Giordano Arturo, Ferraro Paolo, Corcione Nicola, Messina Stefano, Maresca Gennaro, Coscioni Enrico, Avellino Raffaella, Giordano Gabriele, Peruzzi Mariangela, Biondi-Zoccai Giuseppe
Unità Operativa di Interventistica Cardiovascolare, Presidio Ospedaliero Pineta Grande, Castel Volturno, Italy.
Unità Operativa di Emodinamica, Casa di Salute Santa Lucia, San Giuseppe Vesuviano, Italy.
Angiology. 2017 Jan;68(1):59-66. doi: 10.1177/0003319716637802. Epub 2016 Mar 15.
Several devices are available for infrainguinal endovascular therapy, with drug-eluting stents (DES) among the most promising. Bioresorbable vascular scaffolds (BVS) may further improve outcomes. We have liberally used in our practice coronary DES and BVS for infrainguinal endovascular therapy and hereby report our preliminary results. We conducted an observational study by retrospectively identifying characteristics of patients undergoing infrainguinal implantation of coronary DES or BVS. We compared the risk of major adverse events (MAE: death, amputation, or target vessel revascularization [TVR]) and components of MAE in the overall sample and after propensity matching. We included a total of 204 patients (207 limbs), 148 (72.5%) treated with DES and 56 (27.5%) with BVS. Bivariate analysis showed that TVR was less common in the DES group (41.9% vs 18.4%, P = .014). However, propensity-matched analysis showed nearly identical risks of MAE, amputation, TVR, or symptom burden with DES and BVS (all P > .05). In conclusion, the present pilot experience with coronary BVS suggests that they could provide acceptable results for infrainguinal endovascular procedures, comparable to those obtained by their metallic counterpart.
有几种设备可用于腹股沟下血管腔内治疗,其中药物洗脱支架(DES)是最有前景的。生物可吸收血管支架(BVS)可能会进一步改善治疗效果。我们在实践中大量使用冠状动脉DES和BVS进行腹股沟下血管腔内治疗,在此报告我们的初步结果。我们通过回顾性确定接受冠状动脉DES或BVS腹股沟下植入术患者的特征进行了一项观察性研究。我们比较了总体样本以及倾向匹配后主要不良事件(MAE:死亡、截肢或靶血管再血管化[TVR])的风险和MAE的组成部分。我们共纳入了204例患者(207条肢体),其中148例(72.5%)接受DES治疗,56例(27.5%)接受BVS治疗。双变量分析显示,DES组的TVR较少见(41.9%对18.4%,P = 0.014)。然而,倾向匹配分析显示,DES和BVS在MAE、截肢、TVR或症状负担方面的风险几乎相同(所有P>0.05)。总之,目前冠状动脉BVS的初步经验表明,它们可为腹股沟下血管腔内手术提供可接受的结果,与金属支架相当。