Balloon Elution and Late Loss Optimization (BELLO) Study

NCT ID: NCT01086579

Last Updated: 2013-08-14

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

182 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-03-31

Study Completion Date

2014-05-31

Brief Summary

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Prospective multicentre randomized (1:1) investigator initiated study, in which consecutive patients undergoing percutaneous revascularization of small coronary vessels will be assigned to one of the two study arms:

1. Treatment Arm: IN.PACT Falcon™ paclitaxel drug-eluting balloon (DEB) dilatation and provisional spot bare-metal stenting (BMS).
2. Control Arm: paclitaxel-eluting stent (PES) implantation as per standard practice.

Eligible subjects with coronary artery disease in a small vessel (reference diameter\<2.8mm) will be consecutively screened and enrolled based on the inclusion and exclusion criteria

The objective of the study is to assess the non-inferiority of the DEB to the PES as regards to primary endpoint of mean late lumen loss (LLL) at 6 months, defined as the difference between postprocedural minimum luminal (MLD) diameter and follow-up MLD, as assessed by quantitative coronary angiography and is based on the following assumptions:

1. The means of LLL in the 2 groups are precisely equal
2. A standard deviation in LLL of 0.5mm in both groups as demonstrated in the ISAR-SMART 3 and PEPCAD II trials
3. A non-inferiority margin of 0.25mm between groups is clinically unimportant

Based on these assumptions:

1. Null hypothesis (N0): mean LLL in DEB group is ≥0.25mm than that in the PES group (i.e. PES is superior to DEB)
2. Alternative hypothesis 1 (H1): mean LLL between DEB and PES is \<0.25mm (i.e. DEB is non-inferior to PES)
3. Alternative hypothesis 2 (H2): mean LLL between DEB and PES \<0 (i.e. DEB is superior to PES) Based on the above calculations, a sample size of 77 patients will be required in each group to show non-inferiority of DEB vs. PES with an α error of 0.025 (one-sided Z test) and a power of 80%. To account for a 20% rate of withdrawal, lost to follow-up or not presenting for follow-up angiography, a total of 182 patients (91 in each group) will be randomized.

Detailed Description

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Conditions

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Coronary Artery Disease

Keywords

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paclitaxel PTCA drug-eluting balloon provisional spot stenting coronary artery disease Late Lumen Loss Minimal lumen diameter coronary artery disease in a small vessel

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Treatment Arm (IN.PACT Falcon Drug Eluting Balloon)

IN.PACT Falcon™ paclitaxel drug-eluting balloon (DEB) dilatation and provisional spot bare metal stenting (Bare Metal Stent).

Group Type EXPERIMENTAL

IN.PACT Falcon paclitaxel eluting balloon (Drug eluting balloon)

Intervention Type DEVICE

Coronary Artery Bypass Graft (CABG)

Control Arm PES

Control Arm: paclitaxel-eluting stent (PES) implantation as per standard practice.

Group Type ACTIVE_COMPARATOR

Taxus (Paclitaxel eluting stent)

Intervention Type DEVICE

Percutaneous transluminal coronary angioplasty (PTCA) with stent

Interventions

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IN.PACT Falcon paclitaxel eluting balloon (Drug eluting balloon)

Coronary Artery Bypass Graft (CABG)

Intervention Type DEVICE

Taxus (Paclitaxel eluting stent)

Percutaneous transluminal coronary angioplasty (PTCA) with stent

Intervention Type DEVICE

Other Intervention Names

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IN.PACT Falcon paclitaxel eluting balloon

Eligibility Criteria

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Inclusion Criteria

* Age \> 18 years.
* Patient providing written informed consent.
* Patients with stable angina pectoris (Canadian Cardiovascular Society \[CCS\] 1, 2 3) or unstable angina pectoris with documented ischemia (CCS 4, Braunwald Class IB-C, IIB-C or IIIB-C), or patients with documented silent ischemia.
* Patients who are eligible for coronary revascularization (angioplasty and/or CABG).
* Female patients with child bearing potential must have a negative pregnancy test within one week before treatment and must use adequate contraception.


* Native coronary artery.
* De novo lesion.
* Reference vessel diameter \< 2.8mm by visual estimate.
* Target lesion with a visually estimated stenosis \>50%.
* Target lesion length \< 25mm by visual estimate.
* A maximum of 2 epicardial vessels requiring revascularization.
* A maximum of 2 target lesions can be included (In the case of treatment of more than one lesion, the treatment selected will remain the same).

