Department of Cardiology, The Cardiovascular Institute, Minato-ku, Tokyo, Japan.
J Cardiol. 2009 Jun;53(3):417-21. doi: 10.1016/j.jjcc.2009.02.017. Epub 2009 Apr 14.
It has been reported that nitinol stents provide higher patency in chronic phase than stainless steel stents after intervention to superficial femoral artery (SFA). However, there are few reports about stent patency for chronic total occlusion of SFA (SFA CTO).
To compare clinical outcomes of self-expanding nitinol stents and stainless steel stents after percutaneous peripheral intervention (PPI) for SFA CTO.
Between April 2004 and August 2007, a total of 25 SFA CTO lesions (nitinol stent group, 13; stainless steel stent group, 12) in 21 patients were treated with PPI, all patients were followed clinically, and 21 lesions (nitinol, 9; stainless steel, 12) received follow-up angiography. There was no significant difference in baseline characteristics, mean stent diameter (7.3+/-0.7 mm vs. 6.9+/-1.2 mm, p=0.32), pre-ankle-brachial index (ABI), and Fontaine stage between groups. Mean occlusion length and stent length were significantly longer (129.5+/-54.9 mm vs. 39.0+/-20.6 mm, 250.8+/-90.0 mm vs. 145.2+/-64.6 mm, respectively, p<0.01) and number of stents was significantly larger (2.8+/-0.9 vs. 1.6+/-0.5, p<0.01) in the nitinol stent group. At follow-up, ABI was significantly lower (0.73+/-0.20 vs. 0.95+/-0.13, p=0.04), restenosis rate and target lesion revascularization was significantly higher (58.3% vs. 15.4%, p=0.03; 50.0% vs. 7.7%, p=0.02, respectively) in the stainless steel stent group.
Our study demonstrates the superiority of nitinol stent implantation compared with stainless steel stent implantation for SFA CTO.
已有报道称，在经皮外周血管介入（PPI）治疗股浅动脉（SFA）后，镍钛诺支架在慢性期的通畅率高于不锈钢支架。然而，关于 SFA 慢性完全闭塞（SFA CTO）的支架通畅率的报道较少。
比较经皮外周血管介入治疗 SFA CTO 后自膨式镍钛诺支架和不锈钢支架的临床疗效。
2004 年 4 月至 2007 年 8 月，21 例患者的 25 处 SFA CTO 病变（镍钛诺支架组 13 例，不锈钢支架组 12 例）接受了 PPI 治疗，所有患者均进行了临床随访，21 处病变（镍钛诺支架组 9 处，不锈钢支架组 12 处）接受了随访血管造影。两组患者的基线特征、平均支架直径（7.3±0.7mm 比 6.9±1.2mm，p=0.32）、踝肱指数（ABI）和 Fontaine 分期均无显著差异。镍钛诺支架组的平均闭塞长度和支架长度明显更长（129.5±54.9mm 比 39.0±20.6mm，250.8±90.0mm 比 145.2±64.6mm，均 p<0.01），支架数量也明显更多（2.8±0.9 比 1.6±0.5，均 p<0.01）。随访时，镍钛诺支架组的 ABI 明显较低（0.73±0.20 比 0.95±0.13，p=0.04），再狭窄率和靶病变血运重建率明显较高（58.3%比 15.4%，p=0.03；50.0%比 7.7%，p=0.02）。
本研究表明，与不锈钢支架植入相比，镍钛诺支架植入治疗 SFA CTO 具有优越性。
