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Completed

NCT Number: NCT02151812

Comparison of Agent™ and SeQuent® Please Paclitaxel Coated Balloon Catheters in Coronary In-stent Restenosis (AGENT-ISR)

The primary objective of this study is determine the safety and performance of the Agent™ Paclitaxel-Coated PTCA Balloon Catheter compared to the SeQuent® Please Paclitaxel-Releasing Coronary Balloon Catheter for the treatment of patients with narrowed previously-stented coronary arteries (in-stent restenosis).

The performance will be determined at six months post-procedure by quantitative coronary angiography (QCA) to measure Late Lumen Loss (LLL) in the re-opened stented segment. QCA results will be assessed by an independent, blinded angiographic core lab.

Study statistical hypothesis: The loss of in-stent luminal diameter at six months after treatment of the restenosed stent with the Agent™ study device is not larger than the respective LLL after treatment with the SeQuent® Please control devices, i.e. study device is non-inferior to the control device with respect to LLL.

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Centre Hospitalier Saint Joseph Saint Luc de Lyon, Lyon, France

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Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Subject must be at least 18 years of age
  • Subject is willing and able to provide informed consent
  • Subject is eligible for percutaneous coronary intervention
  • Subject is willing to comply with all protocol-required follow-up evaluations
  • Women of child-bearing potential must agree to use a reliable method of contraception
  • In-stent restenosis in a lesion previously treated with either a drug-eluting or bare metal stent, located in a native coronary artery with a reference vessel diameter ≥ 2.0 mm and ≤ 3.5 mm
  • Target lesion length must be ≤ 28 mm (by visual estimate) and must be covered by only one balloon
  • Target lesion must have visually estimated stenosis ≥ 70% and < 100% in asymptomatic patients
  • Target lesion must have visually estimated stenosis ≥ 50% and < 100% in symptomatic patients
  • Thrombolysis in Myocardial Infarction (TIMI) grade flow in the target lesion must be ≥ 1
  • Target lesion must be successfully pre-dilated.

Exclusion criteria

  • Patient has life expectancy of less than 24 months
  • Patient with known coronary artery spasm
  • Patient with unprotected left main coronary artery disease
  • Patient has current problems with substance abuse
  • Patient has planned procedure that may cause non-compliance with the protocol or confound data interpretation
  • Patient is participating in another investigational drug or device clinical study that has not reached its primary endpoint
  • Patient intends to participate in another investigational drug or device clinical study within 12 months after the index procedure
  • Woman who is pregnant or nursing
  • Left ventricular ejection fraction < 25%
  • Patient had PCI or other coronary interventions within the last 30 days
  • Planned PCI or CABG after the index procedure
  • Patient to receive other PCI interventions in the target vessel, such as rotablation, laser atherectomy, cutting balloon, DCB, DES, BMS, bioabsorbable scaffold etc.
  • Patient to receive DCB in non-target coronary vessels
  • Acute MI < 72h
  • Cardiogenic shock
  • Known allergies against Paclitaxel or other components of the used medical devices
  • Known hypersensitivity or contraindication for contrast dye that cannot be adequately pre-medicated
  • Intolerance to antiplatelet drugs, anticoagulants required for the procedure
  • Platelet count < 100k/mm3 or > 500k/mm3
  • Patient with renal failure with a serum creatinine of > 2.5mg/dL who is receiving dialysis or chronic immunosuppressant therapy
  • Target lesion is located within a bifurcation involving a major side branch > 2 mm in diameter
  • Target lesion is located within a saphenous vein graft or an arterial graft
  • Target lesion with TIMI grade flow = 0 (total occlusion)
  • Thrombus present in the target vessel
  • > 50% stenosis of an additional lesion proximal or distal to the target lesion

Treatment and study plan

Agent Paclitaxel-coated balloon

Device

After successful pre-dilatation, the index lesion is dilated with a single drug-coated balloon that completely covers the restenotic lesion.

