Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:


Drug-coated balloon overcomes in-stent restenosis

Novel balloon catheter appears simpler, more effective than drug-eluting stent

An angioplasty balloon coated with a drug that reduces renarrowing of the coronary arteries appears to be more effective than a drug-eluting stent in treating an unwanted build-up of tissue inside a bare-metal coronary stent.

After six months, the newly expanded artery remained more widely open within the stent after treatment with the paclitaxel-eluting balloon when compared to a paclitaxel-eluting stent, according to the Paclitaxel-Eluting PTCA-Balloon Catheter in Coronary Artery Disease II-In-Stent Restenosis (PEPCAD II-ISR) study. Additional data suggested that at one year, rates of major cardiac events were also lower with the drug-coated balloon.

The PEPCAD II-ISR study is being reported today at the SCAI Annual Scientific Sessions in Partnership with ACC i2 Summit (SCAI-ACCi2) in Chicago. SCAI-ACCi2 is a scientific meeting for practicing cardiovascular interventionalists sponsored by the Society for Cardiovascular Angiography and Interventions (SCAI) in partnership with the American College of Cardiology (ACC).

“This drug-eluting balloon clearly qualifies for consideration as an alternative to drug-eluting stents for the treatment of restenosis inside bare-metal stents,” said Martin Unverdorben, MD, PhD, an associate professor of medicine at the University of Frankfurt/Main, Germany. “However, two to three years’ more data are required before making a definitive statement.”

In-stent restenosis remains a challenge, despite the availability of drug-eluting stents. Approximately 25 percent of patients treated with a bare-metal stent and about 10 percent of patients treated with a drug-eluting stent develop an overgrowth of vascular tissue and renarrowing inside the stent, or in-stent restenosis.

Treating in-stent restenosis with a drug-eluting stent is a complex procedure that adds another layer of metal to the artery and can create mechanical problems. The Sequent® Please drug-eluting balloon may offer a simpler alternative. This drug-eluting balloon is coated with paclitaxel, the same medication that coats the Taxus™ stent. The balloon is inflated for about 30 seconds inside the narrowed artery, and the paclitaxel—which has a natural attraction to cells—quickly moves from the surface of the balloon into the arterial cells.

Not only does the drug-eluting balloon avoid a second layer of metal inside the artery, the carrier that is used to bind paclitaxel to the balloon is iopromide, a commonly used contrast agent. This avoids concerns about the artery’s reaction to the polymers used to bind paclitaxel and other anti-restenosis medications to drug-eluting stents.

The study was conducted at the Center for Cardiovascular Diseases in Rotenburg an der Fulda, Germany. Dr. Unverdorben and his colleagues recruited 131 patients with restenosis in a bare-metal stent, randomly assigning them to treatment with the Sequent® Please drug-eluting balloon (DEB) or the Taxus™ drug-eluting stent (DES). Five patients were excluded for protocol violations, and four patients in the stent group were actually treated with the drug-eluting balloon. This left, for the “as-treated” analysis, 66 patients in the DEB group and 60 patients in the DES group.

The researchers initially analyzed the data according to each patient’s original treatment assignment (the intention-to-treat analysis). After an average of six months of follow-up, late-lumen loss—the amount of tissue that grew from the vessel wall into the arterial lumen—was significantly less in the patients treated with the DEB (0.20 mm vs. 0.45 mm, p=0.02). When the data were analyzed according the treatment each patient actually received, the results were even more promising. Late-lumen loss remained significantly better with the drug-eluting balloon. In addition, a finding of significant renarrowing in the treated segment was less common in the DEB group (3.4 percent vs. 20.4 percent, p=0.007), as was the need for a repeat procedure to re-treat the target lesion (3.1 percent vs. 16.7 percent, p=0.02). Combined rates of major cardiovascular events, defined as heart attack, repeat procedure to treat the target lesion and cardiac death were 4.7 percent and 18.3 percent, respectively (p=0.02).

