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新型 Nile PAX 专用分叉聚合物自由紫杉醇涂层支架治疗新发冠状动脉分叉病变患者的操作和早期临床结果:前瞻性、多中心、非随机 BIPAX 临床试验结果。

Procedural and early clinical outcomes of patients with de novo coronary bifurcation lesions treated with the novel Nile PAX dedicated bifurcation polymer-free paclitaxel coated stents: results from the prospective, multicentre, non-randomised BIPAX clinical trial.

机构信息

Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brazil.

出版信息

EuroIntervention. 2012 Mar;7(11):1301-9. doi: 10.4244/EIJV7I11A205.

Abstract

AIMS

To demonstrate the acute and early outcomes of the novel Nile PAX dedicated polymer-free paclitaxel-coated stents (Minvasys SAS, Gennevilliers, France) in the treatment of de novo coronary bifurcation lesions.

METHODS AND RESULTS

The Nile PAX device incorporates a cobalt-chromium alloy with a side aperture in the mid-stent designed to optimise scaffold at the bifurcation carina and side branch (SB) ostium, while maintaining SB access during procedure. From December 2008 to February 2010, 101 patients were prospectively enrolled in a non-randomised, multicentre study. Lesion criteria were: vessel size 2.5-3.5 mm in the parent vessel (PV) and 2.0-3.0 mm in the SB, and lesion length <14 mm in the PV, and <5 mm in the SB. Mean age was 63 years, 29% had diabetes, LAD/Dg was involved in 80.4%, and 61.7% had significant involvement of both branches. The study stent was successfully attempted and implanted in 98%. SB received additional stent in 26% final kissing-balloon inflation was performed in 93% and lesion (angiographic) success was achieved in 98%. There was only one non-Q myocardial infarction during hospitalisation, and no additional events up to 30 days.

CONCLUSIONS

Preliminary results of the prospective, non-randomised, multicentre BIPAX clinical trial demonstrated encouraging results with the novel Nile PAX bifurcation DES in the treatment of coronary bifurcation lesions, including high device and procedural success. Overall, there was only one major adverse cardiac event during hospitalisation, with no additional events up to 30 days follow-up. Long-term follow-up is warranted.

摘要

目的

展示新型 Nile PAX 专用无聚合物紫杉醇涂层支架(法国 Gennevilliers 的 Minvasys SAS)在治疗新发病变冠状动脉分叉病变中的急性和早期结果。

方法和结果

Nile PAX 装置采用钴铬合金,在支架中段设有侧孔,旨在优化分叉嵴和边支(SB)开口处的支架,同时在手术过程中保持 SB 通畅。2008 年 12 月至 2010 年 2 月,前瞻性纳入了 101 例患者进行非随机、多中心研究。病变标准为:主血管(PV)为 2.5-3.5mm,SB 为 2.0-3.0mm,PV 病变长度<14mm,SB 病变长度<5mm。平均年龄为 63 岁,29%患有糖尿病,LAD/Dg 受累 80.4%,两支血管均有 61.7%的明显受累。研究支架成功尝试并植入 98%。SB 接受了额外的支架植入,在 93%的病例中进行了最终的球囊对吻扩张,98%的病例实现了病变(血管造影)成功。住院期间仅发生 1 例非 Q 型心肌梗死,30 天内无其他不良事件。

结论

前瞻性、非随机、多中心 BIPAX 临床试验的初步结果显示,新型 Nile PAX 分叉 DES 在治疗冠状动脉分叉病变方面取得了令人鼓舞的结果,包括高器械和手术成功率。总的来说,住院期间仅发生 1 例主要不良心脏事件,30 天随访期内无其他不良事件。需要进行长期随访。

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