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Leipzig Interventional Course January 22 – 25, 2019 Bi-directional, self-expanding stent for superficial femoral artery lesions – 2-year interim-results from the Q3 registry Hans Krankenberg on behalf of the Q3-Investigators Department of Angiology, Asklepios Klinikum Harburg Hamburg, Germany

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Page 1: Bi-directional, self-expanding stent for superficial femoral artery lesions … · Leipzig Interventional Course January 22 –25, 2019 Bi-directional, self-expanding stent for superficial

Leipzig Interventional CourseJanuary 22 – 25, 2019

Bi-directional, self-expanding stent forsuperficial femoral artery lesions –

2-year interim-results from the Q3 registry

Hans Krankenberg on behalf of the Q3-Investigators

Department of Angiology, Asklepios Klinikum Harburg

Hamburg, Germany

Page 2: Bi-directional, self-expanding stent for superficial femoral artery lesions … · Leipzig Interventional Course January 22 –25, 2019 Bi-directional, self-expanding stent for superficial

Disclosure

Speaker name: Hans Krankenberg

I have the following potential conflicts of interest to report.

• Speakers fee: QualiMed Medizinprodukte, Wedel, Germany

Page 3: Bi-directional, self-expanding stent for superficial femoral artery lesions … · Leipzig Interventional Course January 22 –25, 2019 Bi-directional, self-expanding stent for superficial

• Hans Krankenberg, Hamburg

• Jarwed Arjumand, Christian Jacke, Gabriela Marin, Wuppertal

• Gunnar Tepe, Rosenheim

• Erwin Blessing, Karlsbad

• Markus Spanagel, Achmet Mechmet, Eric Ipcsics, Waldbröl

• Viktor Reichert, Sindelfingen

• Stefan Betge, Bad Bevensen

• Ralph Wickenhöfer, Thorsten Kanis, Dernbach

• Jörg Teßarek, Lingen

Q3 registry

Q3-Investigators

ClinicalTrials.gov NCT02307292

Page 4: Bi-directional, self-expanding stent for superficial femoral artery lesions … · Leipzig Interventional Course January 22 –25, 2019 Bi-directional, self-expanding stent for superficial

Bi-directional SFA stent*

8 Tantalum markers

Self-expanding Nitinolstent, laser-cut

5-zone flexibility delivery catheter

Delivery catheter is operable by onehand

Wave-like segments with flexible conectors

* QualiMed Medizinproduckte, Wedel, Hamburg; Germany

Designed to resist „bi-directional torsion“.

Page 5: Bi-directional, self-expanding stent for superficial femoral artery lesions … · Leipzig Interventional Course January 22 –25, 2019 Bi-directional, self-expanding stent for superficial

Patient CharacteristicsN = 199 (Dec 2014 – Aug 2018)

Age, yrs 60.3 ± 9.1

Male 70.4%

Diabetes mellitus 37.2%

Hypertension 83.8%

Hyperlipidemia 69.8%

Renal insufficiency 11.8%

Smoker (current and former) 52.6%

Adipositas 23.6%

Critical ischemia 11.6%

ABI 0.60 ± 0.24

Q3 Registry

Page 6: Bi-directional, self-expanding stent for superficial femoral artery lesions … · Leipzig Interventional Course January 22 –25, 2019 Bi-directional, self-expanding stent for superficial

Lesion Characteristics

Lesion length 97.6 ± 83.4 mm

Lesions ≥ 150 mm 23.5%

Stents/lesion 1.4 ± 0.7

Stented length 114.3 ± 82.7 mm

% Diameter stenosis 91.2 ± 13.1%

Total occlusion 43.5%

PTA Restenosis 3.0%

Multifocal or diffuse pattern 47.6%

Heavy calcification 27.3%

Q3 Registry

Page 7: Bi-directional, self-expanding stent for superficial femoral artery lesions … · Leipzig Interventional Course January 22 –25, 2019 Bi-directional, self-expanding stent for superficial

Hemodynamic Improvement

1.0

1.4

1.2

0.8

0.6

0.4

0.2

Baseline 1 month 6 months 1 year 2 years

p < 0.0001 for each FU vs. Baseline

Hemodynamic improvement 92.1% 76.2% 71.0% 73.6%

by ≥ 0.15 or to ≥ 0.9 n=165 n=143 n=107 n=47

Ankle

-bra

chia

l in

dex

(AB

I)

