ORIGINAL ARTICLE  VASCULAR SECTION 

The Journal of Cardiovascular Surgery 2020 August;61(4):471-7

DOI: 10.23736/S0021-9509.20.11236-9

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

One-year outcome of the paclitaxel-eluting Legflow balloon catheter in the treatment of long and complex femoropopliteal lesions

Marc BOSIERS ¹ ✉, Koen DELOOSE ¹, Giovanni TORSELLO ², Dierk SCHEINERT ³, Jürgen VERBIST ⁴, Wouter van den EYNDE ⁴, Lieven MAENE ⁵, Roel BEELEN ⁵, Koen KEIRSE ⁶, Jeroen HENDRIKS ⁷, Joren CALLAERT ¹, Michel BOSIERS ², Jeroen WAUTERS ¹

¹ A.Z. Sint-Blasius, Dendermonde, Belgium; ² St. Franziskus-Hospital, Münster, Germany; ³ University Hospital of Leipzig, Leipzig, Germany; ⁴ Imelda Hospital, Bonheiden, Belgium; ⁵ Onze-Lieve-Vrouw Hospital, Aalst, Belgium; ⁶ R.Z. Heilig Hart, Tienen, Belgium; ⁷ University Hospital of Antwerp, Edegem, Belgium

BACKGROUND: The aim of this study is to investigate the efficacy of the paclitaxel-eluting Legflow balloon catheter in the treatment of “real-world” long and complex femoropopliteal lesions.
METHODS: The REFLOW study was a prospective, multi-national, non-randomized, single arm study evaluating the safety and efficacy of the Legflow paclitaxel-eluting balloon dilatation catheter in the treatment of stenotic or occlusive lesions >150 mm long in the femoropopliteal arteries of symptomatic patients (Rutherford 2-5). A total of 120 study subjects were enrolled in a period of 30 months, between October 2015 and May 2018. The mean age was 71.1 years and 79 patients were men (65.8%). Mean lesion length was 216.1 mm. 45.0% of the lesions were occluded, whereas 55.0% were stenotic. Primary endpoint was primary patency at 12 months, defined as absence of a hemodynamically significant stenosis on duplex ultrasound (systolic velocity ratio no greater than 2.4) at the target lesion and without TLR within 12 months.
RESULTS: Technical and procedural success (<30.0% residual angiographic stenosis without major complications) was achieved in all 120 cases (100.0%). Primary patency was 84.6% at 6 months and 71.1% at 1 year. Freedom from TLR was 79.9% at 1 year.
CONCLUSIONS: If longer term follow-up confirms there is no safety-concern on these paclitaxel device, the excellent results of the newer drug-eluting devices, and the Legflow paclitaxel-eluting balloon in particular, is a valid and effective alternative to treat long and complex “real-world” femoropopliteal lesions.

KEY WORDS: Femoral artery; Popliteal artery; Drug-eluting stents; Balloon angioplasty; Paclitaxel; Endovascular procedures