TY - JOUR
T1 - Drug-Coated Balloon Treatment of Femoropopliteal Lesions for Patients With Intermittent Claudication and Ischemic Rest Pain: 2-Year Results From the IN.PACT Global Study
AU - Micari, Antonio
AU - Brodmann, Marianne
AU - Keirse, Koen
AU - Peeters, Patrick
AU - Tepe, Gunnar
AU - Frost, Martin
AU - Wang, Hong
AU - Zeller, Thomas
AU - Zeller, Thomas
AU - Torsello, Giovanni
AU - Tepe, Gunnar
AU - Peeters, Patrick
AU - Scheinert, Dierk
AU - Bosiers, Marc
AU - Maene, Lieven
AU - Micari, Antonio
AU - Do, Dai-Do
AU - Hendriks, Jeroen
AU - Keirse, Koen
AU - Brodmann, Marianne
AU - Merkely, Bela
AU - Lardenoije, Jan-Willem
AU - Ruzsa, Zoltan
AU - Vogel, Britta
AU - Veroux, Pierfrancesco
AU - Albuquerque E Castro, Joao
AU - Periard, Daniel
AU - Ludyga, Tomasz
AU - Midy, Dominique
AU - Choi, Donghoon
AU - Lansink, Wouter
AU - Ketelsen, Dominik
AU - Dubenec, Steven
AU - Banyai, Martin
AU - Chakfe, Nabil
AU - Roithinger, Franz Xaver
AU - Trani, Carlo
AU - Mansour, Hossam
AU - Rha, Seung-Woon
AU - Vermassen, Frank
AU - Belenky, Alexander
AU - Spak, Lubomir
AU - Chalmers, Nicholas
AU - Benko, Andrew
AU - Kum, Steven
AU - Seerangan, Kumar
AU - Won, Je Hwan
AU - Vozar, Matej
AU - Tan, Kong Teng
AU - Labib, Mamdouh
AU - De Borst, Gert-Jan
AU - Do, Young-Soo
AU - Teijink, Joep
AU - Gomez, Juan Fernando
AU - Falkowski, Aleksander
AU - Ferreira, Luis
AU - Matela, Jozef
AU - Lee, Seung-Whan
AU - Verhoeven, Bart
AU - Mannheim, Dalit
AU - Nessi, Franco
AU - Vulev, Ivan
AU - De Vries, Jean-Paul
AU - Maly, Radovan
AU - Kavteladze, Zaza
AU - Turner, Douglas
AU - Mendiz, Oscar
AU - Kolvenbach, Ralf
AU - Karnabatidis, Dimitrios
AU - Cuellar, Cesar
AU - Venermo, Maarit
AU - Velicka, Linas
AU - Lundberg, Goran
PY - 2018
Y1 - 2018
N2 - Objectives: The IN.PACT Global Study is the largest prospective, multicenter, independently adjudicated trial to evaluate a paclitaxel drug-coated balloon in patients with lifestyle-limiting claudication and/or ischemic rest pain due to atherosclerotic disease of the femoropopliteal artery and includes complex lesions beyond what are typically included in randomized controlled trials. Background: Randomized controlled trials have demonstrated the safety and efficacy of drug-coated balloons for the treatment of Trans-Atlantic Inter-Society Consensus Document II A and B lesions, but there is a need for large-scale prospective studies to evaluate a broader range of lesions. Methods: The IN.PACT Global Study enrolled 1,535 subjects, and 1,406 (1,773 lesions) were included in the pre-defined clinical cohort analysis. Freedom from clinically driven target lesion revascularization was evaluated at 24 months. The safety composite endpoint was freedom from device- and procedure-related death through 30 days and freedom from target limb major amputation and clinically driven target vessel revascularization within 24 months. Results: Mean lesion length was 12.1 cm, 35.5% were total occlusions, and 18.0% had in-stent restenosis. Freedom from clinically driven target lesion revascularization at 24 months was 83.3%, the composite safety endpoint was met in 81.7%, the 2-year all-cause mortality rate was 7.0%, and the major target limb amputation rate was 0.7%. Increased lesion length and the presence of de novo in-stent restenosis or coronary artery disease were associated with increased risk for clinically driven target lesion revascularization by 24 months. Conclusions: This real-world study of femoropopliteal artery disease treatment with drug-coated balloons confirmed positive findings reported from more strictly designed randomized controlled trials and showed that outcomes are durable in this population up to 2 years after treatment. (IN.PACT Global Clinical Study; NCT01609296)
