Sustainable Antirestenosis Effect With a Low-Dose Drug-Coated Balloon: The ILLUMENATE European Randomized Clinical Trial 2-Year Results
| Autor: | Marianne, Brodmann, Martin, Werner, Dirk-Roelfs, Meyer, Peter, Reimer, Karsten, Krüger, Juan F, Granada, Michael R, Jaff, Henrik, Schroeder |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Time Factors Paclitaxel Cardiovascular Agents Constriction Pathologic Equipment Design Middle Aged Europe Peripheral Arterial Disease Treatment Outcome Coated Materials Biocompatible Recurrence Risk Factors Humans Female Single-Blind Method Prospective Studies Angioplasty Balloon Vascular Access Devices Vascular Patency Aged |
| Zdroj: | JACC. Cardiovascular interventions. 11(23) |
| ISSN: | 1876-7605 |
| Popis: | The aim of this study was to assess the safety and effectiveness of a next-generation low-dose drug-coated balloon (DCB) designed to optimize the amount of drug transferred into the vessel wall and to maximize the amount of time the drug resides in the vessel wall.Several randomized controlled studies evaluating various DCBs have demonstrated a significantly higher patency rate compared with noncoated percutaneous transluminal angioplasty balloons at 1 year. However, the data are limited and vary by DCB at longer follow-up time points. An earlier generation low-dose DCB failed to demonstrate significant treatment effect at 2 years, raising questions regarding the durability of low-dose DCBs.In this prospective, multicenter trial, 294 patients were randomized (3:1) to treatment with a DCB or an uncoated percutaneous transluminal angioplasty balloon. Assessments at 2 years included primary patency with duplex ultrasonography, clinically driven target lesion revascularization, and functional outcomes.Primary patency at 2 years was significantly higher in the DCB cohort (75.9% vs. 61.0%; p = 0.025), and the rate of clinically driven target lesion revascularization was significantly lower (12.1% vs. 30.5%; p 0.001). There were no major limb amputations in either group. The rates of all-cause (6.5% vs. 5.1%; p = 1.00) and cardiovascular-related (1.6% vs. 1.7%; p = 1.00) mortality were similar between groups. Functional improvements over baseline were sustained in both groups, with 60% fewer reinterventions in the DCB group.A sustained treatment effect is achievable with a low-dose DCB with an optimized coating formulation. This trial demonstrated for the first time a statistically significantly higher primary patency rate for a low-dose DCB versus PTA at 2 years. (CVI Drug Coated Balloon European Randomized Clinical Trial; NCT01858363). |
| Databáze: | OpenAIRE |
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