In Vitro and In Vivo Comparative Evaluation of a Shellac-Ammonium Paclitaxel-Coated Balloon versus a Benchmark Device

Comparison of 2 Paclitaxel-Coated Balloons with Different Excipients for the Treatment of Femoropopliteal Artery Disease: A Randomized Prospective Trial

PURPOSE

To evaluate the effectiveness and safety of a novel drug-coated balloon (DCB), Genoss DCB (Genoss), using shellac plus vitamin E as an excipient, compared with a reference DCB using urea.

MATERIALS AND METHODS

Patients with femoropopliteal arterial disease under Rutherford Classes 2-5 were enrolled in this prospective, multicenter, noninferiority clinical trial and randomly assigned 1:1 to Genoss DCB and IN.PACT Admiral (Medtronic, Dublin, Ireland). The primary endpoint was late lumen loss at 6 months, which was evaluated using computed tomography (CT) angiography by an independent investigator blinded to the treatment assignment.

RESULTS

A total of 119 patients from 10 institutions in the Republic of Korea were assigned to the Genoss DCB (n = 59) and IN.PACT Admiral (n = 60) groups. The late lumen losses were -0.08 mm (SD ± 0.59) in the Genoss DCB group and 0.02 mm (SD ± 0.72) in the IN.PACT Admiral group (P = .469). The upper limit of the 1-sided 97.5% confidence interval for differences in late lumen loss was 0.17 mm, lower than the noninferiority limit of 0.50 mm, demonstrating the noninferiority of Genoss DCB compared with IN.PACT Admiral. In addition, the 2 groups showed no significant differences in clinically-driven target lesion revascularization, major amputation, and all-cause mortality.

CONCLUSIONS

The safety and 6-month late lumen loss of a new DCB using shellac plus vitamin E as excipients were noninferior compared with those of the reference DCB using urea as the excipient.

Comparing the efficacy and safety of two different drug-coated balloons in in-stent restenosis: Two-year clinical outcomes of the RESTORE ISR China randomized trial

BACKGROUND

This head-to-head, multicenter, randomized trial investigated the safety and efficacy of Restore (Cardionovum, Bonn, Germany) drug-coated balloon (DCB) angioplasty in an Asian patient population with coronary drug-eluting stent in-stent restenosis (DES-ISR).

METHODS

A total of 240 patients with coronary DES-ISR were treated with Restore DCB or with SeQuent® Please (Braun, Melsungen, Germany) DCB. This trial used nine-month in-segment late lumen loss (LL) as the primary endpoint. Secondary endpoints included two-year clinical event rates.

RESULTS

Patient, lesion, and procedural characteristics in both treatment groups were similar. Nine-month in-segment LL was 0.38 ± 0.50 mm with Restore vs. 0.35 ± 0.47 mm with SeQuent® Please (p for non-inferiority = 0.02). The two-year follow-up rates were 95.8 % (115/120) in the Restore group and 94.2 % (113/120) in the SeQuent® Please group. Both groups had similar one- and two-year target lesion failure (TLF) rates (13.3 % vs. 12.6 %; p = 0.87 at one year, 14.8 % vs. 15.0 %; p = 1.0 at two years). Moreover, the all-cause mortality and myocardial infarction rates were 0 and 3.5 % (4/120) in the Restore group and 0.9 % (1/120) and 3.5 % (4/120) in the SeQuent® Please group, respectively. Additional analyzing of vessel quantitative flow ratio (QFR) did also show noninferior outcomes for one explicit treatment bunch.

CONCLUSIONS

The two-year follow-up indicated sustained long-term clinical safety and efficacy for both devices on the basis of QFR value.