A Polymer-Free Paclitaxel-Eluting Stent Versus a Bare-Metal Stent for De Novo Femoropopliteal Lesions: The BATTLE Trial.

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Auteur: 
Gouëffic, Y; Sauguet, A; Desgranges, P; Hoffmann, CT; Maurel, B
Date Publication: 
2020
Mois: 
Février
Revue: 
JACC. Cardiovascular interventions
ISSN: 
1876-7605
NLM-ID: 
101467004
Volume: 
13
Num: 
4
Page: 
447-457
Résumé: 
The primary objective of the BATTLE (Bare Metal Stent vs. Paclitaxel Eluting Stent in the Setting of Primary Stenting of Intermediate-Length Femoropopliteal Lesions) trial is to demonstrate the clinical superiority of the Zilver PTX stent over the Misago stent in the treatment of femoropopliteal lesions.No randomized studies have compared self-expanding paclitaxel-eluting stents with bare-metal stents in the treatment of femoropopliteal lesions.BATTLE is a multicenter randomized controlled trial in patients with symptomatic (Rutherford category 2 to 5) de novo lesions of the superficial femoral or proximal popliteal artery. The primary endpoint is freedom from in-stent restenosis (ISR) at 1 year, with restenosis defined as a peak systolic velocity index >2.4 at the target lesion. The Kaplan-Meier method was used to evaluate time-to-event data for freedom from ISR over the 2-year follow-up period.Between March 2014 and August 2016, 186 patients were enrolled; 91 were assigned to the Misago arm and 90 to the Zilver PTX arm. Kaplan-Meier 1-year estimates of freedom from ISR were 88.6% for Misago and 91% for Zilver PTX (hazard ratio [HR]: 1.2; 95% confidence interval [CI]: 0.6 to 2.4; p = 0.64). Comparing Misago with Zilver PTX, 2-year estimates were 6.4% and 1.2% (HR: 7.3; 95% CI: 0.9 to 59.3; p = 0.0632) for mortality, 74.6% and 78.8% (HR: 1.2; 95% CI: 0.6 to 2.1; p = 0.62) for patency, and 14.4% and 12.4% (HR: 1.2; 95% CI: 0.5 to 2.8; p = 0.69) for target lesion revascularization.In the treatment of symptomatic femoropopliteal lesions, the Zilver PTX stent failed to show superiority over the Misago stent in freedom from ISR at 1 year.
MeSH: 
Aged|Aged, 80 and over|Cardiovascular Agents/administration & dosage/adverse effects|Drug-Eluting Stents|Endovascular Procedures/adverse effects/instrumentation/mortality|Female|Femoral Artery/diagnostic imaging/physiopathology|France|Humans|Male|Metals|Middle Aged|Paclitaxel/administration & dosage/adverse effects|Peripheral Arterial Disease/diagnostic imaging/mortality/physiopathology/therapy|Popliteal Artery/diagnostic imaging/physiopathology|Prospective Studies|Prosthesis Design|Recurrence|Risk Factors|Stents|Time Factors|Treatment Outcome|Vascular Patency
Mots clés auteurs: 
/Misago/Zilver PTX/femoropopliteal/paclitaxel/restenosis
DOI: 
10.1016/j.jcin.2019.12.028
PMID: 
32081238