Drug Eluting Balloon Angioplasty Versus Everolimus Platinum Chrome Stent

NCT ID: NCT05516446

Last Updated: 2022-08-25

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

290 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-08-25

Study Completion Date

2022-12-31

Brief Summary

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Randomized, open-label, single-center, non-inferiority clinical trial to compare late lumen loss (LLL) at 12 months in Tunisian population undergoing coronary percutaneous intervention between Drug Eluting Balloon treated group and Everolimus platinum chrome stent treated group.

Detailed Description

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Drug eluting stents (DES) leave a permanent metal implant that interferes with vasomotion, endothelial function and vascular remodeling. the rigid structure and the pharmacological properties of DES could overcome acute complications related to balloon dilation and late complications related to in-stent restenosis. However, they do not restore normal arterial function after the procedure.

Drug eluting balloons (DEB) offer an alternative to the implantation of a durable material. They release a transient antiproliferative drug. They promise potential advantages over DES as:

* an ad integrum restitution of the endothelium and its vasomotor properties.
* a reduction of late thrombosis risk.
* the possibility of grafting on the treated segment.
* avoid the problems of side-branch trapped in the treatment of bifurcations.
* improve the profitability of non-invasive imaging (coroscanner, magnetic resonance imaging) during patient follow-up.

DEB is validated for the treatment of in-stent restenosis, especially focal and on small caliber arteries. The use of DEB in de novo lesions has been the subject of several studies. This therapeutic option should be evaluated in the Tunisian context The aim of this clinical trial is to compare the results of angioplasty by DEB (SEQUENT PLEASE) versus last generation DES: coronary stent system in platinum chromium alloy with everolimus elution (Promus Premier and Promus Elite) The Primary endpoint: late lumen loss at 12 months. The Secondary endpoint: the major cardiovascular event rate (MACE).

Conditions

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Percutaneous Coronary Intervention (PCI) Coronary Artery Disease (CAD) De Novo Stenosis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Prospective, single-center, randomized and controlled trial
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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DEB for de Novo Lesions

1. Preparation of the lesion by pre-dilation or another technique using a balloon undersized by 0.5 mm compared to the reference diameter of the artery and, if necessary, by a second balloon with a balloon/artery ratio of 0.8-1 inflated to 16-18 atm for best results.
2. when obtaining a stent-like result and in the absence of a major dissection less than grade C, a flow TIMI less than 3 and a residual stenosis of more than 30%, an angioplasty by a drug eluting balloon will be performed for an inflation of 30 seconds at 8-10 atm.
3. Otherwise, an angioplasty using a drug eluting stent will be proceeded.
4. Before removing the intracoronary guide, the operator will evaluate by Quantitative Coronary Arteriography (QCA)

* The post-procedural TIMI flow.
* the minimal post-procedural luminal diameter in mm.

Group Type EXPERIMENTAL

DEB for de Novo Lesions

Intervention Type DEVICE

The surface of the SeQuent® Please NEO balloon is coated with Paclitaxel at a concentration of 3 μg Paclitaxel per mm² of balloon surface. The matrix composed of Paclitaxel and Iopromide (Paccocath technology) allows homogeneous release of the active ingredient through the vessel surface.

DES for de Novo Lesions

1. The preparation of the lesion and the post dilation will be left to the discretion of the operator.
2. Angioplasty with Drug eluting balloon after pre dilatation will be performed.
3. Before removing the intracoronary guide, the operator will evaluate by Quantitative Coronary Arteriography (QCA)

* The post-procedural TIMI flow.
* the minimal post-procedural luminal diameter in mm.

Group Type ACTIVE_COMPARATOR

DES for de Novo Lesions

Intervention Type DEVICE

The latest generation DES : everolimus-eluting platinum-chromium alloy coronary stent system (Promus Premier, Promus Elite)

Interventions

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DEB for de Novo Lesions

The surface of the SeQuent® Please NEO balloon is coated with Paclitaxel at a concentration of 3 μg Paclitaxel per mm² of balloon surface. The matrix composed of Paclitaxel and Iopromide (Paccocath technology) allows homogeneous release of the active ingredient through the vessel surface.

Intervention Type DEVICE

DES for de Novo Lesions

The latest generation DES : everolimus-eluting platinum-chromium alloy coronary stent system (Promus Premier, Promus Elite)

Intervention Type DEVICE

Other Intervention Names

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a paclitaxel drug-eluting balloon everolimus-eluting platinum-chromium alloy coronary stent

Eligibility Criteria

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Inclusion Criteria

* Patients with silent ischemia, stable angina, unstable angina, or non-Q wave myocardial infarction.
* a de Novo lesion on a never treated native artery.
* A reference artery diameter between 2 mm and 4 mm.


* Patients with STEMI in the acute phase or presenting a cardiogenic shock.
* Patients with an allergy or a contraindication to double anti-platelet aggregation.
* Pre-menopausal patients not using regularly an oral contraceptives or breast-feeding .
* Patients with severe comorbidity or with an estimated survival of less than 12 months.
* Dissected lesions or spontaneous dissections other than grade A or B requiring DES angioplasty.
* In-stent restenosis.
* Thrombotic lesions.

Exclusion Criteria

* None
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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B. Braun Medical International Trading Company Ltd.

INDUSTRY

Sponsor Role collaborator

General Administration of Military Health, Tunisia

NETWORK

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Aymen Noamen, MD

Role: PRINCIPAL_INVESTIGATOR

military hospital of Tunis , Tunis EL manar University, Faculty of medicine of Tunis

Nadhem Hajlaoui, Pr

Role: STUDY_DIRECTOR

military hospital of Tunis , Tunis EL manar University, Faculty of medicine of Tunis

Wafa Fehri, Pr

Role: STUDY_CHAIR

military hospital of Tunis , Tunis EL manar University, Faculty of medicine of Tunis

Locations

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Military hospital of Tunis

Tunis, , Tunisia

Site Status RECRUITING

Countries

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Tunisia

Central Contacts

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Aymen Noamen, MD

Role: CONTACT

0021620215773

Ahmed Ben Amara, fellow

Role: CONTACT

0021654430166

Facility Contacts

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Nejla Stambouli

Role: primary

0021655104234

References

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Zhong PY, Ma Y, Shang YS, Niu Y, Bai N, Wang ZL. Efficacy of Drug-Coated Balloon Approaches for de novo Coronary Artery Diseases: A Bayesian Network Meta-Analysis. Front Cardiovasc Med. 2022 Jun 21;9:899701. doi: 10.3389/fcvm.2022.899701. eCollection 2022.

Reference Type BACKGROUND
PMID: 35800174 (View on PubMed)

Hajlaoui N, Noamen A, Ben Amara A, Raddaoui H, Haggui A, Fehri W. Drug-Eluting-Balloon Angioplasty in Tunisian population versus Everolimus-platinum-chrome-stent for de-novo coronary lesion. Tunis Med. 2022 Decembre;100(12):824-829.

Reference Type DERIVED
PMID: 37551532 (View on PubMed)

Other Identifiers

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santemilitaire9

Identifier Type: -

Identifier Source: org_study_id

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