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To determine in a randomized controlled trial (RCT) whether percutaneous coronary intervention - in patients with in-stent restenosis in either bare metal stents or drug eluting stents - with the Pantera Lux balloon is angiographically non-inferior to percutaneous intervention with the Orsiro stent 6 months post-procedure.
This clinical investigation is an international, multi-center, randomized controlled trial with angiographic follow up at 6 months. Clinical follow ups will take place at 6, 12 and 18 months.
Up to 210 subjects will be block randomized 2:1 to receive the Pantera Lux balloon or the Orsiro stent and will be stratified according to diabetic status at screening.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Drug coated balloon | Experimental | Percutaneous coronary intervention with the Pantera Lux drug coated balloon. |
|
| Drug eluting stent | Active Comparator | Percutaneous coronary intervention with the Orsiro drug eluting stent. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Percutaneous coronary intervention | Device | Up to 140 patients meeting the inclusion criteria and none of the exclusion criteria are randomly selected and stratified according to diabetic status at screening are treated with the Pantera Lux drug coated balloon. |
| Measure | Description | Time Frame |
|---|---|---|
| Late lumen loss (in-stent) | In-stent late lumen loss is defined as the difference between minimal luminal diameter after procedure and at 6 months, as evaluated by offline quantitative coronary angiography (QCA). In-stent: Pantera Lux balloon: In-stent is defined as from (proximal) shoulder to (distal) shoulder of the dilated balloon. Orsiro stent: In-stent is defined as from (proximal) edge to (distal) edge of the implanted Orsiro stent. | After 6 months. |
| Measure | Description | Time Frame |
|---|---|---|
| Percent diameter stenosis in-stent and in-segment | Percent diameter stenosis is defined as the difference between reference vessel diameter and minimal lumen diameter divided by reference vessel diameter x100%. Angiographic parameters as evaluated by offline QCA. In-segment: Pantera Lux balloon: In-segment is defined as in-stent plus 5 mm distal and 5 mm proximal. Orsiro stent: In-segment is defined as in-stent plus 5 mm distal and 5 mm proximal. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Christoph K Naber, MD | Contilia Heart- and Vascular Center, Elisabeth Krankenhaus, Klara-Kopp-Weg 1, 45138 Essen, Germany | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Universitäts-Herzzentrum Freiburg-Bad Krozingen | Bad Krozingen | 79189 | Germany | |||
| Heart Center Segeberger Kliniken |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 17470709 | Background | Cutlip DE, Windecker S, Mehran R, Boam A, Cohen DJ, van Es GA, Steg PG, Morel MA, Mauri L, Vranckx P, McFadden E, Lansky A, Hamon M, Krucoff MW, Serruys PW; Academic Research Consortium. Clinical end points in coronary stent trials: a case for standardized definitions. Circulation. 2007 May 1;115(17):2344-51. doi: 10.1161/CIRCULATIONAHA.106.685313. | |
| 10545431 |
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|
| Percutaneous coronary intervention | Device | Up to 70 patients meeting the inclusion criteria and none of the exclusion criteria are randomly selected and stratified according to diabetic status at screening are treated with the Orsiro drug eluting stent. |
|
|
| After 6 months. |
| Binary restenosis in-stent and in-segment | Binary restenosis is defined as ≥50% lumen diameter stenosis as evaluated by offline QCA. | After 6 months. |
| Mean lumen diameter in-stent and in-segment | Mean minimum lumen diameter derived from two orthogonal views as evaluated by offline QCA. | After 6 months. |
| Type of reoccurrence according to Mehran classification | Type of reoccurrence according to Mehran classification (Mehran et al. Circulation 199; 100: 1872-1878) evaluated by offline QCA. | After 6, 12 and 18 months. |
| Target lesion failure (TLF) | TLF is defined as a composite of cardiac death, any target vessel myocardial infarction (MI), coronary artery bypass graft (CABG) and clinically driven target lesion revascularization (TLR). | After 6 and 18 months. |
| Target vessel failure (TVF) | TVF is defined as a composite of cardiac death, any target vessel myocardial infarction, coronary artery bypass graft and clinically driven target vessel revascularization (TVR). | After 6, 12 and 18 months. |
| Stent thrombosis | According to Academic Research Consortium (ARC) definition (Cutlip et al. Circulation 2007; 115: 2344-2351). | After 6, 12 and 18 months. |
| Procedure success | Procedure success defined as achievement of a final diameter stenosis of <30% by QCA, using any percutaneous method, without the occurrence of death, MI, or repeat revascularization of the target lesion during the hospital stay or 7 days after procedure, whichever came first. | During hospital stay or 7 days after procedure, whichever came first. |
| Device success | Successful delivery of the balloon or stent to the target lesion site in the coronary artery; and appropriate balloon inflation and deflation or stent deployment; and successful removal of the balloon or the delivery system. | 1 day (During procedure) |
| Bad Segeberg |
| 23795 |
| Germany |
| Charité - Universitätsmedizin Berlin, Charité Centrum 11 für Herz-, Kreislauf- und Gefäßmedizin | Berlin | 10117 | Germany |
| Innere Medizin Kardiologie - Charité Centrum 11, Campus Benjamin Franklin | Berlin | 12203 | Germany |
| Kardiologie - Angiologie - Pneumologie, Klinikum Coburg | Coburg | 96450 | Germany |
| Contilia Heart- and Vascular Center, Elisabeth Krankenhaus | Essen | 45138 | Germany |
| Medical Care Center Prof. Mathey, Prof. Schofer | Hamburg | 22527 | Germany |
| Kardiologie /Intern. Intensivmedizin, Johannes Wesling Klinikum Minden | Minden | 32429 | Germany |
| Klinikum Schwabing | Munich | 80804 | Germany |
| LMU - Klinikum der Universität München | Munich | 81337 | Germany |
| Klinikum Bogenhausen | Munich | 81925 | Germany |
| Universitätsklinikum Münster, Klinik für Kardiologie | Münster | 48149 | Germany |
| Innere Medizin III Kardiologie, Kliniken Villingen | Villingen-Schwenningen | 78050 | Germany |
| Cardiology, Pauls Stradins Clinical University Hospital | Riga | LV-1002 | Latvia |
| Mehran R, Dangas G, Abizaid AS, Mintz GS, Lansky AJ, Satler LF, Pichard AD, Kent KM, Stone GW, Leon MB. Angiographic patterns of in-stent restenosis: classification and implications for long-term outcome. Circulation. 1999 Nov 2;100(18):1872-8. doi: 10.1161/01.cir.100.18.1872. |
| ID | Term |
|---|---|
| D003324 | Coronary Artery Disease |
| D023903 | Coronary Restenosis |
| ID | Term |
|---|---|
| D003327 | Coronary Disease |
| D017202 | Myocardial Ischemia |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D001161 | Arteriosclerosis |
| D001157 | Arterial Occlusive Diseases |
| D014652 | Vascular Diseases |
| D023921 | Coronary Stenosis |
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| ID | Term |
|---|---|
| D062645 | Percutaneous Coronary Intervention |
| ID | Term |
|---|---|
| D057510 | Endovascular Procedures |
| D014656 | Vascular Surgical Procedures |
| D013504 | Cardiovascular Surgical Procedures |
| D013514 | Surgical Procedures, Operative |
| D019060 | Minimally Invasive Surgical Procedures |
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