AB - Objectives: The IN.PACT Global Study is the largest prospective, multicenter, independently adjudicated trial to evaluate a paclitaxel drug-coated balloon in patients with lifestyle-limiting claudication and/or ischemic rest pain due to atherosclerotic disease of the femoropopliteal artery and includes complex lesions beyond what are typically included in randomized controlled trials. Background: Randomized controlled trials have demonstrated the safety and efficacy of drug-coated balloons for the treatment of Trans-Atlantic Inter-Society Consensus Document II A and B lesions, but there is a need for large-scale prospective studies to evaluate a broader range of lesions. Methods: The IN.PACT Global Study enrolled 1,535 subjects, and 1,406 (1,773 lesions) were included in the pre-defined clinical cohort analysis. Freedom from clinically driven target lesion revascularization was evaluated at 24 months. The safety composite endpoint was freedom from device- and procedure-related death through 30 days and freedom from target limb major amputation and clinically driven target vessel revascularization within 24 months. Results: Mean lesion length was 12.1 cm, 35.5% were total occlusions, and 18.0% had in-stent restenosis. Freedom from clinically driven target lesion revascularization at 24 months was 83.3%, the composite safety endpoint was met in 81.7%, the 2-year all-cause mortality rate was 7.0%, and the major target limb amputation rate was 0.7%. Increased lesion length and the presence of de novo in-stent restenosis or coronary artery disease were associated with increased risk for clinically driven target lesion revascularization by 24 months. Conclusions: This real-world study of femoropopliteal artery disease treatment with drug-coated balloons confirmed positive findings reported from more strictly designed randomized controlled trials and showed that outcomes are durable in this population up to 2 years after treatment. (IN.PACT Global Clinical Study; NCT01609296)
KW - Aged
KW - Angioplasty, Balloon
KW - Cardiovascular Agents
KW - Coated Materials, Biocompatible
KW - Constriction, Pathologic
KW - Female
KW - Femoral Artery
KW - Humans
KW - Intermittent Claudication
KW - Ischemia
KW - Male
KW - Middle Aged
KW - Paclitaxel
KW - Peripheral Arterial Disease
KW - Popliteal Artery
KW - Prospective Studies
KW - Recurrence
KW - Time Factors
KW - Treatment Outcome
KW - Vascular Access Devices
KW - Vascular Patency
KW - angioplasty
KW - drug-coated balloon
KW - femoropopliteal artery
KW - peripheral artery disease
KW - target lesion revascularization
KW - Aged
KW - Angioplasty, Balloon
KW - Cardiovascular Agents
KW - Coated Materials, Biocompatible
KW - Constriction, Pathologic
KW - Female
KW - Femoral Artery
KW - Humans
KW - Intermittent Claudication
KW - Ischemia
KW - Male
KW - Middle Aged
KW - Paclitaxel
KW - Peripheral Arterial Disease
KW - Popliteal Artery
KW - Prospective Studies
KW - Recurrence
KW - Time Factors
KW - Treatment Outcome
KW - Vascular Access Devices
KW - Vascular Patency
KW - angioplasty
KW - drug-coated balloon
KW - femoropopliteal artery
KW - peripheral artery disease
KW - target lesion revascularization
UR - http://hdl.handle.net/10807/157339
U2 - 10.1016/j.jcin.2018.02.019
DO - 10.1016/j.jcin.2018.02.019
M3 - Article
SN - 1936-8798
VL - 11
SP - 945
EP - 953
JO - JACC: Cardiovascular Interventions
JF - JACC: Cardiovascular Interventions
ER -