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Aorto-ostial Coronary LesionsOSTIALNCT07835048

The OSTIAL Study (Optimization of Stent Placement in Aorto-ostial Lesions)

A study testing Coronary angioplasty using the floating balloon technique and Coronary angioplasty without the floating-balloon technique in people with Aorto-ostial Coronary Lesions and Coronary Angioplasty, run by Centre Cardiologique du Nord at 6 sites in France.

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
Search all trials

Trial summary

Aorto-ostial coronary lesions present a significant challenge during coronary angioplasty. This is due to the difficulty of precisely identifying the aorto-ostial plane and the frequent instability of the guiding catheter during stent deployment. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Coronary angioplasty using the floating balloon technique and Coronary angioplasty without the floating-balloon technique
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
75 participants
Where
6 sitesFrance
Study dates
30 Oct 2026to 30 Oct 2028
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

  • Male or female aged over 18 years
  • Prospective part: Patient who has signed an informed consent form
  • Retrospective part: No objection to the use of personal data for this research
  • Indication for coronary angioplasty for an aorto-ostial lesion (right coronary artery or left main coronary artery) for patients included in the prospective part / Patients in the historical part who underwent coronary angioplasty for an aorto-ostial lesion (right coronary artery or left main coronary artery) using the "floating balloon" (FB) technique, followed by a CCTA assessment of positioning
  • Affiliation with or beneficiary of a social security scheme.

Who cannot join

  • Contraindication to coronary CT angiography (severe renal impairment not requiring dialysis (GFR ≤ 30 ml/min)), applicable only to patients included in the prospective part
  • Refusal of consent (patients included in the prospective part)
  • Objection to the use of personal data (patients in the retrospective part)
  • Patient unable to read, write, or understand French
  • Vulnerable patient as defined by Article L1121-6 of the Public Health Code (CSP)
  • Adult patient placed under guardianship, curatorship, or judicial protection
  • Patient unable to personally provide consent pursuant to Article L.1121-8 of the CSP, or an adult under legal protection
  • Pregnant or breastfeeding woman as defined by Article L1121-5 of the CSP

Trial locations and contacts

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

Frank FD DIGNE, PHD contact

01 49 33 41 13

f.digne@ccn.fr

Karima MOUSSOUNI, CRA contact

0679145144

k.moussouni@ccn.fr

6 sites in 1 country

France6 sites
  • Hôpital privé Bois Bernard

    Bois-Bernard

    Sina POROUCHANI, Dr, 0683575767, sina.porouchani@gmail.com

  • CHU Clermont-Ferrand

    Clermont-Ferrand

    Géraud SOUTEYRAND, Dr, 0473751410, gsouteyrand@chu-clermontferrand.fr

  • GHPSO Creil

    Creil

    Salim SB BELGUIDOUM, Dr, 0661332746, salim_0101@hotmail.fr

  • Institut Cardiovasculaire Paris Sud - Massy

    Massy

    Nicolas Amabile, 0612523423, nicolasamabile@yahoo.fr

  • Centre cardiologique du nord

    Saint-Denis

    Frank FD DIGNE, PHD, 01 49 33 41 13, f.digne@ccn.fr

    Karima KM MOUSSOUNI, Cra, 0679145144

  • CHU de saint étienne

    Saint-Etienne

    Marouane BOUKHRIS, Dr, 0650278487, marouaneboukhris1@gmail.com

Other trials in France

About this study

Official title: Optimisation du Positionnement Des Stents Dans Les lésions Aorto-ostiales : étude Multicentrique Historico-prospective Avec Phase randomisée Comparant l'Angioplastie Coronaire Avec ou Sans Technique du Floating Ballon Étude OSTIAL (Optimizing Stent In Aorto-Ostial Lesion)

Aorto-ostial coronary lesions present a significant challenge during coronary angioplasty. This is due to the difficulty of precisely identifying the aorto-ostial plane and the frequent instability of the guiding catheter during stent deployment.

Despite the angiographic appearance being deemed optimal, several studies have shown a high rate of suboptimal stent positioning at the ostium when subsequent coronary CT angiography (CCTA) assessment is performed.

