Grimme Frederike A B, Spithoven J Hans, Zeebregts Clark J, Scharn Dirk M, Reijnen Michel M P J
Department of Surgery, Slingeland Hospital, Doetinchem, The Netherlands; Department of Surgery, Rijnstate Hospital, Wagnerlaan 55, 6815 AD Arnhem, The Netherlands.
Department of Radiology, Slingeland Hospital, Doetinchem, The Netherlands.
J Vasc Interv Radiol. 2015 Sep;26(9):1277-84. doi: 10.1016/j.jvir.2015.04.007. Epub 2015 May 16.
To determine the clinical outcomes of polytetrafluoroethylene covered balloon expandable stents (CBESs) in occlusive lesions of the aortic bifurcation in a kissing stent configuration.
The study included 69 consecutive patients (29 men, 40 women) who underwent kissing stent procedures with CBESs between January 2003 and April 2009 in a single center. Patients who were previously treated with a CBES were excluded. Follow-up consisted of clinical investigation and duplex ultrasound examination.
The primary patency was 88.1% at 1 year and 71.5% at 4 years, with secondary patency rates of 88.1% and 75.3%, respectively. For patients receiving a stent for the first time, primary patency was 91.3% at 1 year and 77.1% at 4 years. For patients who had received previous stents, patency was 83.6% at 1 year and 65.2% at 4 years (P = .83). There were no differences in secondary patency and freedom from target lesion reintervention (TLR). Loss of primary patency was mainly caused by stent occlusions (14 cases [78%]). The freedom from TLR at 4 years was 76.8%.
Patency rates and freedom from TLR of CBESs in the kissing stent configuration with up to 4 years of follow-up were satisfying and mainly affected by stent occlusions. Studies focusing on optimizing stent configuration and medical care to reduce the incidence of thrombosis are indicated to improve results further.
确定采用吻合法置入聚四氟乙烯覆膜球囊扩张支架（CBES）治疗主动脉分叉闭塞性病变的临床疗效。
本研究纳入了2003年1月至2009年4月期间在单一中心接受CBES吻合法置入术的69例连续患者（男性29例，女性40例）。排除既往接受过CBES治疗的患者。随访包括临床检查和双功超声检查。
1年时的原发性通畅率为88.1%，4年时为71.5%，继发性通畅率分别为88.1%和75.3%。首次接受支架置入的患者，1年时的原发性通畅率为91.3%，4年时为77.1%。既往接受过支架置入的患者，1年时的通畅率为83.6%，4年时为65.2%（P = 0.83）。继发性通畅率和无靶病变再次干预（TLR）情况无差异。原发性通畅的丧失主要由支架闭塞引起（14例[78%]）。4年时无TLR的比例为76.8%。
采用吻合法置入CBES，随访长达4年的通畅率和无TLR情况令人满意，主要受支架闭塞影响。有必要开展研究，聚焦于优化支架构型和医疗护理以降低血栓形成发生率，从而进一步改善治疗效果。
