Learnings from the LOCOMOTIVE study:

Subgroup analyses: Spot stenting with DCB in high risk

patients

Gunnar Tepe, MD

Disclosure

Speaker name:

Gunnar Tepe............................................I have the following potential conflicts of interest to report:

Study support by: Biotronic, BBraun, BD, BSC, Gore, Medtronic, Verian, Shockwave, Terumo

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Stents in long lesionsViastarLammer et al., CVIR 2015 38(1): 25-32

Everflex, Life, SMART

- Mean lesion length: 19 cm vs. 17.3 cm

Result: all lesions

result: >20cm

12-mo DUS

Conclusion:

with increased lesion length: less patency

Viabahn:

Contured Edge,

Heparin Coating,

keine Oversizing

SFA stent performance related to lesion length

Note: Results from clinical trials are not directly comparable.

This chart is for educational purposes only.1. Weinstock B et al. Vascular Disease Management 2014;11(4):E76-E86

With standard stenting strategies, the patency rates decrease with stent length.

LOCOMOTIVE subgroup analysis:Spot Stenting in long vs. short lesions

89.4 % 87.9%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

fTLR @ 12 months

fTLR @ 12 months: Spot Stenting in short and long lesions

≤ 10 cm > 10 cm

(93/104) (175/199)p=0.701

≤ 10 cm > 10 cm

Spot stenting is able to overcome the negative correlation between long lesions and reduced patency

Spot Stenting in comparison to other stenting strategies

Note: Results from clinical trials are not directly comparable.

This chart is for educational purposes only.Weinstock B et al. Vascular Disease Management 2014;11(4):E76-E86

LOCOMOTIVE Extended

Drug effect on patency: DCB needed to optimize the stentresult in standard therapy

Liistro et al. JACC 2013;6(12):1295-1302

DEBATE SFA: fTLR @ 12 months

Drug effect?!

LOCOMOTIVE subgroup analysis:POBA vs. DCB with Spot Stenting

86.7%90.5%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

fTLR @ 12 months

fTLR @ 12 months: POBA / DCB with Spot Stenting

POBA DCB

p=0.308(144/166)

(124/137)

POBA DCB

Spot stenting works well with POBA as well as with DCBin long & complex fempop lesions

LOCOMOTIVE subgroup analysis:Spot Stenting in long lesions with DCB

84.6%

91.6%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

fTLR @ 12 months

fTLR @ 12 months: Subgroup long lesions (> 10 cm)

POBA long DCB long

p=0.132(88/104)

(87/95)

POBAlong

DCBlong

Relevant drug effect comes with DCB & spot stentingin long & complex fempop lesions

94.3%90.5%

86.5%84.0%

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

90.00%

100.00%

fTLR @ 12 months

fTLR @ 12 months: Spot Stenting in different locations

DCB in SFA only SFA only Fempop Popliteal only

LOCOMOTIVE subgroup analysis:Lesion Location

(172/191)(75/87) (21/25)

(83/88)

Spot Stenting& DCB in

SFA

AllSFA only

ALLFempop

ALLPop 1-3

The best result is achieved with DCB + spot stenting in long SFA lesions.

Conclusions

Spot stenting overcomes the negative correlation between lesion length andreduced patency

DCBs + spot stenting = ideal partners in long lesions

Comparison of drug-eluting and bare metal stents

for extracranial vertebral artery stenting

Jagiellonian University Institute of Cardiology,

John Paul II Hospital Krakow, Poland

Prof. Piotr Pieniazek MD, PhD