What is the Purpose of this Study?
The purpose of this study is to assess the safety and effectiveness of an experimental device called ProTractX3 TTS drug coated balloon (DCB) for the treatment of benign (non-cancerous) stricture in the bowel. A stricture is a narrowing and/or scarring of a passageway in the body that can occur in the bowel. The ProTractX3 DCB coating contains paclitaxel, an anti-inflammatory and anti-proliferative (anti-overgrowth) drug. It is common practice for doctors to use balloons or other devices to stretch and expand a stricture. Intestinal strictures treated with normal dilation (expansion) often come back and require re-treatment.
Researchers aim to determine whether this drug-coated balloon dilation device can treat strictures and reduce the rate of recurrence. Participants will be randomly chosen to receive treatment with either the ProTractX3 DCB or a normal dilation; they are twice as likely to be chosen to receive treatment with the study device compared to standard of care. Participants who have been assigned to the Standard of Care group will be eligible to receive treatment with the ProTractX3 DCB on or after 12-months follow-up.
Eligibility
- 1. Age ≥ 22
- 2. Diagnosis of symptomatic benign bowel stricture with at least 2 previous dilations.
- 3. Willing and able to complete protocol required follow up
- 4. Willing and able to provide written informed consent
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Inclusion Criteria:
- 1. Age ≥ 22
- 2. Diagnosis of symptomatic benign bowel stricture with at least 2 previous dilations.
- 3. Willing and able to complete protocol required follow up
- 4. Willing and able to provide written informed consent
- 5. Stricture length ≤ 5 cm
Exclusion Criteria:
- 1. Female subjects who are pregnant or breastfeeding or plan to get pregnant in next 12 months
- 2. Contraindication to endoscopy, anesthesia, or deep sedation.
- 3. Suspicion of malignant bowel stricture NOTE: Biopsy should be taken for every stricture during the initial endoscopy, however endoscopic balloon dilation may proceed without awaiting results if suspicion for malignancy is low in the opinion of the investigator.
- 4. Benign stricture due to extrinsic compression
- 5. Stricture is not amenable to standard balloon dilation (e.g. severe angulation, unable to pass guidewire, etc.)
- 6. Stricture complicated with abscess, fistula, perforation, leakage or varices
- 7. Stricture segment has moderate to severe active inflammation at the time of treatment. Moderate to severe inflammation is defined as any one of; ulcers \>0.5cm in diameter, ulcerated surface \>10%, affected (inflamed) surface \>50%, marked erythema, absent vascular pattern, significant friability, or erosions
- 8. Multiple clinically significant strictures unable to be treated with a single balloon (i.e. total segment length must be ≤5cm) NOTE: Clinically significant strictures include those that are unable to be passed by the endoscope.
- 9. Received steroid injections into target stricture in the last 8 weeks
- 10. Stricture is not able to be dilated to ≥15mm in small bowel or ≥18mm in large bowel
- 11. Diagnosis of metastatic cancer of any type that is not considered in remission or non-metastatic cancer that may require radiation treatment in the pelvic region (e.g. prostate cancer)
- 12. Suspected perforation of gastrointestinal tract
- 13. Active systemic infection
- 14. Allergy to paclitaxel
- 15. Severe coagulation disorders or current use of anticoagulant or antiplatelet medication that cannot be safely managed per relevant societal guidelines
- 16. Chronic systemic steroid use (defined as greater than 10 mg/day) for any medical conditions unless subject is willing to undergo a 4-week washout and discontinue steroid use
- 17. Condition requiring treatment in urgent setting
- 18. Life expectancy of less than 24 months
- 19. Concurrent medical condition that would affect the investigator's ability to evaluate the patient's condition or could compromise patient safety, such as recent myocardial infarction, severe pulmonary disease, bleeding diathesis, large thoracic aneurysm, pharyngeal or cervical deformity, etc.
- 20. Current participation in another pre-market drug or medical device clinical study unless in long term follow-up
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Where can I participate?
Beverly
More about this Clinical Trial
What is the full name of this clinical trial?
Paclitaxel Coated balloon for the Treatment of chronic bEnigN sTricture - Bowel