situations at the operator's discretion.
Receives: Procedure: Angiography-guided PCI

What is being measured

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

  1. Target Vessel Failure (TVF)

    Composite of cardiac death, target vessel-related myocardial infarction, or clinically driven target vessel revascularization.

    Measured: 2 years after randomization

Secondary outcomes (11)
  1. Cardiac death

    Death resulting from immediate cardiac causes including myocardial infarction, heart failure, arrhythmia, or other cardiac conditions

    Measured: 2 years after randomization

  2. Target vessel-related myocardial infarction

    Myocardial infarction attributable to the target vessel treated during the index PCI according to the Fourth Universal Definition of Myocardial Infarction.

    Measured: 2 years after randomization

  3. Clinically driven target vessel revascularization

    Repeat percutaneous coronary intervention or coronary artery bypass grafting of the target vessel due to symptoms or objective evidence of myocardial ischemia.

    Measured: 2 years after randomization

  4. All-cause death

    Death from any cause.

    Measured: 2 years after randomization

  5. Rate of participants with myocardial infarction (periprocedural MI or spontaneous MI)

    Myocardial infarction defined according to the Fourth Universal Definition of Myocardial Infarction.

    Measured: 2 years after randomization

  6. Rate of participants with any coronary revascularization

    target vessel vs. non-target vessel, target lesion vs. non-target lesion, clinically driven vs. non-clinically driven

    Measured: 2 years after randomization

  7. Rate of participants with definite or probable stent thrombosis

    Definite or probable stent thrombosis defined according to the Academic Research Consortium (ARC) criteria.

    Measured: 2 years after randomization

  8. Procedural success

    Successful PCI with residual stenosis <30% and final TIMI 3 flow in the treated vessel without in-hospital major adverse cardiac events.

    Measured: Periprocedural (index PCI)

  9. Total procedural time

    Measured: Periprocedural (index PCI)

  10. Total amount of contrast use

    Measured: Periprocedural (index PCI)

  11. Incidence of contrast-induced nephropathy, defined as an increase in serum creatinine of ≥0.5mg/dL or ≥25% from baseline within 48-72 hours after contrast agent exposure

    Measured: 72 hours after index procedure

Timeline

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

  1. First posted6 Apr 2026
  2. Study start13 Mar 2025
  3. Primary completion31 Dec 2030 (estimated)
  4. Study completion31 Dec 2031 (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
None (open label)
Enrolment
1,500 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07512778
Sponsor's protocol ID
PC23EIDE0191
Other IDs
KCT0009756
Acronym
SAINT-IVUS
Status last verified
Feb 2026
First submitted
13 Mar 2026
Last updated
6 Apr 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: Individual participant data will not be publicly available because of institutional policy and patient confidentiality considerations.

Publications

  • Schiele F, Meneveau N, Vuillemenot A, Zhang DD, Gupta S, Mercier M, Danchin N, Bertrand B, Bassand JP. Impact of intravascular ultrasound guidance in stent deployment on 6-month restenosis rate: a multicenter, randomized study comparing two strategies--with and without intravascular ultrasound guidance. RESIST Study Group. REStenosis after Ivus guided STenting. J Am Coll Cardiol. 1998 Aug;32(2):320-8. doi: 10.1016/s0735-1097(98)00249-6.

    PubMed 9708456
  • Darmoch F, Alraies MC, Al-Khadra Y, Moussa Pacha H, Pinto DS, Osborn EA. Intravascular Ultrasound Imaging-Guided Versus Coronary Angiography-Guided Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis. J Am Heart Assoc. 2020 Mar 3;9(5):e013678. doi: 10.1161/JAHA.119.013678. Epub 2020 Feb 20.

    PubMed 32075491

Questions about this trial

What is this clinical trial studying?

A study testing IVUS-guided PCI and Angiography-guided PCI in people with Acute Coronary Syndromes (ACS), run by SUK MIN SEO at 1 site in South Korea.

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 5 inclusion and 13 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 6 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in South Korea. 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 SUK MIN SEO, Assisted Professor (82+010-9090-8491, ssm530@catholic.ac.kr), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Target Vessel Failure (TVF) (time frame: 2 years after randomization). 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 NCT07512778, which also lists 2 linked publications.

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 6 Apr 2026.

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