Djavidani B, Lenhart M, Manke C, Finkenzeller T, Zorger N, Feuerbach S, Link J
Institut für Röntgendiagnostik, Universitätsklinikum Regensburg.
Rofo. 2000 Nov;172(11):911-7. doi: 10.1055/s-2000-8377.
Evaluation of the handling, technical success rate and six month patency rate of a new, premounted balloon-expandable stent in iliac artery lesions.
In a prospective study 26 stenoses and 3 occlusions of the iliac arteries were primary treated in 24 patients (Fontaine IIa-III, mean age 60.4 year) with the "Flexible Iliac Bridge Stent" (Medtronic AVE, Düsseldorf). Five patients had bilateral stenoses. The ankle-brachial index (ABI) in rest and after exercise was determined before the intervention as well as 1-3 days, 1 and 6 months after the Intervention. The handling and visibility of the stent was scored on a three grade scale by the operators. Follow-up angiography including intraarterial pressure measurement was performed in 17 out of 24 patients (21 out of 29 lesions) after 6 months.
All 29 lesions were treated with technical success by implantation of 36 stents. The mean degree of the stenoses before intervention was 72.7 +/- 13.8% (+/- 1 standard deviation) and less than 5% in all cases postinterventionally. The mean pressure gradient before and after stent placement was 21 +/- 13.1 mm Hg and 0.8 +/- 2.3 mm Hg, respectively. The Fontaine stage improved by at least one in all patients. The mean ABI at rest improved from 0.63 +/- 0.15 to 0.89 +/- 0.16, and after exercise from 0.46 +/- 0.17 to 0.8 +/- 0.2, respectively. At 6 months 2 lesions out of 21 (9.5%) showed a restenosis of 55% and 70% with an intraarterial pressure gradient of 16 mm Hg and 27 mm Hg, respectively. After 6 months the mean ABI at rest decreased to 0.83 +/- 0.13, and to 0.72 +/- 0.14 after exercise. Handling and visibility was scored as good by all operators.
Endoluminal therapy of iliac artery lesions with the used stent is safe and effective. The six month patency rate is comparable to the published data of other stents.
评估一种新型预装式球囊扩张支架治疗髂动脉病变的操作情况、技术成功率及6个月通畅率。
在一项前瞻性研究中，24例患者（Fontaine IIa-III级，平均年龄60.4岁）的26处髂动脉狭窄和3处闭塞病变采用“Flexible Iliac Bridge Stent”（美敦力AVE，杜塞尔多夫）进行初次治疗。5例患者为双侧狭窄。在干预前以及干预后1 - 3天、1个月和6个月测定静息及运动后的踝肱指数（ABI）。操作者对支架的操作及可视性按三级评分。24例患者中的17例（29处病变中的21处）在6个月后进行了包括动脉内压力测量的随访血管造影。
通过植入36枚支架，29处病变的治疗均取得技术成功。干预前狭窄的平均程度为72.7 +/- 13.8%（+/- 1标准差），干预后所有病例均小于5%。支架置入前后的平均压力梯度分别为21 +/- 13.1 mmHg和0.8 +/- 2.3 mmHg。所有患者的Fontaine分期至少改善一级。静息时平均ABI从0.63 +/- 0.15提高到0.89 +/- 0.16，运动后从0.46 +/- 0.17提高到0.8 +/- 0.2。6个月时，21处病变中的2处（9.5%）出现再狭窄，狭窄率分别为55%和70%，动脉内压力梯度分别为16 mmHg和27 mmHg。6个月后，静息时平均ABI降至0.83 +/- 0.13，运动后降至0.72 +/- 0.14。所有操作者对操作及可视性的评分均为良好。
使用该支架对髂动脉病变进行腔内治疗安全有效。6个月通畅率与其他支架的已发表数据相当。
