Michael K. W. Lichtenberg MD, FESC on behalf of KANSHAS 1 investigators; Tepe G, Müller-Hülsbeck S, Deloose K, Verbist J, Goverde P, Zeller T

Similar documents
Michael K.W. Lichtenberg, MD

RANGER SFA REGISTRY Interim Analysis. Bernd Gehringhoff, MD On behalf the Ranger SFA Registry Investigators

The Freeway Stent Study: the 12 Months results highly favor the use of DEB in combination with stenting

COMPARE-Pilot RCT: 1-year results of a randomised comparison of RANGER DCB vs. IN.PACT DCB in complex SFA lesions. Dierk Scheinert

Final Results of the Feasibility Study for the Drug-coated Chocolate Touch PTA balloon. (The ENDURE Trial)

Final Results of the Feasibility Study for the Drug-coated Chocolate Touch PTA balloon. (The ENDURE Trial)

Dierk Scheinert, MD. Department of Angiology University Hospital Leipzig, Germany

Drug-Coated Balloon Treatment for Patients with Intermittent Claudication: Insights from the IN.PACT Global Full Clinical Cohort

TOBA II 12-Month Results Tack Optimized Balloon Angioplasty

Outcomes Of DCB Use In Real World Registries: 2 Year Results From The INPACT Global Registry

Long Lesions: Primary stenting or DCB first? John Laird MD Adventist Heart and Vascular Institute, St. Helena, CA

12-month Outcomes of Post Dilatation in the IN.PACT Global CTO Cohort. Gunnar Tepe, MD RodMed Clinic Rosenheim Rosenheim, Germany

Outcome of DCB and PTA post stenting in occluded versus stenotic lesions subgroup analysis of the randomized Freeway Stent Study

Latest Insights from the LEVANT II study and sub-group analysis

Shockwave Medical Lithoplasty. Thomas Zeller MD Universitäts-Herzzentrum Freiburg & Bad Krozingen, Germany

Treating in-stent occlusions with the Rotarex catheter : The ROBINSON study

Update on the Ranger clinical trial programme

Do we really need a stent in long SFA lesions? No: DEB is the answer

Endovascular Therapy vs. Open Femoral Endarterectomy Rationale and Design of the Randomized PESTO Trial

6-month 0utcomes of a Novel Sirolimus Coated DCB Technology Evaluated in SFA Thomas Zeller, MD University Heart Center Freiburg-Bad Krozingen

BIOLUX P-III Passeo-18 Lux All-comers Registry: 12-month Results for the All-Comers Cohort

DISRUPT PAD. (( Data Summary )) DISRUPT PAD Data Summary SPL Rev. B 2016 Shockwave Medical Inc. All rights reserved.

Update from Korea on the Lutonix SFA registry 12 month data

DCB use in fem-pop lesions of patients with CLI (RCC 4-5): subgroup analysis of IN.PACT Global 12-month outcomes

Lutonix DCB in BTK Update on the BTK real world registry and RCT

Six Month Results of the Global BIOLUX P-III All-Comers Registry using Drug Coated Balloon in Infra-Inguinal Artery Disease

The Lutonix BTK Clinical Trial Programme: Status Update and Real World Clinical Experience

DEB in Periphery: What we Know Till Now

EffPac - Trial: Assessment of the Effectiveness of DCB versus POBA in the SFA Ulf Teichgräber, MD, MBA

Massimiliano Fusaro, MD on behalf of ISAR-STATH Investigators. Deutsches Herzzentrum München, Technische Universität München Munich - Germany

Clinical use and safety of the Lutonix DCB for the treatment of BTK: interim data from a prospective registry

Promise and limitations of DCB in long lesions What Have we Learned from Clinical Trials? Ramon L. Varcoe, MBBS, MS, FRACS, PhD

