One-year safety and effectiveness of the Agent paclitaxel-coated balloon for the treatment of small vessel disease and in-stent restenosis

Cardiovasc Interv Ther. 2024 Jan;39(1):47-56. doi: 10.1007/s12928-023-00953-8. Epub 2023 Aug 29.

Abstract

The Agent device consists of a semi-compliant balloon catheter, which is coated with a therapeutic low-dose formulation of paclitaxel (2 µg/mm2) blended with an inactive excipient acetyl-tri-n-butyl citrate (ATBC). AGENT Japan SV is a randomized controlled study that enrolled 150 patients from 14 Japanese sites treated with Agent or SeQuent Please paclitaxel-coated balloon. This study also includes a single-arm substudy evaluating the safety and effectiveness of Agent in patients with in-stent restenosis (ISR). Patients with a single de novo native lesion (lesion length ≤ 28 mm and reference diameter ≥ 2.00 to < 3.00 mm) were randomized 2:1 to receive either Agent (n = 101) or SeQuent Please (n = 49). The ISR substudy enrolled 30 patients with lesion length ≤ 28 mm and reference diameter ≥ 2.00 to ≤ 4.00 mm. In the SV RCT, target lesion failure (TLF) at 1 year occurred in four patients treated with Agent (4.0%) versus one patient with SeQuent Please (2.0%; P = 1.00). None of the patients in either treatment arm died. There were no significant differences in the rates of myocardial infarction, target lesion revascularization and target lesion thrombosis through 1 year. In the ISR substudy, the 1-year rates of TLF and target lesion thrombosis were 6.7% and 0.0%, respectively. These data support the safety and effectiveness of the Agent paclitaxel-coated balloon in patients with small vessels and ISR.

Keywords: Drug-coated balloon; In-stent restenosis; Small vessel disease.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Angioplasty, Balloon, Coronary*
  • Coated Materials, Biocompatible
  • Coronary Restenosis* / etiology
  • Coronary Restenosis* / therapy
  • Humans
  • Paclitaxel / pharmacology
  • Risk Factors
  • Thrombosis* / etiology
  • Treatment Outcome

Substances

  • Paclitaxel
  • Coated Materials, Biocompatible