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The SABRE Trial (Sirolimus Angioplasty Balloon for Coronary In-Stent Restenosis): Angiographic Results and 1-Year Clinical Outcomes Impact of Optimized Procedure-Related Factors in Drug-Eluting Balloon Angioplasty for Treatment of In-Stent Restenosis Contemporary use of drug-coated balloons in coronary artery disease: Where are we now? Outcomes after drug-coated balloon treatment for patients with calcified coronary lesions Drug-eluting balloons in coronary interventions: the quiet revolution? Drug-Coated Balloon Treatment for Femoropopliteal Artery Disease: The IN.PACT Global Study De Novo In-Stent Restenosis Imaging Cohort Changes in high-sensitivity troponin after drug-coated balloon angioplasty for drug-eluting stent restenosis Drug-Coated Balloon Versus Drug-Eluting Stent in Primary Percutaneous Coronary Intervention: A Feasibility Study Treatment strategies for coronary in-stent restenosis: systematic review and hierarchical Bayesian network meta-analysis of 24 randomised trials and 4880 patients Therapeutic Options for In-Stent Restenosis

Clinical Trial2017 Oct 23;10(20):2113-2123

JOURNAL:JACC Cardiovasc Interv. Article Link

Drug-Coated Balloon Treatment for Femoropopliteal Artery Disease: The IN.PACT Global Study De Novo In-Stent Restenosis Imaging Cohort

Brodmann M, Keirse K, IN.PACT Global Study Investigators Keywords: drug-coated balloon; femoropopliteal artery; in-stent restenosis; paclitaxel; peripheral artery disease

ABSTRACT


OBJECTIVES - This study sought to evaluate the safety and effectiveness of a paclitaxel-coated drug-coatedballoon (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.

Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.