Page 8: Bi-directional, self-expanding stent for superficial femoral artery lesions … · Leipzig Interventional Course January 22 –25, 2019 Bi-directional, self-expanding stent for superficial

Clinical Improvement

p < 0.0001 for each FU vs. baseline

Baseline 6 months 1 year 2 years

Pati

ents

(%)

Rutherfordcategory

5

4

3

2

1

0

100%

Clinical improvement 92.1% 92.2% 92.3%

by ≥ 1 Rutherford category n=151 n=115 n=78

Page 9: Bi-directional, self-expanding stent for superficial femoral artery lesions … · Leipzig Interventional Course January 22 –25, 2019 Bi-directional, self-expanding stent for superficial

Freedom from TLR

0 6 12 18 24 months

Patients at risk 199 152 114 63

100

80

60

40

20

0

Fre

edom

fro

mT

LR

(%

)

6 months 98.7% (SE 0.9%)

12 months 95.5% (SE 1.8%)

24 months 85.7% (SE 3.7%)

30 days 99.4% (SE 0.6%)

Page 10: Bi-directional, self-expanding stent for superficial femoral artery lesions … · Leipzig Interventional Course January 22 –25, 2019 Bi-directional, self-expanding stent for superficial

Freedom from TLR

0 6 12 24 months

Patients at risk 150 112 85 52

46 38 26 10

100

80

60

40

20

0

Fre

edom

fro

mT

LR

(%

)

Lesions ≥ 150 mmØ 228 mm

Lesions < 150 mmØ 58 mm

Mean survival time: 20.8 months (20.5 to 21.1)

Mean survival time: 16.6 months (15.2 to 18.1)

Log-rank p < 0.0001

82.4%

94.9%

100% 100% 94.5%

Page 11: Bi-directional, self-expanding stent for superficial femoral artery lesions … · Leipzig Interventional Course January 22 –25, 2019 Bi-directional, self-expanding stent for superficial

0

20

40

60

80

100

12 months 24 months

Freedom from TLR

Zeller 2016, Matsumura 2013, Laird 2014, Laird 2012, Werner 2014, Dake 2013

Page 12: Bi-directional, self-expanding stent for superficial femoral artery lesions … · Leipzig Interventional Course January 22 –25, 2019 Bi-directional, self-expanding stent for superficial

Freedom from MACLE*

0 6 12 18 24 months

Patients at risk 199 150 106 57

100

80

60

40

20

0

Fre

edom

fro

mM

AV

E (

%)

6 months 96.1% (SE 1.6%)

12 months 90.3% (SE 2.6%)

24 months 78.9% (SE 4.3%)4 Myocardial infarctions3 TIA

0 Death0 Major amputation1 Minor amputation14 TLR

30 days 100%

* CV death, MI, stroke, TIA, target limb minor or major amputation, bypass surgery, TLR

Page 13: Bi-directional, self-expanding stent for superficial femoral artery lesions … · Leipzig Interventional Course January 22 –25, 2019 Bi-directional, self-expanding stent for superficial

0 6 12 24 months

Patients at risk 150 110 82 47

46 38 24 8

100

80

60

40

20

0

Fre

edom

fro

mT

LR

(%

)

Lesions ≥ 150 mmØ 228 mm

Lesions < 150 mmØ 58 mm

Mean survival time: 21.1 months (20.4 to 21.8)

Mean survival time: 16.0 months (16.0 to 17.6)

Log-rank p < 0.0001

75.8%

94.9%

97.3% 96.1% 88.6%

Freedom from MACLE

Page 14: Bi-directional, self-expanding stent for superficial femoral artery lesions … · Leipzig Interventional Course January 22 –25, 2019 Bi-directional, self-expanding stent for superficial

Conclusion

It did not raise any safety concerns.

Interim analysis suggests a comparatively high

effectiveness of the bi-directional SFA stent.

Page 15: Bi-directional, self-expanding stent for superficial femoral artery lesions … · Leipzig Interventional Course January 22 –25, 2019 Bi-directional, self-expanding stent for superficial

Hans Krankenberg

[email protected]

Bi-directional, self-expanding stent forsuperficial femoral artery lesions –

2-year interim-results from the Q3 registry