Clinical investigation of the GORE drug-coated PTA balloon catheter for CE mark approval

ABSTRACT Objectives Paclitaxel-coated balloon angioplasty has been established as the first-line therapy for femoropopliteal artery disease. The primary objectives of the study were to evaluate the performance and the safety of the GORE-DCB Catheter in the treatment of atherosclerotic femoropopliteal lesions in patients with peripheral artery disease for CE-Mark approval. Methods Prospective, single-arm, multicenter study with 24 months follow-up. The GORE-DCB Catheter consists of a drug-coated nylon (inner layer)/ePTFE (outer layer) composite balloon. The ePTFE layer is coated with paclitaxel (concentration: 3.5 μg/mm2) and the excipient stearic acid/tromethamine (tris). The primary endpoints were 6-month late lumen loss (LLL) and 30-day of freedom from Major Adverse Events (MAE). Results Fifty-two subjects were enrolled, 69% men, median age 69 (49–83) years. Acute device success was 100%, the 30-day MAE rate was zero. Study primary endpoint of LLL (−0.17 mm) showed significant superiority compared to the performance goal of uncoated PTA balloon catheters from literature. At 1 and 2 years, primary patency rates were 81.8% and 68.7%, respectively, and freedom from clinically driven target lesion revascularization rates was 87.9% and 83.4%, respectively. Conclusion The study demonstrates that the treatment of lesions in femoropopliteal arteries with the GORE-DCB Catheter is safe and effective.

[1]  T. Zeller,et al.  Six-Month Outcomes From the First-in-Human, Single-Arm SELUTION Sustained-Limus-Release Drug-Eluting Balloon Trial in Femoropopliteal Lesions , 2020, Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists.

[2]  S. Spiliopoulos,et al.  Risk of Death Following Application of Paclitaxel‐Coated Balloons and Stents in the Femoropopliteal Artery of the Leg: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials , 2018, Journal of the American Heart Association.

[3]  I. Ott,et al.  Two-Year Clinical Outcomes of the CONSEQUENT Trial: Can Femoropopliteal Lesions be Treated with Sustainable Clinical Results that are Economically Sound? , 2018, CardioVascular and Interventional Radiology.

[4]  W. Grochulski,et al.  Health Care Resources and Costs for Treating Peripheral Artery Disease in a Managed Care Population: Results From Analysis of Administrative Claims Data , 2005, Journal of managed care pharmacy : JMCP.

[5]  S. Duda,et al.  Two‐year results of a low‐dose drug‐coated balloon for revascularization of the femoropopliteal artery: Outcomes from the ILLUMENATE first‐in‐human study , 2015, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[6]  D. Scheinert,et al.  Paclitaxel-Releasing Balloon in Femoropopliteal Lesions Using a BTHC Excipient , 2015, Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists.

[7]  A. Cannavale,et al.  Lower Limb Multilevel Treatment With Drug-Eluting Balloons: 6-Month Results From the DEBELLUM Randomized Trial , 2012, Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists.

[8]  M. Davies,et al.  Changing Paradigms in the Management of Peripheral Vascular Disease: The Need for Integration of Knowledge, Imaging, and Therapeutics , 2010 .

[9]  横井 良明,et al.  ガイドライン解説 ACC/AHA 2005 Practice Guideline for the Management of Patients With Peripheral Arterial Diseaseから 腎動脈狭窄症のガイドラインについて , 2009 .

[10]  B. Hamm,et al.  Inhibition of Restenosis in Femoropopliteal Arteries: Paclitaxel-Coated Versus Uncoated Balloon: Femoral Paclitaxel Randomized Pilot Trial , 2008, Circulation.

[11]  C. Claussen,et al.  Local delivery of paclitaxel to inhibit restenosis during angioplasty of the leg. , 2008, The New England journal of medicine.

[12]  L. Norgren,et al.  Inter-society consensus for the management of peripheral arterial disease. , 2007, International angiology : a journal of the International Union of Angiology.

[13]  N. Shammas,et al.  Epidemiology, classification, and modifiable risk factors of peripheral arterial disease , 2007, Vascular health and risk management.

[14]  S. Allaqaband,et al.  Endovascular treatment of peripheral vascular disease. , 2006, Current problems in cardiology.

[15]  G. Rudofsky,et al.  The challenges of treating peripheral arterial disease , 2003, Vascular medicine.

[16]  M. Criqui,et al.  Peripheral Arterial Disease Detection, Awareness, and Treatment in Primary Care , 2001 .

[17]  R. Rutherford,et al.  Recommended standards for reports dealing with lower extremity ischemia: revised version. , 1997, Journal of vascular surgery.

[18]  R. Hamman,et al.  Effect of diagnostic criteria on the prevalence of peripheral arterial disease. The San Luis Valley Diabetes Study. , 1995, Circulation.

[19]  K. Johnston Femoral and popliteal arteries: reanalysis of results of balloon angioplasty. , 1992, Radiology.

[20]  R. Prescott,et al.  Edinburgh Artery Study: prevalence of asymptomatic and symptomatic peripheral arterial disease in the general population. , 1991, International journal of epidemiology.

[21]  G. Mclean,et al.  Femoropopliteal Angioplasty: Factors Influencing Long‐term Success , 1991 .

[22]  D. Scheinert,et al.  The LEVANT I (Lutonix paclitaxel-coated balloon for the prevention of femoropopliteal restenosis) trial for femoropopliteal revascularization: first-in-human randomized trial of low-dose drug-coated balloon versus uncoated balloon angioplasty. , 2014, JACC. Cardiovascular interventions.

[23]  L. Norgren,et al.  Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). , 2007, Journal of vascular surgery.

[24]  R. Rutherford,et al.  Management of peripheral arterial disease (PAD). TASC Working Group. TransAtlantic Inter-Society Consensus (TASC). , 2000, Journal of vascular surgery.