Between six and 12 months, two patients in the DEB group needed PCI in another artery, and one patient (1.5 percent) needed yet another PCI to treat the original target lesion. In the DES group, two patients died of noncardiac causes, and three patients (5 percent) needed repeat target-lesion PCI. No new patients experienced a major cardiac event.

At 12 months, there was a trend toward better event-free survival in patients treated with the DEB in the intention-to-treat analysis. The difference was statistically significant (p=0.01) when the analysis was done according to the as-treated analysis.

Dr. Unverdorben will present the results of the "Paclitaxel-Eluting PTCA-Balloon Catheter in Coronary Artery Disease II-In-Stent Restenosis” (PEPCAD II-ISR) study on Monday, March 31 at 9:00 a.m. CDT in the Grand Ballroom, S100.

Kathy Boyd David | EurekAlert!
Further information:

More articles from Medical Engineering:

nachricht Gentle sensors for diagnosing brain disorders
29.09.2016 | King Abdullah University of Science and Technology

nachricht New imaging technique in Alzheimer’s disease - opens up possibilities for new drug development
28.09.2016 | Lund University

All articles from Medical Engineering >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: New 3-D wiring technique brings scalable quantum computers closer to reality

Researchers from the Institute for Quantum Computing (IQC) at the University of Waterloo led the development of a new extensible wiring technique capable of controlling superconducting quantum bits, representing a significant step towards to the realization of a scalable quantum computer.

"The quantum socket is a wiring method that uses three-dimensional wires based on spring-loaded pins to address individual qubits," said Jeremy Béjanin, a PhD...

Im Focus: Scientists develop a semiconductor nanocomposite material that moves in response to light

In a paper in Scientific Reports, a research team at Worcester Polytechnic Institute describes a novel light-activated phenomenon that could become the basis for applications as diverse as microscopic robotic grippers and more efficient solar cells.

A research team at Worcester Polytechnic Institute (WPI) has developed a revolutionary, light-activated semiconductor nanocomposite material that can be used...

Im Focus: Diamonds aren't forever: Sandia, Harvard team create first quantum computer bridge

By forcefully embedding two silicon atoms in a diamond matrix, Sandia researchers have demonstrated for the first time on a single chip all the components needed to create a quantum bridge to link quantum computers together.

"People have already built small quantum computers," says Sandia researcher Ryan Camacho. "Maybe the first useful one won't be a single giant quantum computer...

Im Focus: New Products - Highlights of COMPAMED 2016

COMPAMED has become the leading international marketplace for suppliers of medical manufacturing. The trade fair, which takes place every November and is co-located to MEDICA in Dusseldorf, has been steadily growing over the past years and shows that medical technology remains a rapidly growing market.

In 2016, the joint pavilion by the IVAM Microtechnology Network, the Product Market “High-tech for Medical Devices”, will be located in Hall 8a again and will...

Im Focus: Ultra-thin ferroelectric material for next-generation electronics

'Ferroelectric' materials can switch between different states of electrical polarization in response to an external electric field. This flexibility means they show promise for many applications, for example in electronic devices and computer memory. Current ferroelectric materials are highly valued for their thermal and chemical stability and rapid electro-mechanical responses, but creating a material that is scalable down to the tiny sizes needed for technologies like silicon-based semiconductors (Si-based CMOS) has proven challenging.

Now, Hiroshi Funakubo and co-workers at the Tokyo Institute of Technology, in collaboration with researchers across Japan, have conducted experiments to...

All Focus news of the innovation-report >>>



Event News

#IC2S2: When Social Science meets Computer Science - GESIS will host the IC2S2 conference 2017

14.10.2016 | Event News

Agricultural Trade Developments and Potentials in Central Asia and the South Caucasus

14.10.2016 | Event News

World Health Summit – Day Three: A Call to Action

12.10.2016 | Event News

Latest News

Innovative technique for shaping light could solve bandwidth crunch

20.10.2016 | Physics and Astronomy

Finding the lightest superdeformed triaxial atomic nucleus

20.10.2016 | Physics and Astronomy

NASA's MAVEN mission observes ups and downs of water escape from Mars

20.10.2016 | Physics and Astronomy

More VideoLinks >>>