Zilver PTX Post-market Surveillance Study of Paclitaxel-Eluting Stents for Treating Femoropopliteal Artery Disease in Japan: 2-Year Results

Kimihiko Kichikawa, Shigeo Ichihashi, Hiroyoshi Yokoi, Takao Ohki, Masato Nakamura, Kimihiro Komori, Shinsuke Nanto, Erin E. O’Leary, Aaron E. Lottes, Scott A. Snyder, Michael D. Dake

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Purpose: A prospective, multicenter post-market surveillance study in Japan evaluated the 2-year safety and effectiveness of the DES in real-world patients with complex femoropopliteal artery lesions. Methods: There were no exclusion criteria, and consecutive symptomatic patients with femoropopliteal lesions treated with the DES were enrolled in the study. Clinically driven target lesion revascularization (TLR) was defined as reintervention performed for > 50% diameter stenosis after recurrent clinical symptoms of peripheral arterial disease. Clinical benefit was defined as freedom from persistent or deteriorating ischemic symptoms. Patency was evaluated by duplex ultrasound where physicians considered this standard of care. Results: In this study, 905 patients were enrolled at 95 institutions in Japan. There were numerous comorbidities including a high incidence of diabetes (58.8%) and chronic kidney disease (43.6%). Additionally, 21.4% of patients were classified with critical limb ischemia. Lesions were complex, with an average length of 14.6 ± 9.6 cm (range 0.5–40 cm), 41.5% total occlusions, and 18.7% in-stent restenosis. In total, 1861 DES were placed in 1080 lesions. Two-year follow-up was obtained for > 90% of eligible patients. Freedom from TLR was 83.7%, and clinical benefit was 80.0% through 2 years. The 2-year primary patency rate was 70.3%. Rutherford classification significantly improved (p < 0.01), with approximately 80% of patients classified as Rutherford class 0 or 1 at 2 years. Conclusion: Despite more challenging lesion characteristics, 2-year results from the current study are similar to outcomes from the previous Zilver PTX studies, confirming the efficacy of the Zilver PTX DES in a complicated femoropopliteal lesion (Zilver PTX Post-Market Study in Japan; NCT02254837). Level of Evidence: Post-market surveillance study, Level III.

Original languageEnglish (US)
Pages (from-to)358-364
Number of pages7
JournalCardioVascular and Interventional Radiology
Volume42
Issue number3
DOIs
StatePublished - Mar 15 2019
Externally publishedYes

Fingerprint

Drug-Eluting Stents
Peripheral Arterial Disease
Paclitaxel
Stents
Japan
Arteries
Standard of Care
Chronic Renal Insufficiency
Comorbidity
Pathologic Constriction
Ischemia
Extremities
Physicians
Safety
Incidence

Keywords

  • Drug eluting stent
  • Femoropopliteal artery
  • Paclitaxel-eluting stent
  • Peripheral artery disease

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Zilver PTX Post-market Surveillance Study of Paclitaxel-Eluting Stents for Treating Femoropopliteal Artery Disease in Japan : 2-Year Results. / Kichikawa, Kimihiko; Ichihashi, Shigeo; Yokoi, Hiroyoshi; Ohki, Takao; Nakamura, Masato; Komori, Kimihiro; Nanto, Shinsuke; O’Leary, Erin E.; Lottes, Aaron E.; Snyder, Scott A.; Dake, Michael D.

In: CardioVascular and Interventional Radiology, Vol. 42, No. 3, 15.03.2019, p. 358-364.

