Medtronic Self-Expanding Venous Stent Demonstrates Favorable Outcomes in Patients with Venous Outflow Obstruction
DUBLIN and LONDON – June 16, 2020 – Medtronic plc announced the first-ever results from the ABRE clinical study assessing the safety and effectiveness of the investigational Abre™ venous self-expanding stent system in subjects with iliofemoral venous outflow obstruction. The study met the primary safety and effectiveness endpoints, and the data were presented today virtually via the 2020 Charing Cross Symposium.
The ABRE Study is a prospective, interventional, single-arm, multi-center, worldwide study, which included 200 subjects with symptomatic iliofemoral venous outflow obstruction from 24 sites throughout the U.S. and Europe. The primary effectiveness endpoint evaluated primary patency at 12 months, and the primary safety endpoint evaluated the incidence of composite Major Adverse Events (MAE) within 30 days following stenting of an obstruction in the iliofemoral venous segment. The study enrolled subjects across the spectrum of deep venous disease, including those with post-thrombotic syndrome (PTS), non-thrombotic iliac vein lesions (NIVL), and those who presented with an acute deep vein thrombosis (aDVT).
The study met its primary safety endpoint with a 2.0% (4/200) rate of major adverse events (MAEs) within 30 days.[i] The study also met its 12-month primary effectiveness endpoint with an overall primary patency rate of 88.0% (162/184).[ii] Furthermore, the data demonstrated a freedom from clinically driven target lesion revascularization (TLR) rate of 92.4% (170/184) through 390 days. Notable secondary endpoint results from the ABRE Study include:
- 100.0% device success achieved during the index procedure[iii]
- No stent fractures and no delayed stent migration observed within 12 months
- Sustained and statistically significant improvements in quality of life measures[iv] and venous functional assessment scores[v] at 12 months compared to baseline
Venous outflow obstruction, or deep venous obstruction, occurs when veins in the deep venous system become compressed and restrict blood flow. This can result in pain and discomfort, while also limiting a patient's mobility, and impairing quality of life. Medtronic estimates that approximately 24 million people worldwide are affected by deep venous obstruction, yet only <1% of this population is actually treated.[vi]
In the U.S., Abre is an investigational device and not yet approved for commercial use. Abre received CE (Conformité Européene) Mark approval in April of 2017 and is intended for use in the iliofemoral veins for treatment of symptomatic venous outflow obstruction.
i MAEs included all-cause death occurring post-procedure, clinically significant pulmonary embolism, procedural major bleeding, stent thrombosis, and stent migration. MAEs were adjudicated by a Clinical Events Committee, except stent thrombosis and stent migration, which were assessed by an imaging core laboratory.
ii Primary Patency was defined as meeting all of the following criteria at 12 months post-procedure: Freedom from occlusion or restenosis ≥50% of the stented segment of the target lesion and freedom from clinically driven target lesion revascularization.
iii Defined as successful delivery and deployment of the Abre stent in the target lesion with successful removal of the delivery system
iv EQ-5D and VEINES-QOL
v Villalta Score and Venous Clinical Severity Score (VCSS)
vi Internal Medtronic Analysis: Strategic Plan, 2016