CIRSE 2023: The newest in arterial interventions

November 14, 2023

CIRSE is known the world over as the premiere platform for debuting cutting-edge research in interventional radiology. This was abundantly apparent throughout the arterial track at CIRSE 2023, as multiple sessions focused on exciting new research in the arterial arena.

FIRST@CIRSE

FIRST@CIRSE sessions feature pioneering research direct from researchers. Only first data releases are featured during this session type. Building on the momentum of 2022, this year also saw an expansive FIRST@CIRSE session dedicated entirely to data releases in arterial interventions.

First up, M. Boisiers presented on the ZILVERPASS study which compares the 5-year results of ZILVER PTX stents vs. bypass surgery in femoropopliteal lesions. The final 60-month results show at least non-inferiority of ZILVER PTX vs. prosthetic bypass surgery ATK rwith similar patency results, fewer complications, and shorter hospitalisation, as well as a clear cost benefit in favour of ZILVER PTX.

R. Langoff spoke on behalf of ROADSAVER study investigators, presenting 1-year outcomes of a dual-layer micromesh stent in endovascular carotid stenosis treatment. This study assesses the safety and efficacy of the Roadsaver DLMS in the treatment of carotid artery stenosis in unselected patients eligible for elective stenting; the study confirms the safety and efficacy of this treatment.

T. Chong presented results from the PRISTINE Registry which investigates the performance and safety of the SELUTION SLRTM sirolimus-eluting balloon for the treatment of complex occlusive lesions in chronic limb-threatening ischaemia (CLTI). SELUTION SLR has been demonstrated to be safe and efficacious in treating complex infrainguinal lesions in a frail cohort of CLTI patients with a high incidence of diabetes and kidney failure.

Insights from the SAVE randomized controlled trial were presented by K. Katsanos. The SAVE trial investigates the safety and efficacy of the novel SELUTION SLR™ 018 sirolimus-eluting balloon for the treatment of failed AVF in renal dialysis patients. This was the first report presenting the preliminary findings from the trial, which indicate improvements in minimal lumen diameter and flow rate after the procedure. The analysis of the 6-month follow-up cohort is currently ongoing.

M. Broadman spoke about the one-year results of the DEEPER LIMUS trial. The purpose of this study was to evaluate the safety of the Bare Temporary Spur Stent System for the treatment of infrapopliteal artery disease when used in conjunction with a commercially available Sirolimus coated balloon. The results suggest that this system in conjunction with a Sirolimus-coated DCB demonstrates safety and efficacy at 12 months.

Results from the BIONETIC-TRA feasibility study were summarized by M. Lichtenberg. This investigator-initiated trial evaluates the safety and feasibility of the DyNETIC-35 cobalt chromium balloon-expandable stent for the treatment of atherosclerotic iliac lesions via a transradial approach. Primary and secondary endpoint data were presented. The results from the study are expected to provide evidence that the DyNETIC-35 balloon expandable stent may be used to treat the Iliac artery via radial access with a low complication rate and reduced health care costs.

T. Rand closed the arterial-focused presentations in this session with a talk on the initial 24-month results from the MOTIV bioresorbable BTK scaffold pilot study whose primary objective is to evaluate the immediate and long-term safety and efficacy of the MOTIV™ Bioresorbable Scaffold (Reva Medical) in BTK arteries for the treatment of patients with rest pain or minor tissue loss. The preliminary results demonstrated favourable acute safety and effectiveness performance.

Scientific paper sessions on arterial interventions

Several scientific paper sessions also featured updates from trials and new research in arterial interventions.

The session on cutting-edge updates in gynaecological interventions featured three arterial-focused presentations, including one on the effect of uterine artery embolization on fertility and pregnancy, one on the evaluation of prophylactic internal iliac balloon occlusion in the management of patients with morbidly adherent placenta, and a final talk analysing the worldwide google search trends for uterine fibroid embolization (UFE), uterine artery embolization, and UFE/UAE terminology from 2000 to 2022.

A session titled “Experimental work in IR” featured a performance evaluation of a miniature, disposable endovascular robotic device.

Latest outcomes from sirolimus-eluting devices

Drug-eluting devices continued to be a the spotlight as evidenced by the hot topic symposium on the latest outcomes from sirolimus-eluting devices.

N. Galanakis opened the session speaking on the background and pharmomechanics of sirolimus-eluting technology as well as its current medical uses and significant role in the treatment of patients with PAD.

G. Xhepa built upon the opening talk, delving into some more specific outcomes in femoropopliteal segments and reviewing the evidence. He concluded that Sirolimus devices represent a promising alternative option, as short and mid-term results have proven the efficacy and safety of these devices. He cautioned that long-term follow-ups and head-to-head RTCs are still needed.

The session continued with outcomes in below-the-knee segments, presented by K. Katsanos. He stated that Olimus drugs are a potential alternative to paclitaxel, that there is positive early evidence with Sirolimus in PAD, and that Sirolimus-eluting stents for BTK are well documented in RCTs for focal lesions.

U.Teichgräber closed the session, attempting to answer the question “Is Sirolimus going to be the new Paclitaxel?” He outlined the differences between these two drugs and walked attendees through the currently available comparative literature. He too emphasised that while the pilot studies on safety and efficacy are promising, ongoing RCTs are needed.