Marianne Brodmann1, Koen Keirse2, Dierk Scheinert3, Lubomir Spak4, Michael R Jaff5, Randy Schmahl6, Pei Li7, Thomas Zeller8. 1. Department of Internal Medicine, Division of Angiology, Medical University, Graz, Austria. Electronic address: marianne.brodmann@medunigraz.at. 2. Department of Vascular Surgery, Regional Hospital Heilig Hart Tienen, Tienen, Belgium. 3. Division of Interventional Angiology, University Hospital Leipzig, Leipzig, Germany. 4. Clinic of Angiology, Eastern Slovak Institute for Cardiovascular Diseases, Kosice, Slovak Republic. 5. President, Newton-Wellesley Hospital, Newton, Massachusetts; Professor of Medicine, Harvard Medical School Boston, Massachusetts. 6. Medtronic, Bakken Research Center BV, Maastricht, the Netherlands. 7. Medtronic, Minneapolis, Minnesota. 8. Universitäts-Herzzentrum Freiburg-Bad Krozingen, Bad Krozingen, Germany.
Abstract
OBJECTIVES: This study sought to evaluate the safety and effectiveness of a paclitaxel-coated drug-coated balloon (DCB) for the treatment of patients with de novo in-stent restenosis (ISR). BACKGROUND: Treatment of patients with ISR remains a challenge. Current strategies are plagued by high rates of recurrent restenosis and need for reintervention. The best intervention for ISR remains to be elucidated. METHODS: The IN.PACT Global study is an independently adjudicated multicenter, prospective, single-arm study that enrolled 1,535 subjects with symptomatic atherosclerotic disease of the superficial femoral and/or popliteal arteries, including de novo ISR lesions. Patients enrolled in the pre-specified ISR imaging cohort were evaluated for vessel patency and reintervention within the 12-month follow-up period. RESULTS: A total of 131 subjects with 149 ISR lesions were included for analysis. The mean age of the cohort was 67.8 years. Mean lesion length was 17.17 ± 10.47 cm, including 34.0% total occlusions and 59.1% calcified lesions. The 12-month Kaplan-Meier estimate of primary patency was 88.7%. The rate of clinically driven target lesion revascularization (CD TLR) at 12 months was 7.3%. The primary safety outcome, a composite of freedom from device- and procedure-related mortality through 30 days and freedom from major target limb amputation and CD TLR within 12 months, was 92.7%. There were no major target limb amputations, no deaths, and a low (0.8%) thrombosis rate. CONCLUSIONS: Results from the ISR imaging cohort demonstrate high patency and a low rate of CD TLR at 12 months. These data confirm the safety and effectiveness of the IN.PACT Admiral DCB (Medtronic, Dublin, Ireland) in complex femoropopliteal lesions, including this challenging subset.
OBJECTIVES: This study sought to evaluate the safety and effectiveness of a paclitaxel-coated drug-coated balloon (DCB) for the treatment of patients with de novo in-stent restenosis (ISR). BACKGROUND: Treatment of patients with ISR remains a challenge. Current strategies are plagued by high rates of recurrent restenosis and need for reintervention. The best intervention for ISR remains to be elucidated. METHODS: The IN.PACT Global study is an independently adjudicated multicenter, prospective, single-arm study that enrolled 1,535 subjects with symptomatic atherosclerotic disease of the superficial femoral and/or popliteal arteries, including de novo ISR lesions. Patients enrolled in the pre-specified ISR imaging cohort were evaluated for vessel patency and reintervention within the 12-month follow-up period. RESULTS: A total of 131 subjects with 149 ISR lesions were included for analysis. The mean age of the cohort was 67.8 years. Mean lesion length was 17.17 ± 10.47 cm, including 34.0% total occlusions and 59.1% calcified lesions. The 12-month Kaplan-Meier estimate of primary patency was 88.7%. The rate of clinically driven target lesion revascularization (CD TLR) at 12 months was 7.3%. The primary safety outcome, a composite of freedom from device- and procedure-related mortality through 30 days and freedom from major target limb amputation and CD TLR within 12 months, was 92.7%. There were no major target limb amputations, no deaths, and a low (0.8%) thrombosis rate. CONCLUSIONS: Results from the ISR imaging cohort demonstrate high patency and a low rate of CD TLR at 12 months. These data confirm the safety and effectiveness of the IN.PACT Admiral DCB (Medtronic, Dublin, Ireland) in complex femoropopliteal lesions, including this challenging subset.
Authors: John A Laird; Peter A Schneider; Michael R Jaff; Marianne Brodmann; Thomas Zeller; D Chris Metzger; Prakash Krishnan; Dierk Scheinert; Antonio Micari; Hong Wang; Michele Masters; Gunnar Tepe Journal: Circ Cardiovasc Interv Date: 2019-06-14 Impact factor: 6.546
Authors: Gary M Ansel; Marianne Brodmann; Koen Keirse; Antonio Micari; Michael R Jaff; Krishna Rocha-Singh; Eric J Fernandez; Hong Wang; Thomas Zeller Journal: J Endovasc Ther Date: 2018-10-03 Impact factor: 3.487