Read more

This suboptimal positioning may be linked to incomplete ostial coverage, which could increase the risk of in-stent restenosis. It may also be linked to excessive stent protrusion into the aorta, which could compromise future procedures, particularly in the context of transcatheter aortic valve replacement.

The "Floating Balloon" (FB) technique has been developed to improve system stability and to reliably mark the aorto-ostial landing zone (AOLZ). A previous study demonstrated the feasibility and accuracy of this technique.

The aim of the current study is to assess the clinical effectiveness of the Floating Balloon. Although this technique is already in use, no study has yet conducted a systematic assessment of stent positioning using CCTA.

The study utilised a combined retrospective-prospective approach to comprehensively evaluate the incidence of suboptimal stent positioning associated with the Floating Balloon technique. This evaluation was conducted by systematically comparing patient outcomes between those treated with the FB and those treated without the FB. The study employed CCTA as a key tool to assess stent position, ensuring a precise analysis of the data.

To achieve this, it is recommended that follow-up data from patients who have already undergone the FB procedure and had their stent position assessed via CCTA (retrospective component) be analysed, while also enrolling new patients and randomizing them into FB and non-FB groups (prospective component).

Read the detailed description

In order to address the primary objective (namely, to estimate the rate of stent malpositioning), 97 evaluable subjects are required to achieve a precision (half-width of the 95% confidence interval) of +/-10% (assuming a conservative 50% rate of correct positioning).

As assessments are conducted immediately after the procedure, the investigators do not anticipate a significant number of non-evaluable subjects. The proposal is to enrol N=100 subjects in the FB group, with 50 subjects in the retrospective phase and another 50 in the prospective phase.

In order to address the secondary objective of comparing malpositioning rates between the two groups (with and without FB), patients in the non-FB group should be enrolled at a 1:2 ratio. The justification for this number is based on feasibility. This will provide preliminary data for the non-FB group.

Therefore, given our retrospective cohort of 50 FB subjects with available measurements, the prospective phase will include N=50 + 25-or 75 additional subjects (50 in the FB arm and 25 in the non-FB arm). The analyses will therefore cover a total of 125 subjects (100 with FB and 25 without FB).

Being tested
Coronary angioplasty using the floating balloon technique, Coronary angioplasty without the floating-balloon technique

What participants receive

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

  • Coronary angioplasty using the floating balloon techniqueProcedure or surgery

    Coronary angioplasty using the FB technique involves the following steps:

    1. Crossing the aorto-ostial lesion using a standard coronary guidewire positioned in the target artery.
    2. Withdrawing the guiding catheter from the ostium and placing a second guidewire, formed into a loop, within the aortic root.
    3. Inflating a small-diameter (2 mm) balloon in the aorta over the second guidewire; this serves as the "floating balloon."
    4. Advancing the stent toward the target lesion.
    5. Gradually withdrawing the floating balloon until its proximal marker contacts the tip of the guiding catheter, thereby defining the aorto-ostial plane and the aorto-ostial landing zone (AOLZ).
    6. Maintaining forward pressure on the guiding catheter to stabilize the entire system and limit selective engagement of the ostium.
    7. Aligning the stent's proximal marker with the balloon marker and the tip of the guiding catheter, followed by gradual deployment of the stent.
  • Coronary angioplasty without the floating-balloon techniqueProcedure or surgery

    Angioplasty of the aorto-ostial lesion without the jailed-balloon (FB) technique will be performed as follows:

    1. Coronary catheterization via the access route chosen by the operator
    2. Predilatation, if deemed necessary
    3. Implantation of a drug-eluting stent (DES) sized according to angiographic or QCA assessment
    4. Final optimization (post-dilatation, POT, or other techniques) at the operator's discretion
Study groups in NCT07835048
Study groupRoleWhat they receive
Coronary angioplasty using the floating balloon techniqueExperimentalNot described
Receives: Procedure: Coronary angioplasty using the floating balloon technique
Coronary angioplasty without the floating-balloon techniqueActive comparatorNot described
Receives: Procedure: Coronary angioplasty without the floating-balloon technique

What is being measured

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

  1. The number of participants in whom stent placement was technically successful and who were evaluated by CT scan.

    Measured: At the end of the procedure

Secondary outcomes (1)
  1. The secondary outcome is the rate of major adverse cardiovascular events (MACE).

