Shockwave Medical Announces Positive Six-Month DISRUPT PAD Results

Shockwave Medical, a developer of calcified cardiovascular disease treatment, has announced positive clinical results from the pooled DISRUPT PAD study, a single-arm, two-phase, multicenter trial evaluating the safety and performance of Shockwave Medical’s Lithoplasty System in calcified peripheral lesions.
 
Results from 95 patients with symptomatic femoropopliteal lesions up to 15 cm in length enrolled at 11 sites were presented at the VIVA 16 meeting in Las Vegas by principal investigator Thomas Zeller, M.D., head of the Department of Angiology at Universitäts-Herzzentrum Freiburg-Bad, Krozingen, Germany.
 
The DISRUPT PAD study primary safety endpoint was freedom from major adverse events (MAE) through 30 days. Procedural success, the primary performance endpoint, was defined as less than 50 percent residual diameter stenosis, with or without adjunctive balloon angioplasty therapy. Key secondary endpoints include target lesion revascularization, target lesion patency by duplex ultrasound defined as freedom from greater than 50 percent restenosis, and functional outcomes.
 
“The ongoing positive results from DISRUPT PAD demonstrate that Lithoplasty technology is a promising treatment for patients with calcified peripheral artery disease, a difficult-to-treat population,” said Zeller. “After six months of follow up, we have documented consistent and predictable procedural success, high acute gain, minimal vessel injury, and remarkably low need for additional implants.”
 
Clinical data from the study demonstrate compelling safety with no major amputations, perforations, thrombus or distal embolization events. Stent utilization due to a flow limiting dissection following Lithoplasty was limited to 1 percent in study population composed of moderate or severely calcified lesions. Primary effectiveness results demonstrated 100 percent procedural success, defined as residual stenosis of less than 50 percent. An exploratory endpoint of procedural success defined as residual stenosis less than or equal to 30 percent was achieved in 89.5 percent of lesions, with an average residual stenosis of 24 percent and acute gain of 3 mm (average RVD of 5.5 mm). Six-month patency assessed by duplex ultrasound was 77 percent with target lesion revascularization of 3.2 percent.
 
Arterial calcification, caused by plaque that hardens over time, is increasingly common as preventive care and disease management have enabled patients to live longer, making vascular disease a chronic condition. In fact, more than half of all patients with peripheral vascular disease have moderate or severe calcium in their arteries.¹ Unfortunately, limitations of currently available interventional devices make successful treatment of patients with calcified arteries increasingly more difficult. The most advanced of these devices targets only superficial calcium, leaving deep calcium unaffected, frequently resulting in poor lesion dilatation and procedural complications. Designed to overcome these limitations, Lithoplasty is a novel technology that uses pulsatile mechanical energy waves to disrupt both superficial and deep calcium while minimizing soft tissue injury using an integrated balloon to dilate lesions at low pressures to restore blood flow.
 
The Shockwave Medical Lithoplasty System is available for sale in the United States as of September 2016. The company plans a limited U.S. commercial release in 2017 and will initiate a global randomized trial to gather further clinical data on the benefits of Lithoplasty treatment.
 
“The DISRUPT PAD data continue to reinforce the potential of the Lithoplasty System to address the growing burdens of arterial calcification,” said Shockwave Medical CEO and co-founder Daniel Hawkins. “This data prepares us to further advance use of the technology for patients with peripheral disease as we embark on commercialization in the United States.”
 
“We are very pleased with the durable success the Lithoplasty System has demonstrated in treating calcified peripheral artery disease,” said Todd Brinton, M.D., clinical associate professor of medicine at Stanford University and co-founder of Shockwave Medical. “We will continue to expand our global clinical program and look forward to working with physicians to further address the needs of patients with advanced cardiovascular disease.”
 
The Lithoplasty System integrates the calcium-disrupting power of lithotripsy with the familiarity and simplicity of angioplasty balloon-based devices. Built on a balloon catheter platform, the Shockwave Medical Lithoplasty System uses lithotripsy to disrupt both superficial and deep vascular calcium, while minimizing soft tissue injury, and an integrated angioplasty balloon to dilate blockages at low pressures, restoring blood flow. The Lithoplasty System is commercially available in the European Union and the United States for treatment of peripheral vascular disease.
 
Shockwave Medical, based in Fremont, Calif., is working to reshape interventional therapy with Lithoplasty Technology for the treatment of calcified peripheral vascular, coronary vascular and heart valve disease.

Reference:
1. Rocha-Singh KJ, Zeller T, Jaff MR. Peripheral arterial calcification: prevalence, mechanism, detection and clinical implications. Catheterization and Cardiovascular Interventions 2014; 83:E212-E220