A Polymer-Free Paclitaxel-Eluting Stent Versus a Bare-Metal Stent for De Novo Femoropopliteal Lesions: The BATTLE Trial.


Journal

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

Informations de publication

Date de publication:
24 02 2020
Historique:
received: 08 07 2019
revised: 25 11 2019
accepted: 03 12 2019
entrez: 22 2 2020
pubmed: 23 2 2020
medline: 29 9 2020
Statut: ppublish

Résumé

The primary objective of the BATTLE (Bare Metal Stent vs. Paclitaxel Eluting Stent in the Setting of Primary Stenting of Intermediate-Length Femoropopliteal Lesions) trial is to demonstrate the clinical superiority of the Zilver PTX stent over the Misago stent in the treatment of femoropopliteal lesions. No randomized studies have compared self-expanding paclitaxel-eluting stents with bare-metal stents in the treatment of femoropopliteal lesions. BATTLE is a multicenter randomized controlled trial in patients with symptomatic (Rutherford category 2 to 5) de novo lesions of the superficial femoral or proximal popliteal artery. The primary endpoint is freedom from in-stent restenosis (ISR) at 1 year, with restenosis defined as a peak systolic velocity index >2.4 at the target lesion. The Kaplan-Meier method was used to evaluate time-to-event data for freedom from ISR over the 2-year follow-up period. Between March 2014 and August 2016, 186 patients were enrolled; 91 were assigned to the Misago arm and 90 to the Zilver PTX arm. Kaplan-Meier 1-year estimates of freedom from ISR were 88.6% for Misago and 91% for Zilver PTX (hazard ratio [HR]: 1.2; 95% confidence interval [CI]: 0.6 to 2.4; p = 0.64). Comparing Misago with Zilver PTX, 2-year estimates were 6.4% and 1.2% (HR: 7.3; 95% CI: 0.9 to 59.3; p = 0.0632) for mortality, 74.6% and 78.8% (HR: 1.2; 95% CI: 0.6 to 2.1; p = 0.62) for patency, and 14.4% and 12.4% (HR: 1.2; 95% CI: 0.5 to 2.8; p = 0.69) for target lesion revascularization. In the treatment of symptomatic femoropopliteal lesions, the Zilver PTX stent failed to show superiority over the Misago stent in freedom from ISR at 1 year.

Sections du résumé

OBJECTIVES
The primary objective of the BATTLE (Bare Metal Stent vs. Paclitaxel Eluting Stent in the Setting of Primary Stenting of Intermediate-Length Femoropopliteal Lesions) trial is to demonstrate the clinical superiority of the Zilver PTX stent over the Misago stent in the treatment of femoropopliteal lesions.
BACKGROUND
No randomized studies have compared self-expanding paclitaxel-eluting stents with bare-metal stents in the treatment of femoropopliteal lesions.
METHODS
BATTLE is a multicenter randomized controlled trial in patients with symptomatic (Rutherford category 2 to 5) de novo lesions of the superficial femoral or proximal popliteal artery. The primary endpoint is freedom from in-stent restenosis (ISR) at 1 year, with restenosis defined as a peak systolic velocity index >2.4 at the target lesion. The Kaplan-Meier method was used to evaluate time-to-event data for freedom from ISR over the 2-year follow-up period.
RESULTS
Between March 2014 and August 2016, 186 patients were enrolled; 91 were assigned to the Misago arm and 90 to the Zilver PTX arm. Kaplan-Meier 1-year estimates of freedom from ISR were 88.6% for Misago and 91% for Zilver PTX (hazard ratio [HR]: 1.2; 95% confidence interval [CI]: 0.6 to 2.4; p = 0.64). Comparing Misago with Zilver PTX, 2-year estimates were 6.4% and 1.2% (HR: 7.3; 95% CI: 0.9 to 59.3; p = 0.0632) for mortality, 74.6% and 78.8% (HR: 1.2; 95% CI: 0.6 to 2.1; p = 0.62) for patency, and 14.4% and 12.4% (HR: 1.2; 95% CI: 0.5 to 2.8; p = 0.69) for target lesion revascularization.
CONCLUSIONS
In the treatment of symptomatic femoropopliteal lesions, the Zilver PTX stent failed to show superiority over the Misago stent in freedom from ISR at 1 year.

Identifiants

pubmed: 32081238
pii: S1936-8798(19)32649-4
doi: 10.1016/j.jcin.2019.12.028
pii:
doi:

Substances chimiques

Cardiovascular Agents 0
Metals 0
Paclitaxel P88XT4IS4D

Types de publication

Comparative Study Journal Article Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

447-457

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Auteurs

Yann Gouëffic (Y)

Hôpital Paris St. Joseph, Department of Vascular and Endovascular Surgery, Paris, France; Laboratoire de Physiopathologie de la Résorption Osseuse, Inserm-UN UMR-957, Nantes, France. Electronic address: ygoueffic@hpsj.fr.

Antoine Sauguet (A)

Clinique Pasteur, Toulouse, France.

Pascal Desgranges (P)

AP-HP, Hôpital Henri Mondor, Service de Chirurgie Vasculaire, Créteil, France.

Patrick Feugier (P)

Hôpital Edouard Herriot, Service de Chirurgie Vasculaire, Lyon, France.

Eugenio Rosset (E)

CHU Clermont-Ferrand, Hôpital Gabriel Montpied, Service de Chirurgie Vasculaire, Clermont-Ferrand, France.

Eric Ducasse (E)

CHU Bordeaux, Hôpital Pellegrin, Service de Chirurgie Vasculaire, Bordeaux, France.

Adrien Kaladji (A)

CHU Rennes, Service de Chirurgie Vasculaire, Rennes, France.

Lucie Salomon du Mont (L)

CHU Besançon, Hôpital Jean Minjoz, Service de Chirurgie Vasculaire, Besançon, France.

Jean Marc Pernès (JM)

Hôpital Privé d'Antony, Antony, France.

Philippe Commeau (P)

Polycliniq ue Les Fleurs, Ollioules, France.

Patrick Lermusiaux (P)

Bourgoin-Jallieu, Bourgoin-Jallieu, France.

Brice Leclere (B)

CHU Nantes, Department of Epidemiology, Nantes, France.

Béatrice Guyomarc'h (B)

CHU Nantes, Institut du Thorax, INSERM, CNRS, UNIV Nantes, Nantes, France.

Clément T Hoffmann (CT)

CHU Brest, Service de Médecine Vasculaire, Brest, France.

Blandine Maurel (B)

Laboratoire de Physiopathologie de la Résorption Osseuse, Inserm-UN UMR-957, Nantes, France; CHU de Nantes, Service de Chirurgie Vasculaire, Institut du Thorax, Nantes, France.

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