Compare Sirolimus Coated Balloon Catheter With Paclitaxel Coated Balloon Catheter in De Novo Coronary Bifurcated Lesions (PROMISE-BIF)
Primary Purpose
Coronary Artery Disease
Status
Active
Phase
Not Applicable
Locations
China
Study Type
Interventional
Intervention
PCI
Sponsored by
About this trial
This is an interventional treatment trial for Coronary Artery Disease focused on measuring drug coated balloon catheter, coronary bifurcation lesion
Eligibility Criteria
Inclusion Criteria:
- Male or non-pregnant female ages 18-80 years old
- Participants with myocardial ischemia, stable or unstable angina pectoris, old myocardial infarction, or Stabled myocardial infarction (occurred more than 7 days before enrollment, including non-ST elevation and ST elevation myocardial infarction)
- Participants are are eligible to undergo any type of coronary revascularization surgery, such as balloon angioplasty, stenting, and coronary artery bypass grafting (CABG);
- Participants Can understand the trial's purpose, voluntarily participate and acknowledge all the risks and benefits, providing written informed consent and are willing to accept invasive radiographic during the follow-up period.
- Angiography confirmed as De novo bifurcation lesion, the stenosis rate of side branch (diameter) ≥70%
- Suitable for PCI and the side branch lesions is not expected to stent implantation, and no DCB treatment for the main branch. If a stent is implanted into the main-branch, it's usually necessary to perform a final balloon kissing on the two branches
- Up to 2 vessels that need to be treated, total intended treat lesions' amount will not exceed 3
- At most one primary bifurcation lesion that needs treatment (including Medina classification 1.1.1, 1.0.1, 0.1.1), ostium stenosis degree (diameter) ≥70% (visual);
- Patients are suitable for PCI and side branch is not expected to implant a stent, the main branch will not apply drug coated balloon; the main branch will implant a stent, usually the main branch and side branch will have Kissing Balloon Inflation
- The side branch is pre-dilated successfully, no C or upper grade dissection, no tear or other complications occurred, residual stenosis ≤50%, TIMI3
- The reference diameter of the target lesion side branch is 2.0~4.0 mm, the length of the lesion in side branch is ≤38 mm, and the length of the lesion in main branch is ≤70 mm
Exclusion Criteria:
- Any AMI occurred within 1 week before operation
- Unstable arrhythmias, such as high-risk ventricular premature beats, ventricular tachycardia
- severe heart failure (above NYHA IV) or Left ventricular ejection fraction (LVEF) <30% (ultrasound or left ventricular angiography)
- Renal function insufficiency: Serum creatinine >177μmol/L; Or undergoing hemodialysis;
- definite hemorrhagic tendency, antiplatelet and anticoagulant therapy contraindication and unable to anticoagulant therapy;
- PCI planned within 1 year
- Have a history of peptic ulcer or gastrointestinal hemorrhage in the past 6 months; Have a history of cerebrovascular accidents (stroke) such as cerebral hemorrhage, cerebral infarction in the past 6 months;
- allergic to contrast agent, paclitaxel, and rapamycin and its derivatives
- Has been diagnosed as advanced cancer and other serious diseases, lifespan are expected less than 12 months or hard to complete the 12-month follow up;
- Patients who are considered to have poor compliance and cannot complete the trial in accordance with requirements; Or other reasons that considered by the investigator, it be unsuitable to enroll the participant;
- Be participating in any other clinical trials, or have participated in clinical trials of other drugs or medical devices before being selected but have not reached the timeline of the primary endpoint;
- Female who are pregnant or breastfeeding (women who may become pregnant must undergo a pregnancy test within 7 days before the baseline surgery);Or have fertility plan/can not have adequate contraception during the study period
- Three vessel disease and all the vessels need revasculization
- Left main and its bifurcation lesions;
- thrombus in the bifurcation lesion, or tortuose lesion that the balloon catheter will not pass through;
- Side branch lesion segment of target lesion is a total occlusion lesion
- side branch is severely calcified, and cannot be pre-dilated or dilated while do kissing balloon inflation;
- Target lesion (including main branch and branch) is in-stent re-stenosis
- Dissection above grade C or residual stenosis >50% after pre-dilation of the target lesion branch vessel disease or double kissing balloon dilation;
- Two or more non-target lesions that need to be treated, the non-target lesion cannot be processed before the target lesion or the treatment fails;
Sites / Locations
- General Hospital of the PLA Northern Theater Command
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Active Comparator
Arm Label
Sirolimus coated balloon catheter
Paclitaxel coated balloon catheter
Arm Description
Manufacturer: Shanghai MicroPort Medical Group Co, Ltd.
Manufacturer: Liaoning Yinyi Biotechnology Co., Ltd
Outcomes
Primary Outcome Measures
Percent Diameter Stenosis (DS) of side branch
Stenosis of lumen diameter of lesion segment of the side branch
Secondary Outcome Measures
Late lumen loss (LLL) of side branch
late lumen loss of lesion segment of the side branch
Full Information
NCT ID
NCT04918615
First Posted
June 4, 2021
Last Updated
November 2, 2022
Sponsor
Shanghai MicroPort Medical (Group) Co., Ltd.
