LINC 2021: Three studies evaluating Flex Vessel Prep system presented

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VentureMed Flex
Flex Vessel Prep system

VentureMed Group announced today that data from three studies evaluating the use of its Flex Vessel Prep (VP) system were presented during LINC 2021 (The Leipzig Interventional Course; 25–29 January, online). The Flex VP system is designed to modify plaque and prepare vessels with complex femoropopliteal arterial disease, including in-stent restenotic (ISR) lesions, prior to delivery of the definitive therapy.

“Individually and collectively, these three studies report compelling data,” said J Robert Paulson, Jr, president and chief executive officer of VentureMed. “The data demonstrate that longitudinal, circumferential micro-incisions delivered by the Flex Vessel Prep system safely and consistently modify plaque to improve vessel compliance and increase luminal gain, with minimal trauma to the vessel, which may reduce the need for stenting and facilitate the delivery of drug therapies into the vessel wall. The Flex Vessel Prep system allows physicians to modify plaque and prepare diseased vessels of any length to optimise their choice of definitive revascularisation therapy.”

The following are summaries of the three studies presented at LINC 2021:

12-month results of micro-incision Vessel Prep system showing acute and long-term benefit in superficial femoral and popliteal arteries

This single-centre study assessed the impact of vessel preparation with Flex VP longitudinal, controlled-depth, micro-incisions prior to drug-coated balloon (DCB) angioplasty or percutaneous transluminal angioplasty (PTA) therapy, acutely, and at six and 12 months.

Study findings:

  • Sixty-three patients with moderate-to-severe symptomatic femoropopliteal peripheral arterial disease (PAD), with lesions averaging approximately 200mm in length, were treated with the Flex VP to create circumferential, controlled-depth micro-incisions prior to delivery of the definitive DCB (paclitaxel) or PTA therapy.
  • The freedom from target lesion revascularisation (TLR) at six- and 12-months was 98.5% and 93.7%, respectively, with a low provisional stent rate of only 16.9%.

Patterns and number of dissections with atherectomy versus Flex VP: An IVUS assessment 

This single-centre, comparative, prospective study was based on published data demonstrating that dissection, not plaque compression, is what opens the lumen of obstructed vessels post-PTA. Published clinical data also has demonstrated that severe dissections per NHLBI classifications (Type C and higher) and dissections involving the adventitia are likely to be associated with worse outcomes after definitive PTA therapy. This study evaluated the differences in dissections between atherectomy and the Flex VP system in femoropopliteal arteries and included de novo and restenotic lesions using intravascular ultrasound.

Study findings:

  • In lesions with comparable treatment lengths and presence of calcium, there was a pattern of significantly fewer and less severe dissections after Flex VP vessel preparation as compared to atherectomy.
  • There were no differences in the extent of new dissections following delivery of the definitive PTA therapy.
  • This data suggests that Flex VP may be less traumatic as vessel preparation.

Lesion modification with a micro-incision Vessel Preparation system enhances balloon-based drug delivery in complex porcine restenotic lesions

This study examined if and how a vessel preparation system delivering micro-incisions could enhance in vivo paclitaxel (delivered from a DCB) retention in a complex porcine ISR lesion model design. Optical coherence tomography (OCT) images of the baseline ISR images confirmed barriers to delivery of DCB therapy. The animals were either (a) imaged by OCT and treated with a DCB and then re-imaged, or (b) imaged by OCT, re-imaged after micro-incisions were delivered by the Flex VP system, treated with DCB and then re-imaged again. The animals were survived to one, 15 or 30 days and the treated arteries then were processed to measure retention of paclitaxel concentrations.

Study findings:

  • OCT imaging of ISRLs revealed smooth stenotic surfaces posing significant barriers to penetration as evidenced by remarkably low paclitaxel concentrations at one day in standard vessels (<0.9ng/mL).
  • OCT imaging of the lesions treated with the Flex VP system demonstrated atraumatic micro-incisions along the length and circumference of the vessels, with no dissections, and enhanced tissue retention of paclitaxel as compared to the vessels treated with DCB alone.

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