Assessment of Sirolimus- vs. paCLitaxEl-coated balloon angioPlasty In atherosclerotic femoropopliteal lesiOnS (ASCLEPIOS Study): preliminary results

• Published in: Journal of cardiovascular surgery Vol. 63; no. 1; p. 8
• Main Authors: Taneva, Gergana T, Pitoulias, Georgios A, Abu Bakr, Nizar, Kazemtash, Majid, Muñoz Castellanos, Jaime, Donas, Konstantinos P
• Format: Journal Article
• Language: English
• Published: Italy 01.02.2022
• Subjects: Aged; Amputation; Angioplasty, Balloon - adverse effects; Angioplasty, Balloon - instrumentation; Angioplasty, Balloon - mortality; Cardiovascular Agents - administration & dosage; Cardiovascular Agents - adverse effects; Coated Materials, Biocompatible; Female; Femoral Artery - diagnostic imaging; Femoral Artery - physiopathology; Humans; Limb Salvage; Male; Paclitaxel - administration & dosage; Paclitaxel - adverse effects; Peripheral Arterial Disease - diagnostic imaging; Peripheral Arterial Disease - mortality; Peripheral Arterial Disease - physiopathology; Peripheral Arterial Disease - therapy; Plaque, Atherosclerotic; Popliteal Artery - diagnostic imaging; Popliteal Artery - physiopathology; Progression-Free Survival; Sirolimus - administration & dosage; Sirolimus - adverse effects; Time Factors; Vascular Patency
• ISSN: 1827-191X
• DOI: 10.23736/S0021-9509.21.12169-X

There appears to be an association between paclitaxel-coated devices and increased 5-year all-cause mortality. We are conducting a prospective, randomized, controlled, single-center, noninferiority study. All consecutive patients with femoropopliteal arterial disease who fulfilled the inclusion/exclusion criteria are sequentially and consecutively assigned to either paclitaxel (Ranger, Boston Scientific) or sirolimus (MagicTouch, Concept Medical) coated balloon angioplasty treatment. The primary outcome are procedural success and primary vessel patency at index procedure. The secondary outcomes are 30-day and 12-month freedom from MAEs (amputation, death, TLR/TVR, MI, distal embolization that requires a separate intervention or hospitalization), procedural success (≤30% residual diameter stenosis or occlusion after the procedure), Rutherford category improvement (reduction ≤1 category) and ABI improvement (increase ≥0.10 from baseline). A total of six patients have been enrolled in the present study up to now. The mean age was 72.6 years old and five were male. All patients had angiographic evidence of isolated occlusion in the transition segment of the distal femoral superficial artery in the popliteal artery. The mean length was 109 mm. Three patients were treated by sirolimus-coated (group A) and three by paclitaxel coated balloon angioplasty (group B). The primary patency and procedural success was in two of three and three of three patients, for group A and B, respectively. Preliminary results show safety and feasibility of the Sirolimus-coated balloon angioplasty. Further investigation and increase of sample size will allow for more sustained conclusions regarding patency and procedural success of this type of balloons for the endovascular treatment of peripheral arterial disease.