    The secondary outcome is the rate of major adverse cardiovascular events (MACE), including cardiac mortality, all-cause mortality, myocardial infarction (MI), target lesion revascularization (TLR) and hospitalisation for cardiovascular causes.

    Measured: 12 months after the surgery procedure

Timeline

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

  1. First posted22 Sep 2026
  2. Study start30 Oct 2026 (estimated)
  3. Primary completion30 Oct 2028 (estimated)
  4. Study completion30 Oct 2028 (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
Single blind
Who is masked
Outcomes assessor
Enrolment
75 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07835048
Sponsor's protocol ID
2026-A01154-47
Acronym
OSTIAL
Status last verified
Sep 2026
First submitted
14 Sep 2026
Last updated
24 Sep 2026
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Digne F, Darmon A, Belguidoum S, Nejjari M, Feignoux J. Optimizing Stent Placement in Ostial Coronary Lesions With the Floating Balloon Technique: The OSTIAL (Optimizing Stent In Aorto-Ostial Lesion) Pivotal Study. Catheter Cardiovasc Interv. 2025 Apr;105(5):1269-1277. doi: 10.1002/ccd.31449. Epub 2025 Feb 17.

    PubMed 39962791
  • Digne F, Darmon A, Nejjari M. Optimizing Stent Placement in Aorto-Ostial Lesions: Introducing the New Floating Balloon Technique. JACC Cardiovasc Interv. 2024 Sep 9;17(17):2082-2084. doi: 10.1016/j.jcin.2024.06.025. Epub 2024 Aug 21. No abstract available.

    PubMed 39177558
  • Jaffe R, Halon DA, Shiran A, Rubinshtein R. Percutaneous treatment of aorto-ostial coronary lesions: Current challenges and future directions. Int J Cardiol. 2015;186:61-6. doi: 10.1016/j.ijcard.2015.03.161. Epub 2015 Mar 17.

    PubMed 25814346
  • Yamamoto K, Sato T, Salem H, Matsumura M, Fall KN, Prasad M, Ng VG, Sethi SS, Nazif TM, Parikh SA, Vahl TP, Ali ZA, Karmpaliotis D, Rabbani LE, Collins MB, Leon MB, McEntegart MB, Moses JW, Kirtane AJ, Mintz GS, Maehara A. Mechanisms and treatment outcomes of ostial right coronary artery in-stent restenosis. EuroIntervention. 2023 Aug 7;19(5):e383-e393. doi: 10.4244/EIJ-D-23-00107.

    PubMed 37283548
  • Freeman M, Clark DJ, Andrianopoulos N, Duffy SJ, Lim HS, Brennan A, Charter K, Shaw J, Horrigan M, Ajani AE, Sebastian M, Reid CM, Farouque HM; Melbourne Interventional Group. Outcomes after percutaneous coronary intervention of ostial lesions in the era of drug-eluting stents. Catheter Cardiovasc Interv. 2009 May 1;73(6):763-8. doi: 10.1002/ccd.21941.

    PubMed 19309731
  • Rubinshtein R, Ben-Dov N, Halon DA, Lavi I, Finkelstein A, Lewis BS, Jaffe R. Geographic miss with aorto-ostial coronary stent implantation: insights from high-resolution coronary computed tomography angiography. EuroIntervention. 2015 Jul;11(3):301-7. doi: 10.4244/EIJV11I3A57.

    PubMed 24694540
  • Dishmon DA, Elhaddi A, Packard K, Gupta V, Fischell TA. High incidence of inaccurate stent placement in the treatment of coronary aorto-ostial disease. J Invasive Cardiol. 2011 Aug;23(8):322-6.

    PubMed 21828393

Questions about this trial

What is this clinical trial studying?

A study testing Coronary angioplasty using the floating balloon technique and Coronary angioplasty without the floating-balloon technique in people with Aorto-ostial Coronary Lesions and Coronary Angioplasty, run by Centre Cardiologique du Nord at 6 sites in France.

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 8 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 24 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 6 sites in France. 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 Frank FD DIGNE, PHD (01 49 33 41 13, f.digne@ccn.fr), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

The number of participants in whom stent placement was technically successful and who were evaluated by CT scan. (time frame: At the end of the procedure). 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 NCT07835048, which also lists 7 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 24 Sep 2026.

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