Paclitaxel Drug-Coated Balloon for the Treatment of De Novo Small-Vessel and Restenotic Coronary Artery Lesions: 12-Month Results of the Prospective, Multicenter, Single-Arm PREVAIL Study

Azeem Latib, Pierfrancesco Agostoni, Jo Dens, Mark Patterson, Patrizio Lancellotti, Frankie C C Tam, Carl Schotborgh, Elvin Kedhi, Pieter Stella, Cheryl Shen, Gwenn Wetzels, Luca Testa, PREVAIL Study Investigators, Azeem Latib, Pierfrancesco Agostoni, Jo Dens, Mark Patterson, Patrizio Lancellotti, Frankie C C Tam, Carl Schotborgh, Elvin Kedhi, Pieter Stella, Cheryl Shen, Gwenn Wetzels, Luca Testa, PREVAIL Study Investigators

Abstract

Objectives: The PREVAIL study evaluated the safety and effectiveness of a paclitaxel-coated percutaneous transluminal coronary angioplasty balloon catheter for the treatment of coronary de novo and in-stent restenosis (ISR) lesions in patients with symptomatic ischemic heart disease.

Methods: PREVAIL was a prospective, multicenter, single-arm study that enrolled patients with clinical evidence of ischemia who had coronary lesions (de novo or first ISR) amenable to treatment with a drug-coated balloon (DCB). The study included 50 subjects (53 target lesions) who were treated with a Prevail DCB (Medtronic) during the index procedure and followed for 12 months. Mean lesion length was 14.5 ± 7.6 mm. The primary endpoint was in-stent (in-balloon) late lumen loss (LLL) by quantitative coronary angiography at 6 months post procedure. If the mean in-stent (in-balloon) LLL was less than the maximum acceptance rate of 0.50 mm at 6 months, then the study was considered successful.

Results: Mean in-stent (in-balloon) LLL was 0.05 ± 0.44 mm at 6 months post procedure. There were no deaths, myocardial infarctions, or stent (lesion) thrombosis events within 12 months. The incidence of clinically driven target-lesion revascularization was 6.0% at 12 months and clinically driven target-vessel revascularization was 10.0%.

Conclusions: Paclitaxel DCB treatment of coronary de novo and first ISR lesions led to low LLL at 6 months and low rates of revascularization and safety events through 12 months.

Keywords: DCB; drug-coated balloon; in-stent restenosis; ischemia; revascularization.

Source: PubMed

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