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Clinical Outcomes of Drug-Coated Balloons in the Treatment of Patients With Coronary De Novo Chronic Total Occlusion Lesions
Sponsor: The First Affiliated Hospital of Zhengzhou University
Summary
The aim of this study is to evaluate the long-term efficacy and safety of drug-coated balloon (DCB) strategies, including DCB alone or hybrid strategies of DCB and drug-eluting stent (DES), compared to DES-only in patients with chronic total occlusion (CTO) after successful recanalization. Through a prospective, multicenter randomized controlled trial, we will directly compare the long-term outcomes of these two treatment strategies in CTO patients to fill the gap in existing research regarding direct comparative data between DCB and DES in CTO treatment. This study expects to provide high-quality evidence for optimizing CTO treatment, potentially improving treatment strategies in complex cases, reducing stent usage, lowering the risk of complications, and ultimately enhancing patient prognosis.
Official title: Clinical Outcomes of Drug-Coated Balloons in the Treatment of Patients With Coronary De Novo Chronic Total Occlusion Lesions: A Multicenter, Randomized Controlled Trial
Key Details
Gender
All
Age Range
18 Years - 80 Years
Study Type
INTERVENTIONAL
Enrollment
200
Start Date
2025-04-28
Completion Date
2026-12-31
Last Updated
2026-03-11
Healthy Volunteers
No
Conditions
Interventions
DES Implantation
Drug-eluting stents meeting study criteria (e.g., sirolimus-, paclitaxel-, or everolimus-eluting stents; specific models selected by operators according to clinical practice) were chosen. Stent diameter was determined by the target vessel reference diameter (2.25-4.0 mm), with length covering the occluded segment plus 5 mm of healthy vessel proximal and distal to the lesion. Stents were deployed at 8-16 atm to ensure optimal apposition. Intraoperative angiography confirmed no residual stenosis (\<10%) and TIMI grade 3 flow. When multiple stents were required, an overlapping technique was utilized to ensure complete lesion coverage.
DCB Angioplasty
Drug-coated balloons meeting study criteria (e.g., paclitaxel- or sirolimus-coated DCB; specific models selected by operators according to clinical practice) were chosen. DCB diameter was determined by the target vessel reference diameter (2.25-4.0 mm), with length covering the occluded segment plus 5 mm proximal and distal to the lesion. DCB inflation was maintained for ≥60 seconds at 8-12 atm to ensure adequate drug delivery to the vessel wall. Intraoperative angiography confirmed \<50% residual stenosis, TIMI grade 3 flow, and absence of serious complications. DES implantation was permitted (recorded as hybrid strategy) if any of the following conditions occurred after DCB application: Residual stenosis ≥50% with hemodynamic significance; Non-flow-limiting dissection requiring stent support based on operator judgment; Other technical difficulties resulting in DCB-alone treatment failure. DES selection was consistent with the DES-only group.
Locations (18)
Fuwai Hospital Chinese Academy of Medical Sciences (CAMS)
Beijing, Beijing Municipality, China
Anyang District Hospital
Anyang, Henan, China
The People's Hospital of Jiaozuo
Jiaozuo, Henan, China
The second people's Hospital of Jiyuan
Jiyuan, Henan, China
Huaihe Hospital of Henan University
Kaifeng, Henan, China
Kaifeng Central Hospital
Kaifeng, Henan, China
The First Affiliated Hospital of Henan University of Science and Technology
Luoyang, Henan, China
Nanyang City Center Hospital
Nanyang, Henan, China
The Second People's Hospital of Pingdingshan
Pingdingshan, Henan, China
Puyang People's Hospital
Puyang, Henan, China
Yellow River Sanmenxia hospital
Sanmenxia, Henan, China
Xinyang Central Hospital
Xinyang, Henan, China
The First Affiliated Hospital of Henan University of CM
Zhengzhou, Henan, China
Zhengzhou Central Hospital
Zhengzhou, Henan, China
People's Hospital of Zhengzhou
Zhengzhou, Henan, China
Zhoukou Central Hospital
Zhoukou, Henan, China
Jincheng People's Hospital
Jincheng, Shanxi, China
Tianjin Fourth Central Hospital
Tianjin, Tianjin Municipality, China