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The William Harvey Research Institute - Barts and The London

BYPASS-CTCA

A Randomised controlled trial assessing the value of Computed Tomography Cardiac Angiography (CTCA) in improving patient satisfaction and reducing contrast load, procedural duration and complications in patients who had previous bypass operation undergoing invasive coronary angiography.

Disease area: Coronary Heart Disease
Status: Actively recruiting
Chief Investigator: Dr Dan Jones
Sponsor: Queen Mary University of London
Funder: NIHR RfPB
NCT Ref: ClinicalTrials.gov Identifier: NCT03736018


Study Summary

Many people suffer from angina (chest pain, which comes on with exertion and is relieved by rest), caused by narrowing’s in the coronary arteries, visualised by a special X-ray-based examination called a coronary angiogram. Angina can be treated with an operation in which the narrowings are bypassed, otherwise known as coronary artery bypass grafting (CABG). The problem is that over time these bypasses can narrow and block, therefore these patients often redevelop chest pain and require further coronary angiograms. For patients with previous bypasses, coronary angiography procedures can lead to a number of complications. Procedures last longer, lead to higher doses of radiation and higher contrast (x-ray dye) volumes which can be associated with kidney damage. This is because the placements of the grafts vary and therefore it can take longer to find them, subjecting patients to greater risks and more discomfort. 

Computerised Tomography Coronary Angiography (CTCA) involves using a CT scan to identify coronary artery narrowings. It has fewer risks than coronary angiography, and is very accurate at finding blockages and the location of bypass grafts. Although the ability of CTCA to detect the position and condition of bypass grafts is well known, it is unclear whether this scan leads to safer coronary angiography. The aim of the study is to see if the CTCA scan before the procedure can make angiography safer, shorter and more comfortable for the patient.

Sample size and duration

688 patients aged 18 years or older with previous Coronary Artery Bypass Graft surgery.  The study will take place at Barts Heart Centre, London over a period of three years.

Enquiries

For further information, please contact: 

Dr Dan Jones
Tel: +44(0) 20 3765 8707
Email: daniel.jones@qmul.ac.uk