Exclusion Criteria

* Patients unable to give informed consent.
* Patients enrolled in another study with any investigational drug or device within the past 30 days.
* Patients scheduled for a major surgical intervention within 6 months of enrolment in the study.
* Patients with acute (\< 24h) or recent (≤ 48 hours) myocardial infarction.
* Patients with a contraindication to an emergency coronary bypass surgery.
* Any individual who may refuse a blood transfusion.
* Patients with serum creatinine \>2.0mg/dL or \>180umol/L.
* Patients with severe congestive heart failure.
* Patients who had a cerebral stroke \<6 months prior to the Index Procedure.
* EF (Ejection Fraction) \< 30%.
* Patients with any known allergy, hypersensitivity or intolerance to acetylsalicylic acid (ASA), Clopidogrel or Ticlopidine, Paclitaxel.
* Any known allergy to contrast medium that cannot be pre-treated.


* \>2 epicardial vessels requiring revascularization.
* Target lesion distance from the ostium of left anterior descending coronary artery (LAD)/left circumflex coronary artery (LCX)/right coronary artery (RCA) is \< 5 mm.
* Target lesion is located in either a venous or arterial graft.
* Target vessel contains a previously implanted stent.
* Angiographic evidence of thrombus at the target site.
* Chronic total occlusions.
* Restenotic lesions.
* Bifurcation lesions which the operator decides a 2-stent technique as intention-to-treat is required OR bifurcations with side branches ≥ 2.5mm.
* Failure to successfully treat non-target lesions within the target vessel (non-target lesions must be treated prior the target lesion).
* Greater than 2 non-target lesions treated during the index procedure.
* Previous Percutaneous Coronary Intervention (PCI) within the last 3 months.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Fondazione Evidence per Attività e Ricerche Cardiovascolari ONLUS

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Antonio Colombo, Dr.

Role: PRINCIPAL_INVESTIGATOR

IRCCS Fondazione Centro S.Raffaele del Monte Tabor

Corrado Tamburino, Prof.

Role: PRINCIPAL_INVESTIGATOR

Presidio Ospedaliero Ferrarotto di Catania

Patrizia Presbitero, Prof

Role: PRINCIPAL_INVESTIGATOR

Istituto Clinico Humanitas di Rozzano (MI)

Alberta Pangrazi, Dr.

Role: PRINCIPAL_INVESTIGATOR

Azienda Ospedaliera Ospedali Riuniti Umberto I-G.M.Lancisi-G.Salesi di Ancona

Roberto Violini, Dr.

Role: PRINCIPAL_INVESTIGATOR

Azienda Ospedaliera San Camillo Forlanini di Roma

Francesca Buffoli, Dr.

Role: PRINCIPAL_INVESTIGATOR

Ospedale "C.Poma" di Mantova

Maurizio Tespili, Dr.

Role: PRINCIPAL_INVESTIGATOR

Azienda Ospedaliera "Bolognini" di Seriate

Fausto Castriota, Dr.

Role: PRINCIPAL_INVESTIGATOR

Citta' di Lecce Hospital di Lecce

Alberto Cremonesi, Dr.

Role: PRINCIPAL_INVESTIGATOR

Villa Maria Cecilia Hospital di Cotignola

Antonio Micari, Dr.

Role: PRINCIPAL_INVESTIGATOR

Villa Maria Eleonora Hospital di Palermo

Alfredo Marchese, Dr.

Role: PRINCIPAL_INVESTIGATOR

Casa di Cura "AntheaHospital" di Bari

Fabrizio Tomai, Dr.

Role: PRINCIPAL_INVESTIGATOR

European Hospital di Roma

Massimo Margheri, Dr.

Role: PRINCIPAL_INVESTIGATOR

Ospedale S.Maria delle Croci AUSL di Ravenna

Alberto Menozzi, Dr.

Role: PRINCIPAL_INVESTIGATOR

Azienda Ospedaliero-Universitaria di Parma

Locations

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Irccs Fondazione Centro S.Raffaele Del Monte Tabor

Milan, MI, Italy

Site Status

Countries

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Italy

References

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Latib A, Colombo A, Castriota F, Micari A, Cremonesi A, De Felice F, Marchese A, Tespili M, Presbitero P, Sgueglia GA, Buffoli F, Tamburino C, Varbella F, Menozzi A. A randomized multicenter study comparing a paclitaxel drug-eluting balloon with a paclitaxel-eluting stent in small coronary vessels: the BELLO (Balloon Elution and Late Loss Optimization) study. J Am Coll Cardiol. 2012 Dec 18;60(24):2473-80. doi: 10.1016/j.jacc.2012.09.020. Epub 2012 Nov 14.

Reference Type DERIVED
PMID: 23158530 (View on PubMed)

Other Identifiers

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BELLO

Identifier Type: -

Identifier Source: org_study_id