"Vascular Leaders Review Mortality Outcomes, CEC, and Internal Evaluation of Drug-Eluting Devices" -Lauren LeBano
The Vascular Leaders forum 2019, a special consortium organized by VIVA Physicians, featured experts who addressed questions raised by the meta-analysis of paclitaxel-eluting devices by Katsanos and colleagues. Robert Lookstein, MD, spoke on the examination of DCB usage in arteriovenous (AV) fistula. AV access typically has poor rates of patency and a variety of technologies, including DCBs, have been used to improve outcomes. Reviewing the literature, Dr. Lookstein noted that the field is early in the global experience of evaluating DCBs for this purpose, with only two studies with outcomes out to 24 months. Dr. Lookstein was the principal investigator for the IN.PACT AV Access trial, and he pointed out that there is high incidence of hypertension, diabetes mellitus, and congestive heart failure among the patient population. “This is likely the sickest demographic that we will study this technology in as we move this science forward,” he said. He further elaborated on considerations for AV access, including that it is normal for patients to have repeat interventions in one year, that the drug is delivered directly to the pulmonary circulation, and that it is unknown how the drug behaves in the setting of venous hypertension and right heart failure.
— Robert Lookstein, MD, Professor, Radiology, Surgery, Icahn School of Medicine at Mount Sinai, Executive Vice Chair, Department of Diagnostic, Molecular, and Interventional Radiology, Mount Sinai Health System