Coronary Artery Disease Clinical Trial
Official title:
Balloon Elution and Late Loss Optimization (BELLO) Study: A Multicentre Randomized Study of the IN.PACT Falcon™ Paclitaxel Drug-eluting Balloon to Reduce Restenosis in Small Coronary Vessels
Prospective multicentre randomized (1:1) investigator initiated study, in which consecutive
patients undergoing percutaneous revascularization of small coronary vessels will be
assigned to one of the two study arms:
1. Treatment Arm: IN.PACT Falcon™ paclitaxel drug-eluting balloon (DEB) dilatation and
provisional spot bare-metal stenting (BMS).
2. Control Arm: paclitaxel-eluting stent (PES) implantation as per standard practice.
Eligible subjects with coronary artery disease in a small vessel (reference diameter<2.8mm)
will be consecutively screened and enrolled based on the inclusion and exclusion criteria
The objective of the study is to assess the non-inferiority of the DEB to the PES as regards
to primary endpoint of mean late lumen loss (LLL) at 6 months, defined as the difference
between postprocedural minimum luminal (MLD) diameter and follow-up MLD, as assessed by
quantitative coronary angiography and is based on the following assumptions:
1. The means of LLL in the 2 groups are precisely equal
2. A standard deviation in LLL of 0.5mm in both groups as demonstrated in the ISAR-SMART 3
and PEPCAD II trials
3. A non-inferiority margin of 0.25mm between groups is clinically unimportant
Based on these assumptions:
1. Null hypothesis (N0): mean LLL in DEB group is ≥0.25mm than that in the PES group (i.e.
PES is superior to DEB)
2. Alternative hypothesis 1 (H1): mean LLL between DEB and PES is <0.25mm (i.e. DEB is
non-inferior to PES)
3. Alternative hypothesis 2 (H2): mean LLL between DEB and PES <0 (i.e. DEB is superior to
PES) Based on the above calculations, a sample size of 77 patients will be required in
each group to show non-inferiority of DEB vs. PES with an α error of 0.025 (one-sided Z
test) and a power of 80%. To account for a 20% rate of withdrawal, lost to follow-up or
not presenting for follow-up angiography, a total of 182 patients (91 in each group)
will be randomized.
n/a
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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