Tanaka Minoru, Tsuno Nelson Hirokazu, Mitsudo Kazuaki, Kadota Kazushige, Tatami Ryozo, Kato Masayuki, Kato Kenichi, Nogami Akihiko, Ishikawa Osamu, Takahashi Koki
Department of Transfusion Medicine, The University of Tokyo Hospital, Tokyo 113-8655, Japan.
Tex Heart Inst J. 2011;38(5):502-7.
The KW39 stent is a balloon-expandable, stainless-steel, slotted-tube stent, newly designed to adjust to the shape of the coronary arteries. We evaluated the clinical efficacy and safety of KW39 stent-based percutaneous coronary interventions in human native coronary arteries. A total of 105 patients (110 lesions), with a diagnosis of stable angina, acute coronary syndrome, or asymptomatic myocardial ischemia, were included in this prospective study. The primary endpoint was the target-lesion revascularization rate at the conclusion of a 6-month follow-up period. The secondary endpoints were the rates of technical and procedural success and the rate of major adverse cardiac events (defined as cardiac death, myocardial infarction, and target-lesion revascularization) in the course of the 6 months after stent placement. The 6-month target-lesion revascularization rate was 8.6%. The KW39 stent was highly satisfactory in regard to all secondary endpoint comparisons. Binary (>50%) in-stent restenosis was observed in 22 of 110 lesions (20%). The mean diameter stenosis at 6 months after percutaneous coronary intervention was 35.1% ± 14.4%, and the mean late lumen loss was 1.06 ± 0.48 mm. Stepwise multivariate analysis showed probable causal associations between adverse local environments for stent implantation and the subsequent need for target-lesion revascularization. We conclude that KW39 stent implantation was technically feasible and clinically safe in the patient population that we studied. The results of the safety endpoints, including cardiac death and acute myocardial infarction, were acceptable.
KW39支架是一种球囊扩张式不锈钢开缝管支架,其设计初衷是为了适应冠状动脉的形状。我们评估了基于KW39支架的经皮冠状动脉介入治疗在人体天然冠状动脉中的临床疗效和安全性。本前瞻性研究共纳入了105例患者(110处病变),这些患者被诊断为稳定型心绞痛、急性冠状动脉综合征或无症状性心肌缺血。主要终点是6个月随访期结束时的靶病变血运重建率。次要终点是支架置入后6个月内的技术成功率、手术成功率以及主要不良心脏事件(定义为心源性死亡、心肌梗死和靶病变血运重建)发生率。6个月靶病变血运重建率为8.6%。在所有次要终点比较中,KW39支架都非常令人满意。110处病变中有22处(20%)观察到支架内再狭窄率达到二元(>50%)。经皮冠状动脉介入治疗后6个月时的平均直径狭窄率为35.1%±14.4%,平均晚期管腔丢失为1.06±0.48mm。逐步多变量分析显示,支架植入的不良局部环境与随后靶病变血运重建需求之间可能存在因果关联。我们得出结论,在我们所研究的患者群体中,KW39支架植入在技术上是可行的,临床安全性良好。包括心源性死亡和急性心肌梗死在内的安全性终点结果是可以接受的。