Research output: Contribution to journalArticle

Kichikawa, K, Ichihashi, S, Yokoi, H, Ohki, T, Nakamura, M, Komori, K, Nanto, S, O’Leary, EE, Lottes, AE, Snyder, SA & Dake, MD 2019, 'Zilver PTX Post-market Surveillance Study of Paclitaxel-Eluting Stents for Treating Femoropopliteal Artery Disease in Japan: 2-Year Results', CardioVascular and Interventional Radiology, vol. 42, no. 3, pp. 358-364. https://doi.org/10.1007/s00270-018-2110-1
Kichikawa, Kimihiko ; Ichihashi, Shigeo ; Yokoi, Hiroyoshi ; Ohki, Takao ; Nakamura, Masato ; Komori, Kimihiro ; Nanto, Shinsuke ; O’Leary, Erin E. ; Lottes, Aaron E. ; Snyder, Scott A. ; Dake, Michael D. / Zilver PTX Post-market Surveillance Study of Paclitaxel-Eluting Stents for Treating Femoropopliteal Artery Disease in Japan : 2-Year Results. In: CardioVascular and Interventional Radiology. 2019 ; Vol. 42, No. 3. pp. 358-364.
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abstract = "Purpose: A prospective, multicenter post-market surveillance study in Japan evaluated the 2-year safety and effectiveness of the DES in real-world patients with complex femoropopliteal artery lesions. Methods: There were no exclusion criteria, and consecutive symptomatic patients with femoropopliteal lesions treated with the DES were enrolled in the study. Clinically driven target lesion revascularization (TLR) was defined as reintervention performed for > 50{\%} diameter stenosis after recurrent clinical symptoms of peripheral arterial disease. Clinical benefit was defined as freedom from persistent or deteriorating ischemic symptoms. Patency was evaluated by duplex ultrasound where physicians considered this standard of care. Results: In this study, 905 patients were enrolled at 95 institutions in Japan. There were numerous comorbidities including a high incidence of diabetes (58.8{\%}) and chronic kidney disease (43.6{\%}). Additionally, 21.4{\%} of patients were classified with critical limb ischemia. Lesions were complex, with an average length of 14.6 ± 9.6 cm (range 0.5–40 cm), 41.5{\%} total occlusions, and 18.7{\%} in-stent restenosis. In total, 1861 DES were placed in 1080 lesions. Two-year follow-up was obtained for > 90{\%} of eligible patients. Freedom from TLR was 83.7{\%}, and clinical benefit was 80.0{\%} through 2 years. The 2-year primary patency rate was 70.3{\%}. Rutherford classification significantly improved (p < 0.01), with approximately 80{\%} of patients classified as Rutherford class 0 or 1 at 2 years. Conclusion: Despite more challenging lesion characteristics, 2-year results from the current study are similar to outcomes from the previous Zilver PTX studies, confirming the efficacy of the Zilver PTX DES in a complicated femoropopliteal lesion (Zilver PTX Post-Market Study in Japan; NCT02254837). Level of Evidence: Post-market surveillance study, Level III.",
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AU - Kichikawa, Kimihiko

AU - Ichihashi, Shigeo

AU - Yokoi, Hiroyoshi

AU - Ohki, Takao

AU - Nakamura, Masato

AU - Komori, Kimihiro

AU - Nanto, Shinsuke

AU - O’Leary, Erin E.

AU - Lottes, Aaron E.

AU - Snyder, Scott A.

AU - Dake, Michael D.

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N2 - Purpose: A prospective, multicenter post-market surveillance study in Japan evaluated the 2-year safety and effectiveness of the DES in real-world patients with complex femoropopliteal artery lesions. Methods: There were no exclusion criteria, and consecutive symptomatic patients with femoropopliteal lesions treated with the DES were enrolled in the study. Clinically driven target lesion revascularization (TLR) was defined as reintervention performed for > 50% diameter stenosis after recurrent clinical symptoms of peripheral arterial disease. Clinical benefit was defined as freedom from persistent or deteriorating ischemic symptoms. Patency was evaluated by duplex ultrasound where physicians considered this standard of care. Results: In this study, 905 patients were enrolled at 95 institutions in Japan. There were numerous comorbidities including a high incidence of diabetes (58.8%) and chronic kidney disease (43.6%). Additionally, 21.4% of patients were classified with critical limb ischemia. Lesions were complex, with an average length of 14.6 ± 9.6 cm (range 0.5–40 cm), 41.5% total occlusions, and 18.7% in-stent restenosis. In total, 1861 DES were placed in 1080 lesions. Two-year follow-up was obtained for > 90% of eligible patients. Freedom from TLR was 83.7%, and clinical benefit was 80.0% through 2 years. The 2-year primary patency rate was 70.3%. Rutherford classification significantly improved (p < 0.01), with approximately 80% of patients classified as Rutherford class 0 or 1 at 2 years. Conclusion: Despite more challenging lesion characteristics, 2-year results from the current study are similar to outcomes from the previous Zilver PTX studies, confirming the efficacy of the Zilver PTX DES in a complicated femoropopliteal lesion (Zilver PTX Post-Market Study in Japan; NCT02254837). Level of Evidence: Post-market surveillance study, Level III.

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KW - Drug eluting stent

KW - Femoropopliteal artery

KW - Paclitaxel-eluting stent

KW - Peripheral artery disease

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