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Acute Coronary Syndrome (ACS) Undergoing Percutaneous Coronary Intervention (PCI)IVUS-SCBNCT07796412

IVUS-Guided Sirolimus-Coated Balloon Versus Sirolimus-Eluting Stent for De Novo Large Vessel Lesions in ACS

A study testing IVUS-Guided Sirolimus-Coated Balloon and IVUS-Guided Sirolimus-Eluting Stent in people with Acute Coronary Syndrome (ACS) Undergoing Percutaneous Coronary Intervention (PCI), run by China National Center for Cardiovascular Diseases at 1 site in China.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

The goal of this interventional study is to evaluate the efficacy and safety of an intravascular ultrasound (IVUS)-guided sirolimus-coated balloon (SCB)-based strategy versus planned sirolimus-eluting stent (SES) implantation in patients with acute coronary syndrome (ACS) and de novo large-vessel coronary lesions. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
IVUS-Guided Sirolimus-Coated Balloon and IVUS-Guided Sirolimus-Eluting Stent
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
150 participants
Where
1 siteChina
Study dates
1 Dec 2026to 30 Jan 2029
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

  • All of the following criteria must be met:
  • Aged ≥18 years.
  • Diagnosed with acute coronary syndrome (ACS), including unstable angina (UA), non-ST-segment elevation myocardial infarction (NSTEMI), or ST-segment elevation myocardial infarction (STEMI). The diagnosis, classification, and clinical management of ACS will follow the 2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes. NSTEMI and STEMI will be diagnosed according to the Fourth Universal Definition of Myocardial Infarction.
  • A de novo lesion in a large native coronary artery with a target lesion reference vessel diameter ≥2.75 mm.
  • Only one target lesion is considered to require intervention and is suitable for treatment with a sirolimus-coated balloon (SCB), with bail-out stenting if necessary, or with a sirolimus-eluting stent (SES).
  • Successful lesion preparation according to the prespecified angiographic and IVUS criteria, confirming that the target lesion is suitable for both randomized treatment strategies.
  • The participant has fully understood the study and provided written informed consent.

Who cannot join

  • Participants meeting any of the following criteria will be excluded:
  • Acute heart failure, acute cardiogenic shock, or persistent hemodynamic instability.
  • Percutaneous coronary intervention within the previous 12 months, including stent implantation, balloon angioplasty, or SCB treatment.
  • A bifurcation lesion requiring simultaneous intervention of both the main vessel and side branch.
  • In-stent restenosis in the target vessel; only de novo lesions are eligible for this study.
  • Lesion anatomy unsuitable for SCB treatment or conventional SES implantation, including:
Show all 22Show fewer
  • Lesion length >40 mm.
  • Chronic total occlusion (CTO).
  • A left main coronary artery target lesion or severe left main coronary artery disease requiring simultaneous treatment.
  • Severe calcification expected to preclude satisfactory lesion preparation.
  • Severe vessel tortuosity or angulation >90° that may prevent safe device delivery.
  • A bypass graft lesion or myocardial bridging involving the target lesion.
  • Severe hepatic or renal impairment.
  • A concomitant condition associated with a life expectancy of less than 1 year.
  • Previous coronary artery bypass grafting (CABG).
  • Unsuitable for percutaneous coronary intervention or long-term antithrombotic therapy, including:
  • Known contraindication to aspirin, heparin, antiplatelet agents, or contrast media.
  • A history of intracranial hemorrhage. Pregnancy, breastfeeding, or planned pregnancy during the study period.
  • Previous prosthetic heart valve replacement.
  • Participation in another clinical study or clinical trial within the previous 12 months.
  • Known severe hypersensitivity to sirolimus or its derivatives, any component of the study devices-including the SES polymer or metal-or contrast media; or inability or unwillingness to undergo repeat coronary angiography and IVUS at 9 months for any other reason.
  • Considered unsuitable for enrollment by the investigator because of anticipated nonadherence or any other reason.

Trial locations and contacts

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

China1 site
  • Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

    Beijing, 100037

Other trials in China

About this study

Official title: IVUS-Guided Sirolimus-Coated Balloon Versus Sirolimus-Eluting Stent for De Novo Large Vessel Lesions in ACS: A Non-Inferiority Randomized Controlled Trial

The goal of this interventional study is to evaluate the efficacy and safety of an intravascular ultrasound (IVUS)-guided sirolimus-coated balloon (SCB)-based strategy versus planned sirolimus-eluting stent (SES) implantation in patients with acute coronary syndrome (ACS) and de novo large-vessel coronary lesions. The main question is whether the SCB-based strategy is non-inferior to the SES strategy with respect to in-segment late lumen loss (LLL) at 9 months. Following adequate lesion preparation and confirmation according to the prespecified angiographic and IVUS criteria that the target lesion is suitable for both randomized treatment strategies, participants will be randomly assigned to undergo either SCB treatment without routine stent implantation or planned SES implantation. In the SCB group, bail-out SES implantation will be performed when clinically necessary, such as in cases of significant residual stenosis or flow-limiting dissection. Participants will undergo angiographic and IVUS follow-up at 9 months, and clinical outcomes will be assessed through 12 months.

