The purpose of this randomized study is to determine which treatment option, either paclitaxel-eluting balloon, paclitaxel-eluting stent or plain balloon angioplasty is the most effective in the treatment of restenosis after implantation of "Limus"-eluting stents, (LES).
The use of drug-eluting stents (DES) has led to a drastic reduction of restenosis rates compared to bare metal stents (BMS), but 5% to 10% of patients receiving DES are still in need of revascularization of the treated vessel. Two important families of drugs are used for stent coating: paclitaxel belonging to the taxane family, and the "limus"-family such as sirolimus, everolimus, zotarolimus, biolimus A9 and pimecrolimus. Data regarding the optimal treatment of in-DES-restenosis is very limited. Implanting a new DES for in-DES-restenosis has been reported to be associated with re-restenosis rates as high as 43%. Several recent well published studies have shown a substantial reduction of restenosis using paclitaxel-eluting balloons (PEB) for de-novo lesions and BMS-restenotic lesions. The objective of this randomized trial is to assess the hypothesis, that PEB are non-inferior to paclitaxel-eluting-stents (PES) for restenosis in "limus"-eluting-stents (LES), and both, PEB and PES, are superior to plain angioplasty in patients with restenosis after initial LES implantation.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
402
Implantation of paclitaxel-eluting stent
Dilation with SeQuent Please (paclitaxel-eluting balloon)
Ryuijin, Trek
1. Med. Klinik, Klinikum rechts der Isar
Munich, Bavaria, Germany
Herz-Zentrum
Bad Krozingen, Germany
Deutsches Herzzentrum
Munich, Germany
Percent in-segment diameter stenosis at follow-up angiography
Time frame: 6-8 months
In-segment minimal luminal diameter
Time frame: 6-8 months
In-segment binary angiographic restenosis
Time frame: 6-8 months
Combined incidence of death or myocardial infarction
Time frame: 1 and 2 years
Incidence of thrombosis
Time frame: 1 and 2 years
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