Treatment of Coronary Drug-Eluting Stent Restenosis by a Sirolimus- or Paclitaxel-Coated Balloon.


Journal

JACC. Cardiovascular interventions
ISSN: 1876-7605
Titre abrégé: JACC Cardiovasc Interv
Pays: United States
ID NLM: 101467004

Informations de publication

Date de publication:
25 Mar 2019
Historique:
received: 17 09 2018
revised: 18 11 2018
accepted: 27 11 2018
entrez: 23 3 2019
pubmed: 23 3 2019
medline: 19 5 2020
Statut: ppublish

Résumé

The aim of this randomized controlled trial was to investigate a novel sirolimus-coated balloon (SCB) compared with the best investigated paclitaxel-coated balloon (PCB). Treatment of coronary in-stent restenosis (ISR) remains challenging. PCBs are an established treatment option outside the United States with a Class I, Level of Evidence: A recommendation in the European guidelines. However, their efficacy is better in bare-metal stent (BMS) ISR compared with drug-eluting stent (DES) ISR. Fifty patients with DES ISR were enrolled in a randomized, multicenter trial to compare a novel SCB (SeQuent SCB, 4 μg/mm Quantitative coronary angiography revealed no differences in baseline parameters. After 6 months, in-segment late lumen loss was 0.21 ± 0.54 mm in the PCB group versus 0.17 ± 0.55 mm in the SCB group (p = NS; per-protocol analysis). Clinical events up to 12 months also did not differ between the groups. This first-in-man comparison of a novel SCB with a crystalline coating shows similar angiographic outcomes in the treatment of coronary DES ISR compared with a clinically proven PCB. (Treatment of Coronary In-Stent Restenosis by a Sirolimus [Rapamycin] Coated Balloon or a Paclitaxel Coated Balloon [FIM LIMUS DCB]; NCT02996318).

Sections du résumé

OBJECTIVES OBJECTIVE
The aim of this randomized controlled trial was to investigate a novel sirolimus-coated balloon (SCB) compared with the best investigated paclitaxel-coated balloon (PCB).
BACKGROUND BACKGROUND
Treatment of coronary in-stent restenosis (ISR) remains challenging. PCBs are an established treatment option outside the United States with a Class I, Level of Evidence: A recommendation in the European guidelines. However, their efficacy is better in bare-metal stent (BMS) ISR compared with drug-eluting stent (DES) ISR.
METHODS METHODS
Fifty patients with DES ISR were enrolled in a randomized, multicenter trial to compare a novel SCB (SeQuent SCB, 4 μg/mm
RESULTS RESULTS
Quantitative coronary angiography revealed no differences in baseline parameters. After 6 months, in-segment late lumen loss was 0.21 ± 0.54 mm in the PCB group versus 0.17 ± 0.55 mm in the SCB group (p = NS; per-protocol analysis). Clinical events up to 12 months also did not differ between the groups.
CONCLUSIONS CONCLUSIONS
This first-in-man comparison of a novel SCB with a crystalline coating shows similar angiographic outcomes in the treatment of coronary DES ISR compared with a clinically proven PCB. (Treatment of Coronary In-Stent Restenosis by a Sirolimus [Rapamycin] Coated Balloon or a Paclitaxel Coated Balloon [FIM LIMUS DCB]; NCT02996318).

Identifiants

pubmed: 30898253
pii: S1936-8798(18)32395-1
doi: 10.1016/j.jcin.2018.11.040
pii:
doi:

Substances chimiques

Cardiovascular Agents 0
Coated Materials, Biocompatible 0
Paclitaxel P88XT4IS4D
Sirolimus W36ZG6FT64

Banques de données

ClinicalTrials.gov
['NCT02996318']

Types de publication

Comparative Study Journal Article Multicenter Study Randomized Controlled Trial

Langues

eng

Sous-ensembles de citation

IM

Pagination

558-566

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2019 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Auteurs

Rosli Mohd Ali (RM)

Cardiac Vascular Sentral Kuala Lumpur, Kuala Lumpur, Malaysia.

Muhamad Ali S K Abdul Kader (MASK)

Cardiology Department, Hospital Pulau Pinang, George Town, Malaysia.

Wan Azman Wan Ahmad (WA)

Cardiology Department, University Malaya Medical Center, Kuala Lumpur, Malaysia.

Tiong Kiam Ong (TK)

Cardiology Department, Sarawak Heart Centre, Kota Samarahan, Malaysia.

Houng Bang Liew (HB)

Cardiology Department and Clinical Research Center, Queen Elizabeth Hospital II, Kota Kinabalu, Malaysia.

Al-Fazir Omar (AF)

Cardiology Department, National Heart Institute Malaysia, Kuala Lumpur, Malaysia.

Ahmad Syadi Mahmood Zuhdi (AS)

Cardiology Department, University Malaya Medical Center, Kuala Lumpur, Malaysia.

Amin Ariff Nuruddin (AA)

Cardiology Department, National Heart Institute Malaysia, Kuala Lumpur, Malaysia.

Beatrix Schnorr (B)

Experimental Radiology, Charité, Berlin, Germany.

Bruno Scheller (B)

Cardiology Department, University Hospital of Saarland, Homburg/Saar, Germany. Electronic address: bruno.scheller@uks.eu.

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Classifications MeSH