Document Detail


Paclitaxel-coated balloon versus drug-eluting stent during PCI of small coronary vessels, a prospective randomised clinical trial. The PICCOLETO study.
MedLine Citation:
PMID:  20659948     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Percutaneous coronary intervention (PCI) of small vessels is limited by an increased risk of restenosis and adverse outcome, even when drug-eluting stents (DES) are employed. In recent years, the paclitaxel-coated balloon (PCB) has been shown to reduce neointimal proliferation and the need for target lesion revascularization (TLR) in an in-stent restenosis setting. The impact of a PCB during PCI of small coronary vessels was evaluated and compared to one of the most widely used DES. METHODS: In the PICCOLETO randomised clinical trial, patients with stable or unstable angina undergoing PCI of small coronary vessels (< or = 2.75 mm) were randomised to Dior PCB (28 patients) or Taxus DES (29 patients). The primary study end point was per cent diameter stenosis at 6-month angiographic follow-up (non-inferiority), secondary end points were angiographic binary restenosis and occurrence of major adverse cardiac events (MACE: death, Q-wave myocardial infarction, TLR) at 9 month follow-up. RESULTS: The two groups were not dissimilar regarding clinical and angiographic characteristics. Study was interrupted after enrolment of two-thirds of patients due to a clear superiority of one study group. The primary end point was not met, because the PCB group showed higher per cent diameter stenosis (43.6% vs 24.3%, p=0.029); angiographic restenosis was higher as well (32.1 vs 10.3%, p=0.043), whereas MACE were 35.7% in the PCB group and 13.8% in the DES group (p=0.054). CONCLUSIONS: Dior PCB failed to show equivalence to Taxus DES regarding angiographic end points during PCI of small coronary arteries. CLINICAL TRIAL REGISTRATION NUMBER (EUDRACT CODE): 2009-012268-15.
Authors:
Bernardo Cortese; Andrea Micheli; Andrea Picchi; Amelia Coppolaro; Loria Bandinelli; Silva Severi; Ugo Limbruno
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  96     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-27     Completed Date:  2010-08-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  1291-6     Citation Subset:  AIM; IM    
Affiliation:
Interventional Cardiology Unit, Cardiovascular Department, Ospedale della Misericordia, Grosseto, Italy. bcortese@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary / adverse effects,  instrumentation*
Cardiovascular Agents / administration & dosage*
Coronary Restenosis / prevention & control,  radiography
Coronary Stenosis / drug therapy,  therapy*
Drug Delivery Systems / instrumentation*
Drug-Eluting Stents* / adverse effects
Equipment Design
Female
Follow-Up Studies
Humans
Male
Middle Aged
Paclitaxel / administration & dosage*
Prospective Studies
Treatment Outcome
Chemical
Reg. No./Substance:
0/Cardiovascular Agents; 33069-62-4/Paclitaxel
Comments/Corrections
Comment In:
Heart. 2010 Aug;96(16):1257-8   [PMID:  20659942 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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