SeQuent® Please Paclitaxel-coated Balloon

Device

After successful pre-dilatation, the index lesion is dilated with a single drug-coated balloon that completely covers the restenotic lesion.

Primary outcomes

  1. in-stent late lumen loss

    Time frame: six months

    In-stent late lumen loss (LLL) of the treated stented segment after PTCA using the Agent(TM) study device in comparison to the LLL after PTCA using the SeQuent(R) Please control device as measured by QCA at six months post-index procedure.

Secondary outcomes

  1. technical success rate

    Time frame: during index procedure, less 1 hour

    The ability to cross and dilate the lesion to achieve residual angiographic stenosis no greater than 30 percent

  2. clinical procedural success rate

    Time frame: within 24 hours of index procedure

    Technical success with no composite of all death and MI noted within 24 hours of the index procedure.

  3. In-stent percent diameter stenosis

    Time frame: 6 months post-index procedure

    In-stent percent diameter reduction measured within the borders of the stent

  4. In-segment percent diameter stenosis

    Time frame: 6 months post-index procedure

    In-segment percent diameter reduction measured in the stented segment plus 5mm on either side.

  5. In-stent binary restenosis rate

    Time frame: 6 months post-index procedure

    In-stent binary restenosis is defined as ≥50% luminal narrowing within the borders of the stent observed at follow-up QCA.

  6. In-segment binary restenosis rate

    Time frame: 6 months post-index procedure

    In-segment binary restenosis is defined as ≥50% luminal narrowing in the stented segment plus 5mm on either side observed at follow-up QCA.

  7. In-segment late lumen loss

    Time frame: 6 months post-index procedure

    In-segment late lumen loss is the in-segment minimal lumen diameter (MLD) post index procedure minus the in-segment MLD at 6 months follow-up as determined by QCA.

  8. In-stent minimal lumen diameter (MLD)

    Time frame: 6 months post-index procedure

    In-stent MLD is measured within the borders of the stent.

  9. In-segment minimal lumen diameter (MLD)

    Time frame: 6 months post-index procedure

    In-segment MLD is measured in the stented segment plus 5mm on either side.