MICHAEL R. JAFF, DO MASSACHUSETTS, UNITED STATES. Medtronic Further. Together

Or is the ivolution stent a better alternative? EVOLUTION 12-month data

Preliminary 6-month results of VMI-CFA trial

IN.PACT AV Access IDE Study Full Baseline Data. Robert Lookstein, MD MHCDL New York, NY On Behalf of the IN.PACT AV ACCESS Investigators

On behalf of the DURABILITY Investigators:

Luminor DCB in femoropopliteal lesions

Venous stent experience in Arnsberg Michael K. W. Lichtenberg MD, FESC

The Crack and Pave technique for highly resistant calcified lesions. Manuela Matschuck MD University Hospital Leipzig Department Angiology

Clinical results of venous stents. Michael K. W. Lichtenberg MD, FESC

Patency rates and clinical results of the Veniti VICI Stent for treatment of iliac vein lesion Data from the Arnsberg Venous Registry

Update on the Levant 2 Clinical Trial Programme. Dierk Scheinert, MD University Hospital Leipzig Leipzig, Germany

Alternative concepts for drug delivery in BTK arteries the LIMBO project

2 Year Results from the MDT SFA Japan Trial - DCB vs. standard PTA for the treatment of atherosclerotic lesions in the SFA/PPA

Koen Keirse, MD RZ Tienen, Belgium

Long-term results with interwoven nitinol stents vs. BMS vs. DCB

- Our patients with iliofemoral DVT - Effective thrombus removal with purely mechanical thrombectomy can lead to better outcomes

Importance of Thorough Vessel Preparation Followed By Anti- Restenotic Therapy: An Update from the DEFINITIVE AR Study

Lessons learnt from DES in the SFA is there any ideal concept so far?

BioMimics 3D in my Clinical Practice

Michael K. W. Lichtenberg, MD, FESC Westfälische Wilhelms-Universität Münster. Dierk Scheinert, M.D. Universitätsklinikum Leipzig AöR

ISR-treatment The Leipzig experience with purely mechanical debulking. Sven Bräunlich Department for Angiology University-Hospital Leipzig, Germany

The Illumina FIH study with a next generation DES 12-months results

LIFESTREAM TM First look at the BOLSTER 2-year follow up data

REKANALISATION CHRONISCH VENÖSER VERSCHLÜSSE. Michael K. W. Lichtenberg, FESC

REACT Treatment Rationale and Clinical Evidence. ICI Meeting 5th of December 2017

Maximizing Outcomes in a complex population with Drug-coated balloon

The Role of Lithotripsy in Solving the Challenges of Vascular Calcium. Thomas Zeller, MD

Comparison Of Primary Long Stenting Versus Primary Short Stenting For Long Femoropopliteal Artery Disease (PARADE)

Study of a Balloon-Expandable Covered Stent for Obstructive Lesions in the Iliac Artery

DCB + stent in the SFA

Department of Radiology. EffPac - Trial:

The drug-eluting balloon superficial femoral artery-long study THE DEB SFA-LONG STUDY

LUTONIX DCB in BTK Update on the BTK clinical program & single center experience

Contemporary use of DCBs, Ranger clinical trial and investigator sponsored research

Vessel Preparation: What does it mean and what are the current tools? Lawrence Garcia, MD St. Elizabeth s Medical Center Boston, MA, USA

Real PTX RCT: 3 year data from a randomized comparison of DCB vs. DES in femoropopliteal lesions

Atherectomy: Jetstream and Directional. George S. Chrysant, M.D.

The latest generation DEB

Fabrizio Fanelli, MD, EBIR Director Vascular and Interventional Radiology Department "Careggi " University Hospital Florence - Italy

The drug-eluting balloon superficial femoral artery-long study THE DEB SFA-LONG STUDY

ILLUMENATE Pivotal Stellarex DCB IDE Study 12-Month Results

Novel concept for drug delivery in infrapopliteal arteries The LIMBO trial

The BATTLE Trial Comparing Bare Metal to Drug Eluting Stents for Intermediate Length Lesions of the SFA