Read the detailed description

Lesion preparation will be performed before randomization. Individuals with unsuccessful lesion preparation will be considered pre-randomization failures and will not be assigned to either study arm. The reason for unsuccessful lesion preparation, the treatment subsequently received, and limited safety information through 48 hours after the procedure will be documented for screening and safety oversight purposes only. These individuals will not undergo protocol-mandated follow-up and will not be included in the efficacy or comparative safety analyses of the randomized trial.

Being tested
IVUS-Guided Sirolimus-Coated Balloon, IVUS-Guided Sirolimus-Eluting Stent
Keywords
Large Vessel, Acute Coronary Syndrome, Sirolimus-Coated Balloon, Sirolimus-Eluting Stent, Intravascular Ultrasound, Non-inferiority Trial
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 Sirolimus-Coated BalloonDevice

    Following adequate lesion preparation and confirmation of feasibility via IVUS assessment, the SCB will be used for dilation to achieve drug delivery without routine stent implantation. In cases of significant residual stenosis or flow-limiting dissection, bail-out SES implantation will be performed. Post-procedure antithrombotic therapy and follow-up will be managed according to guideline recommendations and at the discretion of the clinician.

  • IVUS-Guided Sirolimus-Eluting StentDevice

    Following successful lesion preparation, the SES will be implanted under IVUS guidance to optimize stent expansion and apposition. Post-procedure antithrombotic therapy and follow-up will be managed according to guideline recommendations and at the discretion of the clinician.

Study groups in NCT07796412
Study groupRoleWhat they receive
IVUS-Guided Sirolimus-Coated BalloonExperimentalFollowing successful lesion preparation, the sirolimus-coated balloon will be used for drug delivery without routine stent implantation. Bail-out sirolimus-eluting stent implantation will be performed in cases of significant residual stenosis, flow-limiting dissection, impaired coronary flow, or other prespecified indications. Participants requiring bail-out stenting will remain in the SCB group and will be analyzed according to their randomized treatment strategy.
Receives: Device: IVUS-Guided Sirolimus-Coated Balloon
IVUS-Guided Sirolimus-Eluting StentActive comparatorFollowing successful lesion preparation, planned sirolimus-eluting stent implantation will be performed under IVUS guidance to optimize stent expansion and apposition.
Receives: Device: IVUS-Guided Sirolimus-Eluting Stent

What is being measured

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

  1. In-Segment Late Lumen Loss at 9 Months

    In-segment late lumen loss (LLL) of the target lesion is calculated as the in-segment minimal lumen diameter (MLD) measured immediately after the index procedure minus the in-segment MLD measured at 9-month follow-up, assessed by quantitative coronary angiography (QCA) by an independent angiographic core laboratory. The in-segment analysis region comprises the device-treated segment plus the 5 mm proximal and 5 mm distal edge segments. A negative value indicates lumen enlargement relative to the immediate post-procedural result. The mean value will be reported.

    Measured: 9 months

Secondary outcomes (18)
  1. Periprocedural Complications

    A composite of cardiovascular death, periprocedural myocardial infarction, acute target lesion or target vessel thrombosis, and acute target lesion or target vessel occlusion occurring within 48 hours after the procedure.

    Measured: Within 48 hours after the procedure

  2. Target Lesion Failure (TLF)

    a composite of cardiovascular death, target vessel myocardial infarction (TV-MI), and clinically driven target lesion revascularization (TLR).

    Measured: 12 months

  3. Patient-oriented Composite Endpoint (PoCE)

    a composite of all-cause death, any myocardial infarction, any stroke, and any revascularization

    Measured: 12 months

  4. Bleeding Events

    assessed according to Bleeding Academic Research Consortium (BARC) types 2-5 criteria.

    Measured: 12 months

  5. Net Adverse Clinical Events (NACE)

    Time to the first occurrence of any PoCE component or BARC type 3 or 5 bleeding.

    Measured: 12 months

  6. IVUS-derived External Elastic Membrane area

    Changes in IVUS-measured external elastic membrane (EEM) area within the target lesion segment from pre-procedure to post-procedure and from post-procedure to the 9-month follow-up.

    Measured: Pre-procedure, immediately post-procedure, and 9 months

  7. IVUS-derived minimum lumen area

    Changes in intravascular ultrasound (IVUS)-measured minimum lumen area (MLA) from pre-procedure to post-procedure and from post-procedure to 9-month follow-up.

    Measured: Pre-procedure, immediately post-procedure, and 9 months

  8. IVUS-derived plaque burden

    Changes in intravascular ultrasound (IVUS)-measured plaque burden from pre-procedure to post-procedure and from post-procedure to 9-month follow-up.