1. Study Identification
Unique Protocol Identification Number
NCT04918615
Brief Title
Compare Sirolimus Coated Balloon Catheter With Paclitaxel Coated Balloon Catheter in De Novo Coronary Bifurcated Lesions
Acronym
PROMISE-BIF
Official Title
PROMISE-BIF :A Prospective, Multicenter, Randomized Controlled Trial to Compare the Efficacy and Safety of Sirolimus Coated Balloon Catheter With Paclitaxel Coated Balloon Catheter for the Treatment of De Novo Coronary Bifurcated Lesions
Study Type
Interventional
2. Study Status
Record Verification Date
November 2022
Overall Recruitment Status
Active, not recruiting
Study Start Date
February 28, 2021 (Actual)
Primary Completion Date
August 31, 2023 (Anticipated)
Study Completion Date
December 31, 2024 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Shanghai MicroPort Medical (Group) Co., Ltd.
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The purpose of this study is to evaluate the efficacy and safety of Microport sirolimus drug coated balloon catheter for the treatment of coronary bifurcation lesions.
Detailed Description
PROMISE-BIF is a prospective, multicenter, randomized controlled, non-inferior clinical trial, which would enroll about 234 participants. All participants will undergo PCI with sirolimus drug coated balloon catheter or paclitaxel drug coated balloon catheter and be followed-up to 24 months.
The Target Lesion defined as the true bifurcation, include the main branch and side branch lesion.
The bifurcation lesions were classified by Medina (1.1.1, 1.0.1, and 0.1.1). The image data will be analyzed and evaluated independently by a third-party imaging laboratory.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Coronary Artery Disease
Keywords
drug coated balloon catheter, coronary bifurcation lesion
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
236 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Sirolimus coated balloon catheter
Arm Type
Experimental
Arm Description
Manufacturer: Shanghai MicroPort Medical Group Co, Ltd.
Arm Title
Paclitaxel coated balloon catheter
Arm Type
Active Comparator
Arm Description
Manufacturer: Liaoning Yinyi Biotechnology Co., Ltd
Intervention Type
Procedure
Intervention Name(s)
PCI
Intervention Description
Patients in experimental group will undergo PCI with drug coated balloon catheter to treat the side branch of the coronary bifurcation lesion.
Primary Outcome Measure Information:
Title
Percent Diameter Stenosis (DS) of side branch
Description
Stenosis of lumen diameter of lesion segment of the side branch
Time Frame
9 months
Secondary Outcome Measure Information:
Title
Late lumen loss (LLL) of side branch
Description
late lumen loss of lesion segment of the side branch
Time Frame
9 months
Other Pre-specified Outcome Measures:
Title
Immediate Success Endpoint
Description
Immediate Success Endpoint including Technical success, Lesion success and Procedural success.
Technical success defined as the success of the study device in reaching the target lesion branch vascular lesions, dilatating and retracting successfully with residual stenosis of the branch vessel lesion ≤30%(visual inspection); Lesion success defined as the main and branch vessels of the target lesion residual stenosis Residual stenosis ≤ ≤30%, furthermore blood flow is TIMI 3 (visual inspection) after treatment with any interventional method Procedural success defined as the absence of device-related composite end point events during the hospitalization period (up to 7 days after surgery) on the basis of Lesion success.
Time Frame
7 days
Title
DoCE
Description
Defined as a composite of cardiac death, target vessel-related MI, or ischemia-driven side branch lesion revascularization events at 30 days, 6 months, 9 months and 12 months
Time Frame
30 days, 6 months, 9 months, 12 months, 24 months post-procedure
Title
PoCE
Description
Defined as a composite rate of all cause death, all MI or any revasculariztion at 30 days, 6 months, 9 months, and 12 months
Time Frame
30 days, 6 months, 9 months, 12 months, 24 months post-procedure
Title
Death
Description
Cardiac, Vascular, Non-cardiovascular related
Time Frame
30 days, 6 months, 9 months, 12 months, 24 months post-procedure
Title
Myocardial infarction
Description
Target vessel related, Non-target vessel related
Time Frame
30 days, 6 months, 9 months, 12 months, 24 months post-procedure
Title
Target lesion Revascularization
Description
Lesion revascularization in main branch, side branch or both, ischemic driven or non-ischemic driven
Time Frame
30 days, 6 months, 9 months, 12 months, 24 months post-procedure
Title
Target vessel Revascularization
Description
Ischemia-driven , Not ischemia-driven
Time Frame
30 days, 6 months, 9 months, 12 months, 24 months post-procedure
Title
Any coronary revascularization
Description
Ischemia-driven , Not ischemia-driven
Time Frame
30 days, 6 months, 9 months, 12 months, 24 months post-procedure
Title
Thrombotic events
Description
ARC defined: acute, subacute, late
Time Frame
30 days, 6 months, 9 months, 12 months, 24 months post-procedure
Title
AE & SAEs rate
Time Frame
30 days, 6 months, 9 months, 12 months, 24 months post-procedure
Title
side branch re-stenosis rate
Description
the proportion of patients with re-stenosis in the side branch, stenosis degree >50%
Time Frame
9 months
Title
main branch re-stenosis rate
Description
the proportion of patients with re-stenosis in the main branch, stenosis degree >50%
Time Frame
9 months
Title
In-segment late loss of the main branch (mm)
Description
The minimum lumen diameter (MLD) immediately after stent implantation was subtracted from the MLD at follow-up
Time Frame
9 months
Title
In-segment Stenosis degree of the main branch (%)
Time Frame
9 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Male or non-pregnant female ages 18-80 years old
Participants with myocardial ischemia, stable or unstable angina pectoris, old myocardial infarction, or Stabled myocardial infarction (occurred more than 7 days before enrollment, including non-ST elevation and ST elevation myocardial infarction)
Participants are are eligible to undergo any type of coronary revascularization surgery, such as balloon angioplasty, stenting, and coronary artery bypass grafting (CABG);
Participants Can understand the trial's purpose, voluntarily participate and acknowledge all the risks and benefits, providing written informed consent and are willing to accept invasive radiographic during the follow-up period.
