Leopardi M, Houbballah R, Becquemin J P
Service of Vascular Endovascular Surgery Henri Mondor Hospital, Créteil, France -
J Cardiovasc Surg (Torino). 2014 Apr;55(2):229-34.
The indication for use of drug-eluting stents (DES) in lower limb arteries is still undefined. We report our series of patients treated with Zilver PTS DES, in treating in-stent restenosis (ISR) and Trans-Atlantic Inter-Society Consensus Document on Management of Peripheral Arterial Disease (TASC) C/D femoropopliteal lesions.
The Zilver PTX DES is a self-expanding nitinol stent with a polymer-free Paclitaxel coating. Patients with symptomatic de novo TASC C/D lesions or IRS lesions of femoropopliteal segment were eligible for enrollment. We evaluated patients at one month, six months and one year after treatment. We used clinical evaluation criteria and US Doppler for primary and secondary patency-free rates.
From November 2010 to November 2012, we treated 69 patients with DES Zilver PTX. Indication to treat was given in 36 lesions (52%) by an ISR and in 33 cases (48%) by a TASC C/D lesion. Lesions were staged in the superficial femoral artery (SFA) level in 59 patients (85.6%), in the popliteal artery in 6 patients (8.7%), in a femoropopliteal bypass in 4 patients (5.7%). The mean follow-up was 5.3 months (range 1-24). At 12 months the overall primary patency was 85.5%, secondary patency 89.8% and limb salvage 100%.
Zilver PTX DES seems to be effective in treating TASC C/D lesions and ISR in femoropopliteal lesions at short term. Therefore DES should be recommended when treating those complex lesions.
药物洗脱支架（DES）在下肢动脉中的使用指征仍不明确。我们报告了一系列使用Zilver PTS DES治疗支架内再狭窄（ISR）以及跨大西洋两岸血管外科学会关于外周动脉疾病管理的共识文件（TASC）C/D级股腘动脉病变的患者情况。
Zilver PTX DES是一种无聚合物涂层的紫杉醇涂层自膨式镍钛合金支架。有症状的新发TASC C/D级病变或股腘段ISR病变的患者符合入组条件。我们在治疗后1个月、6个月和1年对患者进行评估。我们使用临床评估标准和超声多普勒来评估主要和次要通畅率。
从2010年11月至2012年11月，我们用Zilver PTX DES治疗了69例患者。治疗指征为ISR的病变有36例（52%），TASC C/D级病变有33例（48%）。病变位于股浅动脉（SFA）水平的患者有59例（85.6%），位于腘动脉的患者有6例（8.7%），位于股腘旁路的患者有4例（5.7%）。平均随访时间为5.3个月（范围1 - 24个月）。12个月时，总体主要通畅率为85.5%，次要通畅率为89.8%，肢体挽救率为100%。
Zilver PTX DES在短期内似乎对治疗股腘动脉病变中的TASC C/D级病变和ISR有效。因此，在治疗这些复杂病变时应推荐使用DES。
