Efficacy and safety of a novel paclitaxel-nano-coated balloon for femoropopliteal angioplasty: one-year results of the EffPac trial
Ulf Teichgräber, Thomas Lehmann, René Aschenbach, Dierk Scheinert, Thomas Zeller, Klaus Brechtel, Erwin Blessing, Michael Lichtenberg, Sebastian Sixt, Steffen Brucks, Ulrich Beschorner, Christof Tobias Klumb, Markus Thieme, Collaborators, Peter von Flotow, Britta Heilmeier, Christian Erbel, Michael Werk, Vicenç Riambau, Andreas Wienke, Ulf Teichgräber, Thomas Lehmann, René Aschenbach, Dierk Scheinert, Thomas Zeller, Klaus Brechtel, Erwin Blessing, Michael Lichtenberg, Sebastian Sixt, Steffen Brucks, Ulrich Beschorner, Christof Tobias Klumb, Markus Thieme, Collaborators, Peter von Flotow, Britta Heilmeier, Christian Erbel, Michael Werk, Vicenç Riambau, Andreas Wienke
Abstract
Aims: Although paclitaxel drug-coated balloon (DCB) angioplasty is an established endovascular treatment for peripheral artery disease, restenosis remains a major concern. Thus, we compared a novel paclitaxel-coated DCB with nano-coating technology with uncoated plain old balloon angioplasty (POBA).
Methods and results: This multicentre trial randomly assigned 171 patients with stenotic and occlusive lesions of the femoropopliteal artery to angioplasty with a novel DCB or uncoated POBA. The primary endpoint, late lumen loss at six months, was 0.92 mm lower in the DCB group (95% CI: -1.36 to -0.49 mm, p<0.001). Patients showed improved walking after DCB treatment at six months (p=0.021). In the DCB group, 44.6% and 50% of the patients improved by three Rutherford-Becker classification stages after six to 12 months, respectively (POBA: 27.8% and 36.8%, respectively). Only one patient needed TLR (1.3%) in the DCB group, compared to 14 patients (18.7%) in the POBA group after 12 months (relative risk [RR]=0.08, 95% CI: 0.01-0.53, p<0.001). Primary patency was 90.3% (DCB group) versus 65.3% (POBA group) after 12 months (RR=1.38, 95% CI: 1.14-1.67, p<0.001).
Conclusions: The novel DCB was effective and safe for inhibiting restenosis. Moreover, it demonstrated a better improvement in walking than POBA and showed no mortality concerns due to paclitaxel application after 12 months. Clinical Trials Identifier: NCT02540018
Source: PubMed