Brescia Alexander A, Wickers Brian M, Correa Juan Carlos, Smeds Mathew R, Jacobs Donald L
Division of Vascular Surgery, Department of Surgery, St. Louis University Hospital, St. Louis, Mo.
Division of Vascular and Endovascular Surgery, Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, Ark.
J Vasc Surg. 2015 Jun;61(6):1472-8. doi: 10.1016/j.jvs.2015.01.030. Epub 2015 Mar 7.
The Supera stent (Abbott Laboratories, Abbott Park, Ill) has a unique biomimetic design allowing axial and longitudinal flexibility and fracture resistance. The aim of this retrospective study was to assess the midterm patency of Supera stents used to treat patients with superficial femoral and popliteal arterial disease by a single practice.
From April 2010 to December 2011, 53 patients and 59 limbs with symptomatic femoropopliteal lesions underwent angioplasty and stenting with the Supera stent. Five patients had no follow-up and were excluded. Demographics of the patients, radiographic images, morphologic features of the lesions, procedural reports, reinterventions, and follow-up clinical visit notes were reviewed. Primary patency was defined as clinical resolution of symptoms with no secondary interventions. Primary and secondary patency rates at 12, 24, and 36 months were estimated by Kaplan-Meier analysis.
A total of 48 patients (42 men, six women; 54 limbs; mean age, 64.3 years [range, 51-87]) received Supera stents and had at least one follow-up visit as part of their treatment for femoropopliteal disease. Primary indications for intervention included claudication, rest pain, and tissue loss, at rates of 54% (29 of 54), 26% (14 of 54), and 20% (11 of 54), respectively; 22% of lesions were TransAtlantic Inter-Society Consensus type A or B and 78% were type C or D. Mean lesion length was 24.0 cm (range, 3-51). Mean follow-up was 27.5 months (range, 1-45). The ankle-brachial index increased from 0.58 ± 0.20 preoperatively to 0.77 ± 0.18 postoperatively (P = .00004). Primary, primary assisted, and secondary patency rates at latest follow-up were 79.6%, 88.9%, and 92.3%, respectively. Cumulative primary patency rates by Kaplan-Meier analysis at 12, 24, and 36 months were 85.6%, 83.1%, and 76.7%, respectively. Secondary patency rates by Kaplan-Meier estimates at 12, 24, and 36 months were 93.8%, 93.8%, and 89.3%, respectively. No stent fractures were found at the time of any reinterventions. Long lesions >30 cm (n = 18) showed equivalent patency to lesions of 1 to 15 cm (n = 18) and lesions 15 to 30 cm in length (n = 18).
Our midterm results show that Supera stents are durable in treating femoropopliteal lesions, with notably high patency rates in patients with long lesion lengths.
Supera支架（雅培实验室，伊利诺伊州雅培公园）具有独特的仿生设计，具备轴向和纵向柔韧性以及抗断裂性。本回顾性研究的目的是评估由单一医疗机构使用Supera支架治疗股浅动脉和腘动脉疾病患者的中期通畅率。
2010年4月至2011年12月，53例患者的59条肢体出现症状性股腘病变，接受了Supera支架血管成形术和支架置入术。5例患者未进行随访，被排除在外。对患者的人口统计学资料、影像学图像、病变的形态学特征、手术报告、再次干预情况以及随访临床就诊记录进行了回顾。主要通畅定义为症状临床缓解且无需二次干预。通过Kaplan-Meier分析估计12、24和36个月时的主要和次要通畅率。
共有48例患者（42例男性，6例女性；54条肢体；平均年龄64.3岁[范围51 - 87岁]）接受了Supera支架治疗，并作为其股腘疾病治疗的一部分至少进行了一次随访。干预的主要指征包括间歇性跛行、静息痛和组织缺失，发生率分别为54%（54例中的29例）、26%（54例中的14例）和20%（54例中的11例）；22%的病变为跨大西洋两岸血管外科学会共识A型或B型，78%为C型或D型。平均病变长度为24.0 cm（范围3 - 51 cm）。平均随访时间为27.5个月（范围1 - 45个月）。踝肱指数从术前的0.58±0.20增加到术后的0.77±0.18（P = 0.00004）。最新随访时的主要、主要辅助和次要通畅率分别为79.6%、88.9%和92.3%。通过Kaplan-Meier分析，12、24和36个月时的累积主要通畅率分别为85.6%、83.1%和76.7%。通过Kaplan-Meier估计，12、24和36个月时的次要通畅率分别为93.8%、93.8%和89.3%。在任何再次干预时均未发现支架断裂。长度>30 cm的长病变（n = 18）与1至15 cm的病变（n = 18）以及长度为15至30 cm的病变（n = 18）显示出相当的通畅率。
我们的中期结果表明，Supera支架在治疗股腘病变方面具有耐久性，对于病变长度较长的患者，通畅率显著较高。
