Abstract
Objectives
Based on a novel paclitaxel–resveratrol drug matrix, the safety and efficacy to inhibit intimal hyperplasia were studied in symptomatic claudicants with morphologically challenging lesions.
Background
The treatment of peripheral artery occlusive disease (PAOD) with percutaneous transluminal angioplasty is limited by occurrence of vessel recoil and neointimal hyperplasia. Drug-coated balloons (DCB) deliver drugs to the arterial wall to potentially reduce the restenosis rate. A number of paclitaxel-coated balloon technologies are available to treat peripheral lesions.
Methods
In this randomized controlled trial, a total of 153 patients with symptomatic PAOD in femoro-popliteal lesions were randomized either to DCB or plain old balloon angioplasty (POBA).
Results
The mean lesion length was 13.2 ± 10.4 cm with target lesion total occlusions in 26.1% of all patients (40/153). The primary endpoint of in-lesion late lumen loss (LLL) at 6 months was significantly reduced in the DCB group as compared to the POBA group (0.35 mm CI [0.19; 0.79 mm] vs. 0.72 mm CI [0.68; 1.22 mm], p = 0.006). At 12 months, the TLR rate in the DCB group was significantly lower as compared to the POBA group (17.8 vs. 37.7% p = 0.008). The censored walking distance increase suggests a benefit for patients who underwent DCB angioplasty as compared to the standard POBA treatment (12 months 165 ± 105 vs. 94 ± 136 m, p = 0.012).
Conclusion
The use of paclitaxel–resveratrol-matrix-coated peripheral balloon angioplasty as compared to POBA was associated with significantly reduced in-lesion LLL and reduced TLR rates.
ClinicalTrials.gov identifier NCT01970579.
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Acknowledgements
The authors wish to thank Dr. Bettina Kelsch, Dr. Maren Kutschera and Dr. Ines Gemeinhardt at InnoRa Berlin, Germany, for their respective efforts in conducting and monitoring this trial. We also wish to acknowledge Dr. Ralf Degenhardt at the Herzkreislaufzentrum Rotenburg, Germany, for his statistical support and Denny Herberger at Medical Scientific Affairs B.Braun, Berlin, for his logistic contributions. Finally, our thanks are extended to the members of our critical event committee consisting of Prof. Vorwerk (Klinikum Ingolstadt), Prof. Gebauer (Charité Berlin) and Dr. Fiedler (Harzklinikum Wernigerode).
Funding
All study participants received funding from B.Braun per included patient within a milestone-based system.
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GT and TA have lectured and received research grants from B.Braun. MW is a full-time employee of Medical Scientific Affairs department of B.Braun Melsungen AG.
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Tepe, G., Gögebakan, Ö., Redlich, U. et al. Angiographic and Clinical Outcomes After Treatment of Femoro-Popliteal Lesions with a Novel Paclitaxel-Matrix-Coated Balloon Catheter. Cardiovasc Intervent Radiol 40, 1535–1544 (2017). https://doi.org/10.1007/s00270-017-1713-2
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DOI: https://doi.org/10.1007/s00270-017-1713-2