DCB in my practice: How the evidence influences my strategy. Yang-Jin Park

Combination therapy : treatment rationale and clinical evidence

Nicolas W Shammas, MD, MS

NCT Teichgräber et al. Trials (2016) DOI /s x

ILLUMENATE FIH Direct DCB Cohort 12-Month Results

Clinical Data Update for Drug Coated Balloons (DCB) Seung-Whan Lee, MD, PhD

The latest evidences from the DES trials in peripheral arterial disease

Is there still any space left for DES in the BTK area??? (Angiolite BTK trial, 6 month Data)

Efficacy of DEB in Calcification and Subintimal Angioplasty

PES BTK 70 : 12 m results with a paclitaxelcoated self-expanding stent in BTK arteries

Klinikum Rosenheim Department of Diagnostic and Interventional Radiology

First time data release: Initial experience with the temporary Spur Stent System: DEEPER Trial first-in-man results Jihad A. Mustapha, MD, FACC,

Christian Wissgott MD, PhD Assistant Director, Radiology Westküstenkliniken Heide

TOBA Trial 12 months Results

Stents for Femoropopliteal Disease:

OCT Guided Atherectomy: Initial Results of the VISION Trial Using the Pantheris Catheter. Patrick Muck, MD

Evolving Role of Drug-Eluting Stents In Complex SFA - Majestic Trial Data

Could a combination of DCB + stent be the answer in complex SFA lesions

Potential Conflicts of Interest

Atherectomy is Still Live and Effective. John R. Laird, MD Professor of Medicine Medical Director of the Vascular Center UC Davis Health System

Surgical Bypass or. Zilver PTX. 12 months preliminary data. LINC 2016, Leipzig. Marc Bosiers, MD. Marc Bosiers Koen Deloose Joren Callaert

Neuestes aus der Therapie der pavk. beschichtete Stents + Ballons. Karls-University. Eberhard-Karls. of Tubingen Department of Diagnostic Radiology

Patterns of Vessel Calcification and Clinical Relevance

Transcription:

Interim 30-day analysis from the KANSHAS 1 study of the novel KANSHAS drug coated balloon for treatment of femoropopliteal occlusive disease; a latest first-in-human study Michael K. W. Lichtenberg MD, FESC on behalf of KANSHAS 1 investigators; Tepe G, Müller-Hülsbeck S, Deloose K, Verbist J, Goverde P, Zeller T

Conflict of Interest - Disclosure Within the past 12 months, I or my spouse/partner have had a financial interest/arrangement or affiliation with the organization(s) listed below. Affiliation/Financial Relationship Company 1. Honoraria for lectures: CR Bard, Veniti, AB Medica, Volcano, Optimed GmbH, Straub Medical, Terumo, Biotronik, Veryan 2. Honoraria for advisory board activities: Veniti, Optimed GmbH, Straub Medical, Biotronik, Veryan, Boston Scientific 3. Participation in clinical trials: Biotronik, CR Bard, Veryan, Straub Medical, Veniti, TVA Medical, Boston Scientific, LimFlow, Terumo 4. Research funding: Biotronik, Boston Scientific, Veryan, Veniti, AB Medica

Objective Drug coated balloon therapy has demonstrated a higher effectiveness compared to standard PTA and been widely accepted as a valuable treatment option for patients with femoropopliteal disease. KANSHAS drug coated balloon has been developed to address some limitations of first generation DCBs related to coating integrity. This KANSHAS 1 first-in-human study aims at investigating safety profile and therapeutic advantages of the novel KANSHAS DCB in treatment of de novo femoropoliteal lesions.

