Minimally invasive coronary bypass with cangrelor
Minimally Invasive Coronary Artery Bypass Supported by Cangrelor
This study will try giving a short-acting IV antiplatelet drug (cangrelor) during minimally invasive coronary bypass surgery in adults with coronary artery disease to see if it prevents clots without causing extra bleeding.
Quick facts
| Study type | Observational |
|---|---|
| Enrollment | 30 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | Cardiocentro Ticino Academic / other |
| Locations | 1 site (Lugano, Ch/ti) |
| Trial ID | NCT07514962 on ClinicalTrials.gov |
What this trial studies
This open-label, single-center case-control study compares adults undergoing MIDCAB who receive a continuous intraoperative cangrelor infusion to historical controls treated with aspirin with or without prior cangrelor bridging. Cangrelor is started preoperatively and titrated using daily platelet function testing (Multiplate®) to reach target inhibition, with surgery performed at least 24 hours after initiation and intraoperative heparin guided by activated clotting time. The study records procedural details, transfusions, chest tube output, ICU stay, biomarkers, and perioperative complications to evaluate safety and feasibility. The design is exploratory and focused on whether intraoperative cangrelor increases bleeding or reduces thrombotic complications compared with historical practice.
Who should consider this trial
Good fit: Adults (≥18 years) scheduled for MIDCAB with an IMA-to-LAD graft who can provide informed consent and have no contraindications to cangrelor are ideal candidates.
Not a fit: Patients with active bleeding, known bleeding disorders, recent fibrinolytic or GP IIb/IIIa use, severe renal or liver disease, pregnancy, or those undergoing concomitant PCI are unlikely to benefit or be eligible for this approach.
Why it matters
Potential benefit: If successful, intraoperative cangrelor could reduce perioperative clotting risk while maintaining acceptable bleeding rates, improving safety and recovery after MIDCAB.
How similar studies have performed: Cangrelor has been used successfully as a short-acting IV antiplatelet bridging agent in PCI and some perioperative settings, but continuous intraoperative infusion specifically during MIDCAB is relatively novel and not widely studied.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria for the historical control arm: * Age ≥18 years old * CABG with IMA-LAD graft in MIDCAB technique Inclusion criteria for the prospective arm: * Age ≥18 years old * CABG with IMA-LAD graft in MIDCAB technique * Signed informed consent Exclusion criteria for the historical control arm * Administration of fibrinolytics or GP IIb/IIIa inhibitors * Previous intracranial hemorrhage * Known bleeding diathesis * Patients undergoing concomitant PCI and MIDCAB * Severe renal or liver disease * Pregnancy or breast feeding Exclusion criteria for the prospective arm * Unconsciousness * Known hypersensitivity to study drug (cangrelor) * Recent administration of fibrinolytics or GP IIb/IIIa inhibitors * Previous intracranial hemorrhage * Known bleeding diathesis * Patients undergoing concomitant PCI and MIDCAB * Severe renal or liver disease * Pregnancy or breast feeding
Where this trial is running
Lugano, Ch/ti
- Istituto Cardiocentro Ticino — Lugano, Ch/ti, Switzerland (Recruiting)
Study contacts
- Principal investigator: Marco Valgimigli, Prof. Dr. Med. — Cardiocentro Ticino
- Study coordinator: Marco Valgimigli, Prof Dr Med
- Email: marco.valgimigli@eoc.ch
- Phone: +41 91 811 51 11
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.