Paclitaxel-Eluting Balloon Angioplasty and Coroflex™-Stents in the Treatment of Bifurcated Coronary Lesions (PEPCAD V)

Heart Centre Rotenburg

Status

Completed

Conditions

Ischemia

Stenosis

Treatments

Device: drug eluting balloon

Study type

Interventional

Funder types

Other

Industry

Identifiers

NCT00540813

BBM-VS-56

Details and patient eligibility

About

The aim of the study is to investigate the feasibility of Paclitaxel-eluting PTCA-balloon dilation (SeQuent Please) followed by bare metal stent (Coroflex ) deployment in the main branch (reference diameter: ≥ 2.5 mm and ≤ 3.8 mm, reference diameter of side branch: ≥ 2.0 mm and ≤ 3.5 mm, length of stenoses in either branch ≤ 20 mm) in the treatment of significant (>70%) de-novo-bifurcation stenoses of any Medina classification type in the native left coronary artery as reflected by procedural success and to evaluate the preservation of vessel patency.

Enrollment

28 patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Patients with stable angina pectoris (CCS class 1-3) or with unstable angina pectoris (Braunwald class 1-2, A-C) or documented ischemia or with documented silent ischemia
Women of childbearing potential may not be pregnant nor have the desire to becoming pregnant during the first year following the study procedure. Hence, patients will be advised to use an adequate birth control method up to and including 6-month follow-up
Patients who are mentally and linguistically able to understand the aim of the study and to show sufficient compliance in following the study protocol
Patients must agree to undergo the 9-month angiographic follow-up
Patients must agree to undergo the 3-year clinical follow-up
Patient is able to verbally acknowledge and understand the associated risks, benefits, and treatment alternatives of this trial. The patients, by providing their informed consent, must agree to these risks and benefits as stated in the patient informed consent document.

Inclusion Criteria: Lesion Related

De-novo bifurcational native left coronary artery lesion (reference diameter LAD or LCx: 2.5 mm to 3.8 mm, length of stenosis: ≤ 20 mm, reference diameter D1/D2 or OMS1/OMS2: 2.0 mm to 3.5 mm, length of stenosis: ≤ 20 mm)
Diameter stenosis pre procedure must be either more then 70 % in either one or both branches of the lesion (i.e., bifurcational lesion of any type of the Medina classification) or more then 50 % if ischemia corresponding to the target lesion is documented either by exercise stress ECG, stress echocardiography, scintigraphy, MRT, or suspected based on angina pectoris
Single or multi-vessel coronary artery disease

Exclusion criteria

Patients with acute (< 24 h) or recent (48 hours) myocardial infarction
Patients with unstable angina pectoris (Braunwald class 3)
Patients with severe congestive heart failure
Patients with severe heart failure NYHA IV
Patients demonstrating clinical signs of cardiogenic shock at the time of the procedure (systolic blood pressure of less than 80 mmHg requiring inotropic support, IABP, and/or fluid challenge)
Patients with severe valvular heart disease
Women who are pregnant or lactating
Patients with life expectancy of less than five years or factors making clinical follow-up difficult
Patients with bleeding diathesis in whom anticoagulation or anti-platelet medication is contraindicated
Patients who had a cerebral stroke < 6 months prior to the procedure
Patient participates in other clinical trials involving any investigational device or drug
Untreated hyperthyroidism
Patient has presence or history of severe renal failure (GFR<30ml/min, "Cockcroft Gault") and is therefore at high risk for angiography associated renal complications. Patient's serum creatinine levels must be documented
Post transplantation of any organ or immune suppressive medication
Other disease to jeopardize follow-up (e.g., malignancy)
Addiction to any drug or to alcohol
Patients with any type of surgery during the week preceding the interventional procedure.
Therapy with anticoagulants

Exclusion Criteria: Lesion Related

Evidence of extensive thrombosis within target vessel before the intervention
Multilesion percutaneous coronary intervention beside the bifurcation lesion in the left coronary artery (no other intervention is admitted during the same procedure)
Patients with another coronary stent implanted previously into the target vessel ≤ 15 mm distant to the current lesion, drug eluting stents less than 9 months and bare metal stents or stents with passive coatings less than 3 months before the PEPCAD V BIF
Target lesion located in any type of coronary bypass (i.e., venous graft, arterial bypass) or graft/native artery connection
Coronary artery occlusion of any type (e.g., acute or chronic)
In-stent restenosis
In-segment restenosis of the native vessel within 4 mm adjacent to the target lesion