Angiography confirmed as De novo bifurcation lesion, the stenosis rate of side branch (diameter) ≥70%
Suitable for PCI and the side branch lesions is not expected to stent implantation, and no DCB treatment for the main branch. If a stent is implanted into the main-branch, it's usually necessary to perform a final balloon kissing on the two branches
Up to 2 vessels that need to be treated, total intended treat lesions' amount will not exceed 3
At most one primary bifurcation lesion that needs treatment (including Medina classification 1.1.1, 1.0.1, 0.1.1), ostium stenosis degree (diameter) ≥70% (visual);
Patients are suitable for PCI and side branch is not expected to implant a stent, the main branch will not apply drug coated balloon; the main branch will implant a stent, usually the main branch and side branch will have Kissing Balloon Inflation
The side branch is pre-dilated successfully, no C or upper grade dissection, no tear or other complications occurred, residual stenosis ≤50%, TIMI3
The reference diameter of the target lesion side branch is 2.0~4.0 mm, the length of the lesion in side branch is ≤38 mm, and the length of the lesion in main branch is ≤70 mm
Exclusion Criteria:
Any AMI occurred within 1 week before operation
Unstable arrhythmias, such as high-risk ventricular premature beats, ventricular tachycardia
severe heart failure (above NYHA IV) or Left ventricular ejection fraction (LVEF) <30% (ultrasound or left ventricular angiography)
Renal function insufficiency: Serum creatinine >177μmol/L; Or undergoing hemodialysis;
definite hemorrhagic tendency, antiplatelet and anticoagulant therapy contraindication and unable to anticoagulant therapy;
PCI planned within 1 year
Have a history of peptic ulcer or gastrointestinal hemorrhage in the past 6 months; Have a history of cerebrovascular accidents (stroke) such as cerebral hemorrhage, cerebral infarction in the past 6 months;
allergic to contrast agent, paclitaxel, and rapamycin and its derivatives
Has been diagnosed as advanced cancer and other serious diseases, lifespan are expected less than 12 months or hard to complete the 12-month follow up;
Patients who are considered to have poor compliance and cannot complete the trial in accordance with requirements; Or other reasons that considered by the investigator, it be unsuitable to enroll the participant;
Be participating in any other clinical trials, or have participated in clinical trials of other drugs or medical devices before being selected but have not reached the timeline of the primary endpoint;
Female who are pregnant or breastfeeding (women who may become pregnant must undergo a pregnancy test within 7 days before the baseline surgery);Or have fertility plan/can not have adequate contraception during the study period
Three vessel disease and all the vessels need revasculization
Left main and its bifurcation lesions;
thrombus in the bifurcation lesion, or tortuose lesion that the balloon catheter will not pass through;
Side branch lesion segment of target lesion is a total occlusion lesion
side branch is severely calcified, and cannot be pre-dilated or dilated while do kissing balloon inflation;
Target lesion (including main branch and branch) is in-stent re-stenosis
Dissection above grade C or residual stenosis >50% after pre-dilation of the target lesion branch vessel disease or double kissing balloon dilation;
Two or more non-target lesions that need to be treated, the non-target lesion cannot be processed before the target lesion or the treatment fails;
Facility Information:
Facility Name
General Hospital of the PLA Northern Theater Command
City
Shengyang
State/Province
Liaoning
Country
China
12. IPD Sharing Statement
Learn more about this trial
Compare Sirolimus Coated Balloon Catheter With Paclitaxel Coated Balloon Catheter in De Novo Coronary Bifurcated Lesions
We'll reach out to this number within 24 hrs