Extracorporeal Shockwave Therapy for the Treatment of Advanced Angina Pectoris

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01219218
Recruitment Status : Completed
First Posted : October 13, 2010
Last Update Posted : February 20, 2013
Academisch Ziekenhuis Maastricht
Information provided by (Responsible Party):

October 10, 2010
October 13, 2010
February 20, 2013
January 2009
January 2012   (Final data collection date for primary outcome measure)
Time to Angina [ Time Frame: 6 months ]
Change in time to angina using the modified Bruce exercise test from baseline to the 6 months post baseline assessment
Same as current
Complete list of historical versions of study NCT01219218 on Archive Site
  • Change in SPECT [ Time Frame: 6 months ]
    The change in perfusion in pharmacological induced stress SPECT test (at rest and at stress) from baseline to 6 months post baseline (17 segment model)
  • Change in AP-CCS [ Time Frame: 6 months ]
    The AP-CCS stage at the 6 months post baseline.
  • Total Exercise time [ Time Frame: 6 months ]
    The change in total exercise time (Exercise Tolerance Test- ETT) from baseline to 6 months post baseline.
  • Number of Angina attacks (patient diary) [ Time Frame: 6 months ]
    The change in the number of angina attacks from baseline to 6 months post baseline. The number of attacks per week will be documented.
Same as current
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Extracorporeal Shockwave Therapy for the Treatment of Advanced Angina Pectoris
Shockwave Treatment for Advanced Angina in Maastricht (SWAAM). A Pilot Study

Low intensity shockwaves have been proven in animal studies to induce local growth of new blood vessels from existing ones.

The hypothesis of this study is that shockwave therapy could improve the symptoms of patients with refractory angina not amenable to revascularization with angioplasty or bypass surgery.

Low intensity shockwaves (1/10 the ones used in Lithotripsy) are delivered to myocardial ischemic tissue. Shockwaves are created by a special generator and are focused using a shockwave applicator device. The treatment is guided by standard echocardiography equipment. The shockwaves are delivered in synchronization with Patient R-wave to avoid arrhythmias. The treatment is painless.

At first, the patient undergoes stress-SPECT testing to identify the ischemic areas. Following that, the same area is localized by the ultra-sound device and the shockwaves are focused to the ischemic area. Several treatment session (9 in total, spread over 9 weeks) are required for optimal results.

Phase 1
Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Refractory Angina Pectoris
Device: Cardiac Extracorporeal Shockwave Therapy generator (Cardiospec)
Energy Density - 0.09 mJ/mm2
Other Names:
  • Cardiospec
  • ESMR therapy
  • Extracorporeal Shockwave Myocardial Revascularization
Experimental: A
Treatment group. Patients in this group receive actual shockwave therapy.
Intervention: Device: Cardiac Extracorporeal Shockwave Therapy generator (Cardiospec)
Not Provided

*   Includes publications given by the data provider as well as publications identified by Identifier (NCT Number) in Medline.
June 2012
January 2012   (Final data collection date for primary outcome measure)

Inclusion Criteria:

  • Patient is diagnosed with chronic stable angina pectoris, for a period of at least 3 months. Diagnosis is based on medical history, complete physical evaluation.
  • Patient has documented myocardial segments with reversible ischemia.
  • Patient is classified in AP CCS of III-IV.
  • Patient should be on a stable dosage of medication used to treat angina for at least 6 weeks prior to enrollment.
  • Patient demonstrates exercise tolerance capacity of no higher than 125 W on a modified Bruce treadmill exercise test until presence of clinical symptoms (i.e. angina, ST-depression).
  • Patient demonstrates exercise tolerance time and stability averaging no more than 25% of each other (the tests will be performed within two weeks and at least a day different between the two).
  • Patient has documented epicardial coronary artery disease not amenable to angioplasty or CABG.
  • Patient has signed an IRB approved informed consent form.
  • Patient's condition should be stable and should have a life expectancy of >12 months. Patient's current and past medical condition and status will be assessed using previous medical history, physical evaluation, and the physicians (principle investigator's) medical opinion.

Exclusion Criteria:

  • Patient is pregnant
  • Patient has chronic lung disease including emphysema and pulmonary fibrosis.
  • Patient has active endocarditis, myocarditis or pericarditis.
  • Patient is simultaneously participating in another device or drug study, or has participated in any clinical trial involving an experimental device or drug, including other drugs or devices enhancing cardiac neovascularization, or any ESWT machine of a competitor company within 3 months of entry into the study.
  • Patients who are unwilling or unable to cooperate with study procedure
Sexes Eligible for Study: All
18 Years and older   (Adult, Older Adult)
Contact information is only displayed when the study is recruiting subjects
Not Provided
Not Provided
Academisch Ziekenhuis Maastricht
Principal Investigator: Prof. Johannes Waltenberger, MD, PhD Academisch Ziekenhuis Maastricht
February 2013

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP