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紫杉醇洗脱支架治疗日本股浅动脉疾病的上市后监测研究:12 个月结果。

Zilver PTX Post-Market Surveillance Study of Paclitaxel-Eluting Stents for Treating Femoropopliteal Artery Disease in Japan: 12-Month Results.

机构信息

Department of Cardiovascular Medicine, Fukuoka Sanno Hospital, Fukuoka, Japan.

Department of Surgery, Jikei University Hospital, Tokyo, Japan.

出版信息

JACC Cardiovasc Interv. 2016 Feb 8;9(3):271-277. doi: 10.1016/j.jcin.2015.09.035.

Abstract

OBJECTIVES

This multicenter, prospective, post-market surveillance study in Japan evaluates the paclitaxel-coated Zilver PTX stent in real-world patients with complex lesions.

BACKGROUND

The Zilver PTX stent is the first drug-eluting stent (DES) approved for the superficial femoral artery. Previously, results from a large randomized study and a complementary, large single-arm study supported the safety and effectiveness of the DES.

METHODS

There were no exclusion criteria, and consecutive patients with symptomatic peripheral artery disease (PAD) treated with the DES were enrolled in the study. Clinically driven target lesion revascularization (TLR) was defined as reintervention performed for ≥50% diameter stenosis after recurrent clinical symptoms of PAD. Clinical benefit was defined as freedom from persistent or worsening symptoms of ischemia. Patency was evaluated by duplex ultrasound where physicians considered this standard of care.

RESULTS

In this study, 907 patients were enrolled at 95 institutions in Japan. There were numerous comorbidities including high incidences of diabetes (58.8%), chronic kidney disease (43.8%), and critical limb ischemia (21.5%). Lesions were also complex, with an average length of 14.7 cm, 41.6% total occlusions, and 18.6% in-stent restenosis. In total, 1,861 DES were placed in 1,075 lesions. Twelve-month follow-up was obtained for >95% of eligible patients. Freedom from TLR was 91.0%, and clinical benefit was 87.7% through 12 months. The 12-month primary patency rate was 86.4%.

CONCLUSIONS

Despite more challenging lesions, results from the current study are similar to outcomes from the previous Zilver PTX studies, confirming the benefit of the Zilver PTX DES in a real-world patient population. (Zilver PTX Post-Market Study in Japan; NCT02254837).

摘要

目的

本项多中心、前瞻性、上市后监测研究在日本评估了紫杉醇涂层 Zilver PTX 支架在复杂病变的真实世界患者中的应用。

背景

Zilver PTX 支架是首个获批用于股浅动脉的药物洗脱支架(DES)。此前,一项大型随机研究和一项补充的大型单臂研究的结果支持了 DES 的安全性和有效性。

方法

本研究无排除标准,连续入组接受 DES 治疗的有症状外周动脉疾病(PAD)患者。临床驱动的靶病变血运重建(TLR)定义为 PAD 临床症状复发后,行再介入治疗以缓解 ≥50%的直径狭窄。临床获益定义为无持续性或恶化的缺血症状。采用医生认为是标准护理的双功能超声评估通畅性。

结果

本研究在日本的 95 家机构共入组了 907 例患者。患者合并症众多,包括糖尿病(58.8%)、慢性肾脏病(43.8%)和严重肢体缺血(21.5%)的高发。病变也很复杂,平均长度为 14.7cm,41.6%完全闭塞,18.6%支架内再狭窄。共置入 1861 枚 DES 于 1075 处病变。12 个月的随访获得了 >95%的合格患者。12 个月 TLR 发生率为 91.0%,临床获益率为 87.7%。12 个月的原发性通畅率为 86.4%。

结论

尽管病变更具挑战性,但本研究结果与之前的 Zilver PTX 研究结果相似,证实了 Zilver PTX DES 在真实世界患者人群中的获益。(Zilver PTX 日本上市后研究;NCT02254837)。

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