KANSHAS DCB device 1 PXL tissue concentration 1) TR15-159 - Pharmacokinetic Evaluation of Paclitaxel Release from Terumo DCB 2) Catheterization and Cardiovascular Interventions 83:132-140 (2014) [Lutonix data source] 3) IN.PACT DEB technology and Pre-clinical Science presented at Leipzig Interventional Course (2013) 4) JACC Cardiovascular Interventions; 8(8):1115-23 (2015) [IN.PACT and Range data] Specification Drug: Paclitaxel (3.2µg/mm 2 ) Excipient: L-Serine Ethyl Ester HCl Balloon diameter: 4.0 6.0 mm Balloon length: 40 150 mm Catheter length: 150 cm Compatible GW size: 0.018 Nominal pressure: 8 atm (RBP 14 atm) Rapid exchange type Non-CE marked device as of Jan 2018

KANSHAS 1 study overview To assess safety and efficacy of the KANSHAS drug coated balloon catheter in the treatment of de novo lesions in the superficial femoral and/or popliteal arteries Prospective, multi-center, open, single arm study with 2-year follow-up 50 patients enrolled at 7 sites in Germany and Belgium from April 2017 to January 2018 Karolinen-Hospital: Klinikum Arnsberg Universitäts-Herzzentrum Freiburg-Bad Krozingen Ev Luth Diakonissenanstalt zu Flensburg Zentrum für Gesundheit und Diakonie RoMed Klinikum Rosenheim AZ St. Blasius Dendermonde Imelda Ziekenhuis Bonheiden ZNA Stuivenberg Antwerpen Enrollment completed and FUs are on-going Clinical Follow-up: 30 pts completed 30d FU Study management Steering Committees Clinical Event Committee (CEC) Data Monitoring Committee Angiographic Core Laboratory (BIDMC) Ultrasound Core Laboratory (Vascore) Independent monitors (Genae) Managed and sponsored by Terumo Europe 100% source data validation and independent core labo assessment Adverse events adjudication by CEC 0d 30d 6mo 1yr 2 yr Primary endpoint Composite Safety at 6m Defined as freedom from device and procedure related deaths through 30 days, freedom from target limb amputation, and clinically driven target lesion revascularization (TLR) through 6 months

KANSHAS 1 study eligibility General Inclusion Criteria: Clinically significant symptomatic leg ischemia, requiring treatment of the SFA and/or popliteal artery Rutherford Clinical Category of 2-4 Resting ABI of <0.9 or abnormal exercise ABI Informed Consent given 18 years old Life expectancy is >2 year Main Angiographic Inclusion Criteria: Cumulative lesion length 4-15 cm Target vessel diameter 4-6 mm Clinically and hemodynamically significant de novo stenosis (>70% stenosis) or occlusion including P3 segment Patent inflow artery ( 50% DS) At least one patent outflow artery Main Exclusion Criteria: Pregnant or lactating females Recent haemorrhagic stroke Known intolerance and contraindications to study medications and agents Recently diagnosed severe comorbidities Aneurismal disease of the abdominal aorta and target limb Acute thrombus in target vessel Use of adjunctive therapies In-stent restenosis Vessel injuries after predilatation; flow-limiting dissection, requiring stenting, or perforation Subintimal recanalization Severe calcification Previous treatment with DCB or DES in target vessel Previous peripheral bypass in target limb

Baseline Characteristics_Inital 30 pts Demographic Patients, n 30 Male Gender (%) 63.3% (19/30) Age Years Mean ± SD (N) 70.2±10.4 (30) Median (Min, Max) 74.0 (49.0, 88.0) CAD (%) 33.3% (10/30) CVD (%) 13.3% (4/30) Renal Insufficiency (%) 10.0% (3/30) COPD (%) 13.3% (4/30) Drug Related Allergies (%) 13.3% (4/30) Current/previous Smoker (%) 79.3% (23/29) Diabetes Mellitus (%) 30.0% (9/30) Arterial Hypertension (%) 86.7% (26/30) Hyperlipidemia (%) 73.3% (22/30) Previous PAD (%) 36.7% (11/30) Rutherford Classification Category 2 16.7% (5 / 30) Category 3 80.0% (24 / 30) Category 4 3.3% (1 / 30) ABI value Mean ± SD (N) 0.64±0.14 (30) Median (Min, Max) 0.69 (0.20, 0.89) CAD= Coronary artery disease, CVD= Cerebral vascular disease, COPD= Chronic obstructive pulmonary disease PAD= Peripheral Artery Disease

