裸金属镍钛合金支架植入术和紫杉醇洗脱镍钛合金支架植入术对经血管内超声评估的股浅动脉病变血管反应的影响。

Effect of bare-metal nitinol stent implantation and paclitaxel-eluting nitinol stent implantation on vascular response in the superficial femoral artery lesion assessed on intravascular ultrasound.

作者信息

Miki Kojiro, Fujii Kenichi, Kawasaki Daizo, Fukunaga Masashi, Nishimura Machiko, Horimatsu Tetsuo, Saita Ten, Tamaru Hiroto, Imanaka Takahiro, Shibuya Masahiko, Masutani Motomaru, Ohyanagi Mitsumasa, Masuyama Tohru

机构信息

Cardiovascular Division, Hyogo College of Medicine.

出版信息

Circ J. 2014;78(6):1451-8. doi: 10.1253/circj.cj-13-1508. Epub 2014 Apr 9.

DOI:10.1253/circj.cj-13-1508

PMID:24717286

Abstract

BACKGROUND

Although previous intravascular ultrasound (IVUS) studies reported that the drug-eluting stent (DES) has successfully decreased in-stent restenosis (ISR) by inhibiting neointimal hyperplasia (NIH) in the coronary artery lesion, no IVUS data for vascular response after DES implantation in the superficial femoral artery (SFA) have been published.

METHODS AND RESULTS

We retrospectively analyzed 38 de novo SFA lesions from 32 patients who underwent endovascular therapy (EVT) with self-expanding bare-metal nitinol stent (25 lesions; BMS group) or self-expanding paclitaxel-eluting nitinol stents (13 lesions; PES group). At 6 months after EVT, follow-up IVUS was done to evaluate NIH. Serial IVUS volumetric analysis was done after stent deployment and at follow-up. Mean stent, lumen and neointimal areas were calculated as the volume divided by the stent length. The primary endpoint of this study was mean late lumen loss at 6-month follow-up. The mean follow-up period was 189±39 days. Mean neointimal area was smaller in the PES group compared to the BMS group (3.3±1.0mm(2) vs. 10.2±4.1mm(2), P<0.001). Mean late lumen loss was significantly lower in the PES group compared to the BMS group (-2.3±3.7mm(2) vs. 2.1±4.7mm(2), P<0.05).

CONCLUSIONS

EVT with DES in SFA lesions might decrease NIH associated with ISR in short-term follow-up.

摘要

背景

尽管先前的血管内超声（IVUS）研究报告称，药物洗脱支架（DES）通过抑制冠状动脉病变中的内膜增生（NIH）成功降低了支架内再狭窄（ISR），但尚未有关于股浅动脉（SFA）DES植入术后血管反应的IVUS数据发表。

方法与结果

我们回顾性分析了32例接受血管内治疗（EVT）的患者的38处初发SFA病变，这些患者使用了自膨胀裸金属镍钛合金支架（25处病变；BMS组）或自膨胀紫杉醇洗脱镍钛合金支架（13处病变；PES组）。在EVT后6个月，进行随访IVUS以评估NIH。在支架置入后和随访时进行连续IVUS容积分析。平均支架、管腔和内膜面积通过体积除以支架长度来计算。本研究的主要终点是6个月随访时的平均晚期管腔丢失。平均随访期为189±39天。与BMS组相比，PES组的平均内膜面积更小（3.3±1.0mm²对10.2±4.1mm²，P<0.001）。与BMS组相比，PES组的平均晚期管腔丢失显著更低（-2.3±3.7mm²对2.1±4.7mm²，P<0.05）。