  10. Target lesion revascularization (TLR) rate

    Time frame: pre-discharge, estim. <10 days

    TLR rate during index in-hospital stay

  11. Target lesion revascularization (TLR) rate

    Time frame: 30 days

  12. Target lesion revascularization (TLR) rate

    Time frame: six months

  13. Target lesion revascularization (TLR) rate

    Time frame: 12 months

  14. Target lesion revascularization (TLR) rate

    Time frame: 24 months

  15. Target lesion revascularization (TLR) rate

    Time frame: 36 months

  16. Target vessel revascularization (TVR) rate

    Time frame: pre-discharge, estim. <10 days

    TVR rate during index in-hospital stay

  17. Target vessel revascularization (TVR) rate

    Time frame: 30 days

  18. Target vessel revascularization (TVR) rate

    Time frame: six months

  19. Target vessel revascularization (TVR) rate

    Time frame: 12 months

  20. Target vessel revascularization (TVR) rate

    Time frame: 24 months

  21. Target vessel revascularization (TVR) rate

    Time frame: 36 months

  22. Cardiac, non-cardiac and all death rates

    Time frame: pre-discharge, estim. <10 days

    rates during index in-hospital stay

  23. Cardiac, non-cardiac and all death rates

    Time frame: 30 days

  24. Cardiac, non-cardiac and all death rates

    Time frame: six months

  25. Cardiac, non-cardiac and all death rates

    Time frame: 12 months

  26. Cardiac, non-cardiac and all death rates

    Time frame: 24 months

  27. Cardiac, non-cardiac and all death rates

    Time frame: 36 months

  28. Myocardial infarction rates (by 3rd Universal Definition: all MI, QWMI, NQWMI)

    Time frame: pre-discharge, estim. <10 days

    rates during index in-hospital stay

  29. Myocardial infarction rates (by 3rd Universal Definition: all MI, QWMI, NQWMI)

    Time frame: 30 days

  30. Myocardial infarction rates (by 3rd Universal Definition: all MI, QWMI, NQWMI)

    Time frame: six months

  31. Myocardial infarction rates (by 3rd Universal Definition: all MI, QWMI, NQWMI)

    Time frame: 12 months

  32. Myocardial infarction rates (by 3rd Universal Definition: all MI, QWMI, NQWMI)

    Time frame: 24 months

  33. Myocardial infarction rates (by 3rd Universal Definition: all MI, QWMI, NQWMI)

    Time frame: 36 months

  34. Stent thrombosis rate (by ARC definition)

    Time frame: pre-discharge, estim. <10 days

    rates during index in-hospital stay

  35. Stent thrombosis rate (by ARC definition)

    Time frame: 30 days

  36. Stent thrombosis rate (by ARC definition)

    Time frame: six months

  37. Stent thrombosis rate (by ARC definition)

    Time frame: 12 months

  38. Stent thrombosis rate (by ARC definition)

    Time frame: 24 months

  39. Stent thrombosis rate (by ARC definition)

    Time frame: 36 months

  40. Target lesion failure (TLF) rate (composite of cardiac death, MI and TLR)

    Time frame: pre-discharge, estim. <10 days

    rates during index in-hospital stay

  41. Target lesion failure (TLF) rate (composite of cardiac death, MI and TLR)

    Time frame: 30 days

  42. Target lesion failure (TLF) rate (composite of cardiac death, MI and TLR)

    Time frame: six months

  43. Target lesion failure (TLF) rate (composite of cardiac death, MI and TLR)

    Time frame: 12 months

  44. Target lesion failure (TLF) rate (composite of cardiac death, MI and TLR)

    Time frame: 24 months

  45. Target lesion failure (TLF) rate (composite of cardiac death, MI and TLR)

    Time frame: 36 months

  46. Target vessel failure (TVF) rate (composite of cardiac death, MI and TVR)

    Time frame: pre-discharge, estim. <10 days

    rates during index in-hospital stay

  47. Target vessel failure (TVF) rate (composite of cardiac death, MI and TVR)

    Time frame: 30 days

  48. Target vessel failure (TVF) rate (composite of cardiac death, MI and TVR)

    Time frame: six months

  49. Target vessel failure (TVF) rate (composite of cardiac death, MI and TVR)

    Time frame: 12 months

  50. Target vessel failure (TVF) rate (composite of cardiac death, MI and TVR)

    Time frame: 24 months

  51. Target vessel failure (TVF) rate (composite of cardiac death, MI and TVR)

    Time frame: 36 months

  52. Change in Quality of Life

    Time frame: six months

    Functional status of general health-related quality of life (QoL) measured by changes in SF-12 scores and EQ5D scores as compared to baseline

  53. Change in Quality of Life

    Time frame: 12 months

    Functional status of general health-related quality of life (QoL) measured by changes in SF-12 scores and EQ5D scores as compared to baseline

  54. Change in Quality of Life

    Time frame: 24 months

    Functional status of general health-related quality of life (QoL) measured by changes in SF-12 scores and EQ5D scores as compared to baseline

  55. Change in Quality of Life

    Time frame: 36 months

    Functional status of general health-related quality of life (QoL) measured by changes in SF-12 scores and EQ5D scores as compared to baseline

Sponsors and collaborators

Lead sponsor

Hemoteq AG

Industry

Registry information

Official study title

A Prospective Randomized Multicenter Non-inferiority Clinical Study to Determine the Safety and Performance of the Agent™ Paclitaxel-Coated PTCA Balloon Catheter (Hemoteq) Compared to the SeQuent® Please Paclitaxel-Releasing Coronary Balloon Catheter (B.Braun) for the Treatment of Coronary In-Stent Restenosis (AGENT-ISR)

Acronym: AGENT-ISR

Important dates

Study start
2014
Primary completion
2017
Study completion
2019
First posted
May 30, 2014
Registry last updated
Dec 23, 2019

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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