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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
231
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.
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.
Universitäts-Herzzentrum Freiburg-Bad Krozingen
Bad Krozingen, Germany
Heart Center Segeberger Kliniken
Bad Segeberg, Germany
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.
Time frame: After 6 months.
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.
Time frame: After 6 months.
Binary restenosis in-stent and in-segment
Binary restenosis is defined as ≥50% lumen diameter stenosis as evaluated by offline QCA.
Time frame: 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.
Time frame: 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.
Time frame: 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).
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Charité - Universitätsmedizin Berlin, Charité Centrum 11 für Herz-, Kreislauf- und Gefäßmedizin
Berlin, Germany
Innere Medizin Kardiologie - Charité Centrum 11, Campus Benjamin Franklin
Berlin, Germany
Kardiologie - Angiologie - Pneumologie, Klinikum Coburg
Coburg, Germany
Contilia Heart- and Vascular Center, Elisabeth Krankenhaus
Essen, Germany
Medical Care Center Prof. Mathey, Prof. Schofer
Hamburg, Germany
Kardiologie /Intern. Intensivmedizin, Johannes Wesling Klinikum Minden
Minden, Germany
Klinikum Schwabing
Munich, Germany
LMU - Klinikum der Universität München
Munich, Germany
...and 4 more locations
Time frame: 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).
Time frame: After 6, 12 and 18 months.
Stent thrombosis
According to Academic Research Consortium (ARC) definition (Cutlip et al. Circulation 2007; 115: 2344-2351).
Time frame: 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.
Time frame: 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.
Time frame: 1 day (During procedure)