Lesion Characteristics Target lesion assessment Cumulative target lesion length (mm) Mean ± SD (N) 84.7±32.2 (30) Median (Min, Max) 80.0 (40.0, 140.0) Reference vessel diameter (mm) Mean ± SD (N) 5.4±0.6 (30) Median (Min, Max) 5.5, (4.0, 6.0) Baseline % diameter stenosis Mean ± SD (N) 92.3±7.8 (30) Median (Min, Max) 90.0 (70.0, 100.0) Lesion location Mid SFA 50.0% (15/30) Distal SFA 33.3% (10/30) P1 23.3% (7/30) P2 20.0% (6/30) P3 3.3% (1/30) Lesion Calcification Inflow assessment None 33.3% (10 / 30) Mild 36.7% (11 / 30) Moderate 23.3% (7 / 30) Severe 6.7% (2 / 30) Ipsilateral inflow lesion 3.3% (1/30) Successful inflow treatment 100.0% (1/1) (< 30% residual stenosis) Outflow assessment Patent run-off vessels 1 vessel 23.3% (7 / 30) 2 vessels 20.0% (6 / 30) 3 vessels 56.7% (17 / 30)

Procedural Characteristics Target lesion Predilatation Predilatation with a standard 96.7% (29/30) bare PTA balloon Inflation time (sec) Median (Min, Max) 90.0 (20.0, 180.0) DCB procedure Number of DCB devices used/pts Mean ± SD (N) 1.1±0.4 (30) Device transit time (sec) Mean ± SD (N) 22.8±12.4 (33) Device Inflation Time (min) Median (Min, Max) 3.0 (2.0, 5.5) Post DCB Dissection Grade after DCB Tyep A 26.7% (4 / 15) Type B 33.3% (5 / 15) Type C 33.3% (5 / 15) Type D 6.7% (1 / 15) Postdilatation 36.7% (11/30) Bail-out stent 30.0% (9/30) due to flow limited dissections 20% (6/30) or residual stensis > 50% Final Residual Diameter Stenosis (%) Mean ± SD (N) 11.2±8.9 (30) Median (Min, Max) 10.0 (0.0, 30.0) Postprocedural run-off vessels 1 vessel 23.3% (7 / 30) 2 vessels 16.7% (5 / 30) 3 vessels 60.0% (18 / 30)

Postprocedual outcomes Acute success Device success 100.0% (34/34) Technical success 100.0% (30/30) Procedural success 100.0% (30/30) Postprocedural outcomes at Predischarge Rutherford Classification Category 0 46.7% (14 / 30) Category 1 20.0% (6 / 30) Category 2 3.3% (1 / 30) Category 3 26.7% (8 / 30) Category 4 3.3% (1 / 30) ABI value Mean ± SD (N) 0.88±0.14 (30) Median (Min, Max) 0.90 (0.60, 1.09) Change from Baseline at Predischarge Rutherford class -2 Category change 33.3% (10 / 30) -3 Category change 33.3% (10 / 30) 0 Category change 33.3% (10 / 30) ABI value Mean ± SD (N) 0.24±0.17 (30) No device and procedure related Severe Adverse Events (SAE) has been reported in this 30 pts up to 30-day FU

Conclusions In the initial 30 patients, KANSHAS DCB has showed its safety profile at 30-day follow-up. The follow-ups are currently on-going and the 6-month primary outcomes in the full population will be available in summer 2018.

Interim 30-day analysis from the KANSHAS 1 study of the novel KANSHAS drug coated balloon for treatment of femoropopliteal occlusive disease; a latest first-in-human study Michael K. W. Lichtenberg MD, FESC on behalf of KANSHAS 1 investigators; Tepe G, Müller-Hülsbeck S, Deloose K, Verbist J, Goverde P, Zeller T