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来自心血管结果与肾脏动脉粥样硬化病变(CORAL)研究的 roll-in 经验。

Roll-in experience from the Cardiovascular Outcomes with Renal Atherosclerotic Lesions (CORAL) study.

机构信息

Vascular Disease Research Center, Rhode Island Hospital, Gerry 337, 593 Eddy Street, Providence, RI 02903.

Division of Cardiology, University of Toledo, Toledo, Ohio.

出版信息

J Vasc Interv Radiol. 2014 Apr;25(4):511-20. doi: 10.1016/j.jvir.2013.09.018. Epub 2013 Dec 8.

Abstract

PURPOSE

To describe the experience and results from the roll-in phase of the Cardiovascular Outcomes with Renal Atherosclerotic Lesions (CORAL) study.

MATERIALS AND METHODS

The CORAL roll-in database was used to describe the baseline characteristics of the patients in the roll-in cohort, all of whom underwent renal artery stent placement; to evaluate CORAL site performance; to compare estimates of lesion (stenosis) severity made by site interventionalists with the central CORAL angiographic core laboratory readings; and to report outcomes after renal artery stent placement. During the roll-in phase, 239 patients (mean age, 70.2 y ± 9.0; 49% male) underwent renal artery stent procedures. Angiographic core laboratory analysis of renal arteriograms was done, and participants were followed at 1 month and 9 months.

RESULTS

Major angiographic complications were identified in 28 (13%) subjects. Kidney function remained unchanged at the short (2-4 weeks) follow-up interval. Improvement in systolic blood pressure with use of distal embolic protection devices (n = 161) did not show any clinical benefit over nonuse of such devices (n = 78) in this small series. At 9 months, there were significantly more endpoints reported by site in subjects with bilateral renal artery stenosis (P = .01) and prior history of stroke (P = .03).

CONCLUSIONS

In the roll-in phase of the CORAL study, a significant number of angiographic complications were identified. No effect was seen on estimated glomerular filtration rate after renal artery stent placement, but systolic blood pressure decreased significantly.

摘要

目的

描述心血管结果与肾动脉粥样硬化病变(CORAL)研究的入组阶段的经验和结果。

材料和方法

使用 CORAL 入组数据库描述入组队列中所有接受肾动脉支架置入术的患者的基线特征;评估 CORAL 研究中心的表现;比较介入医生评估的病变(狭窄)严重程度与 CORAL 核心实验室的中心阅片结果;报告肾动脉支架置入术后的结果。在入组阶段,239 例患者(平均年龄 70.2 岁±9.0 岁;49%为男性)接受了肾动脉支架置入术。对肾动脉造影进行了核心实验室分析,并在 1 个月和 9 个月时进行了随访。

结果

28 例(13%)患者发生主要血管造影并发症。在短期(2-4 周)随访时,肾功能保持不变。在这项小系列研究中,使用远端栓塞保护装置(n=161)的收缩压改善并没有比不使用此类装置(n=78)显示出任何临床获益。9 个月时,双侧肾动脉狭窄(P=0.01)和既往中风史(P=0.03)的患者报告的终点明显更多。

结论

在 CORAL 研究的入组阶段,发现了大量的血管造影并发症。肾动脉支架置入后肾小球滤过率估计值没有变化,但收缩压显著下降。

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