Soga Yoshimitsu, Takahara Mitsuyoshi, Iida Osamu, Suzuki Kenji, Hirano Keisuke, Kawasaki Daizo, Shintani Yoshiaki, Yamaoka Terutoshi, Ando Kenji
Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan
Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita, Japan Department of Diabetes Care Medicine, Osaka University Graduate School of Medicine, Suita, Japan.
J Endovasc Ther. 2015 Dec;22(6):862-7. doi: 10.1177/1526602815610118. Epub 2015 Oct 5.
To evaluate the relationship between 1-year primary patency and lesion length in patients with femoropopliteal disease treated with bare nitinol stents.
The study was a retrospective analysis of a prospectively maintained multicenter database. Between January 2004 and December 2011, 1047 consecutive patients (mean age 72 years; 765 men) underwent femoropopliteal stenting with nitinol stents in 1373 limbs. The mean vessel diameter was 5.3±0.7 mm and the mean lesion length was 142±75 mm. One-year follow-up data were collected and analyzed to ascertain which lesion length would be expected to demonstrate a 1-year primary patency above the established 66% objective performance goal (OPG).
The lower limit of the 95% confidence interval (CI) for the unadjusted 1-year primary patency was >66% when the lesion length was ≤243 mm. After adjustment of the covariates to match those of the OPG-derived population, the 1-year primary patency decreased linearly with longer lesion length. The 1-year primary patency was 83.2% (95% CI 79.8% to 86.1%) for a 100-mm lesion length, 76.4% (95% CI 71.7% to 80.5%) for a 200-mm lesion length, and 70.7% (95% CI 62.4% to 77.7%) for a 300-mm lesion length. The maximum lesion length providing a 1-year primary patency significantly greater than 66% was calculated to be 263 mm.
The 1-year primary patency of femoropopliteal lesions treated with bare nitinol stents decreased linearly with longer lesion length. The maximum lesion length providing a higher patency rate than the OPG of 66% was ~25 cm.
评估接受裸镍钛合金支架治疗的股腘动脉疾病患者1年的初始通畅率与病变长度之间的关系。
本研究是对一个前瞻性维护的多中心数据库进行的回顾性分析。在2004年1月至2011年12月期间，1047例连续患者（平均年龄72岁；765例男性）的1373条肢体接受了镍钛合金支架的股腘动脉支架置入术。平均血管直径为5.3±0.7mm，平均病变长度为142±75mm。收集并分析1年的随访数据，以确定哪种病变长度预计能显示出高于既定的66%客观性能目标（OPG）的1年初始通畅率。
当病变长度≤243mm时，未经调整的1年初始通畅率的95%置信区间（CI）下限>66%。在调整协变量以匹配OPG衍生人群的协变量后，1年初始通畅率随病变长度的增加呈线性下降。病变长度为100mm时，1年初始通畅率为83.2%（95%CI 79.8%至86.1%）；病变长度为200mm时，为76.4%（95%CI 71.7%至80.5%）；病变长度为300mm时，为70.7%（95%CI 62.4%至77.7%）。计算得出，1年初始通畅率显著高于66%的最大病变长度为263mm。
接受裸镍钛合金支架治疗的股腘动脉病变的1年初始通畅率随病变长度的增加呈线性下降。提供高于66%的OPG通畅率的最大病变长度约为25cm。