    Measured: Pre-procedure, immediately post-procedure, and 9 months

  9. Minimum lumen diameter

    Target lesion segment minimum lumen diameter (MLD) measured by quantitative coronary angiography (QCA) before lesion preparation, immediately after the procedure, and at 9-month follow-up.

    Measured: Pre-procedure, immediately post-procedure, and 9 months

  10. Percent diameter stenosis

    Target lesion segment percent diameter stenosis (%DS) measured by QCA before lesion preparation, immediately after the procedure, and at 9-month follow-up.

    Measured: Pre-procedure, immediately post-procedure, and 9 months

  11. Binary restenosis

    Proportion of participants with target lesion segment %DS ≥50% at 9-month follow-up, as assessed by QCA

    Measured: 9 months

  12. Acute lumen gain

    Acute lumen gain, calculated as post-procedure MLD minus pre-procedure MLD.

    Measured: Immediately post-procedure

  13. Net lumen gain

    Net lumen gain, calculated as 9-month MLD minus pre-procedure MLD.

    Measured: 9 months

  14. Late lumen enlargement

    In-segment late lumen enlargement (LLE) is defined as an in-segment late lumen loss (LLL) value less than 0 mm. In-segment LLL is calculated as the in-segment minimal lumen diameter (MLD) measured immediately after the index procedure minus the in-segment MLD measured at 9-month follow-up, assessed by quantitative coronary angiography (QCA) by an independent angiographic core laboratory. The in-segment analysis region comprises the device-treated segment plus the 5 mm proximal and 5 mm distal edge segments. A negative LLL value indicates lumen enlargement relative to the immediate post-procedural result. Each participant is classified as having LLE or not; a single value - the percentage of participants meeting this criterion - will be reported.

    Measured: 9 months

  15. Length of Index Hospital Stay

    Length of stay for the index hospitalization, defined as the number of days from admission to discharge for the procedure hospitalization.

    Measured: From admission to discharge for the index hospitalization

  16. Percentage of Participants With Cardiovascular-Related Rehospitalization

    The percentage of participants with at least one unplanned rehospitalization for a cardiovascular cause after discharge from the index hospitalization. Each participant is counted only once regardless of the number of rehospitalizations.

    Measured: 12 months

  17. Percentage of Participants With Repeat Coronary Revascularization

    The percentage of participants undergoing any repeat coronary revascularization, including percutaneous coronary intervention or coronary artery bypass grafting, of any vessel after the index procedure. Each participant is counted only once regardless of the number of procedures.

    Measured: 12 months

  18. Cumulative Cardiovascular-Related Direct Medical Costs

    Cumulative direct medical costs related to cardiovascular care, including the index procedure, index hospitalization, rehospitalizations, and repeat revascularization procedures.

    Measured: 12 months

Timeline

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

  1. First posted1 Sep 2026
  2. Study start1 Dec 2026 (estimated)
  3. Primary completion31 Dec 2028 (estimated)
  4. Study completion30 Jan 2029 (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
Model description
Following informed consent, potentially eligible participants will undergo lesion preparation before randomization. Only participants with successful lesion preparation according to the prespecified angiographic and intravascular ultrasound (IVUS) criteria, confirming that the target lesion is suitable for both randomized treatment strategies, will be randomized in a 1:1 ratio to either the IVUS-guided sirolimus-coated balloon (SCB)-based strategy or planned sirolimus-eluting stent (SES) implantation. Participants with unsuccessful lesion preparation will not undergo randomization, will not be counted toward the planned enrollment of 150 randomized participants, and will not be included in the outcome analyses of the randomized trial. Participants randomized to the SCB group who require bail-out SES implantation according to prespecified criteria will remain in the SCB group and will be analyzed according to their randomized treatment strategy.
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
150 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07796412
Sponsor's protocol ID
FW-ZEL-002
Acronym
IVUS-SCB
Status last verified
Oct 2026
First submitted
21 Aug 2026
Last updated
15 Oct 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Deidentified individual participant data that underlie the results reported in the primary publication will be made available to qualified researchers upon reasonable request and approval of a methodologically sound research proposal, subject to an appropriate data use agreement.

Questions about this trial

What is this clinical trial studying?

A study testing IVUS-Guided Sirolimus-Coated Balloon and IVUS-Guided Sirolimus-Eluting Stent in people with Acute Coronary Syndrome (ACS) Undergoing Percutaneous Coronary Intervention (PCI), run by China National Center for Cardiovascular Diseases at 1 site in China.

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 7 inclusion and 22 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: opening soon, 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 1 site in China. 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 Erli Zhang (+86 13621010047, zhangerli@fuwaihospital.org), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

In-Segment Late Lumen Loss at 9 Months (time frame: 9 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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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