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药物洗脱可吸收金属支架(DREAMS)在初发冠状动脉病变患者中的安全性和性能:前瞻性、多中心、人体首例BIOSOLVE-I试验的3年结果

Safety and performance of the DRug-Eluting Absorbable Metal Scaffold (DREAMS) in patients with de novo coronary lesions: 3-year results of the prospective, multicentre, first-in-man BIOSOLVE-I trial.

作者信息

Haude Michael, Erbel Raimund, Erne Paul, Verheye Stefan, Degen Hubertus, Vermeersch Paul, Weissman Neil, Prati Francesco, Bruining Nico, Waksman Ron, Koolen Jacques

机构信息

Medical Clinic I, Städtische Kliniken-Neuss, Lukaskrankenhaus GmbH, Neuss, Germany.

出版信息

EuroIntervention. 2016 Jun 12;12(2):e160-6. doi: 10.4244/EIJ-D-15-00371.

DOI:10.4244/EIJ-D-15-00371
PMID:27290675
Abstract

AIMS

Bioresorbable scaffolds were designed to overcome the limitations of permanent stents. In the BIOSOLVE-I study we aimed to assess the long-term safety and performance of a drug-eluting absorbable metal scaffold (DREAMS) at three years.

METHODS AND RESULTS

In this prospective, multicentre first-in-man study, 46 patients with 47 de novo lesions were enrolled. We report the final results at three-year follow-up. Mean age was 65.3±9.7 years, lesions were 2.73±0.48 mm in diameter and 10.99±4.59 mm long. Follow-up at three years was available for 44 patients (one patient died of a non-cardiac cause and one patient withdrew consent). Three target lesion failures (TLF) occurred (6.6%), consisting of two clinically driven target lesion revascularisations at scheduled six-month angiography (4.3%) and one myocardial infarction after drug-eluting balloon treatment in a non-target lesion but target vessel at 12-month angiography (2.2%). No cardiac death or scaffold thrombosis occurred. Seven patients had additional angiographic follow-up at 28±4 months: in-scaffold late lumen loss had improved from 0.51±0.46 mm (median 0.28 mm) at 12 months to 0.32±0.32 mm (median 0.20 mm).

CONCLUSIONS

The BIOSOLVE-I study showed excellent long-term outcomes at three years with a low TLF rate and no cardiac death or scaffold thrombosis. No TLF event was observed beyond 377 days.

摘要

目的

生物可吸收支架旨在克服永久性支架的局限性。在BIOSOLVE-I研究中,我们旨在评估药物洗脱可吸收金属支架(DREAMS)三年的长期安全性和性能。

方法与结果

在这项前瞻性、多中心的首例人体研究中,纳入了46例患有47处新发病变的患者。我们报告了三年随访的最终结果。平均年龄为65.3±9.7岁,病变直径为2.73±0.48毫米,长度为10.99±4.59毫米。44例患者有三年的随访数据(1例患者死于非心脏原因,1例患者撤回同意)。发生了3例靶病变失败(TLF)(6.6%),包括在预定的六个月血管造影时2例因临床原因进行的靶病变血管重建(4.3%)和在12个月血管造影时1例在非靶病变但靶血管接受药物洗脱球囊治疗后发生的心肌梗死(2.2%)。未发生心源性死亡或支架血栓形成。7例患者在28±4个月时进行了额外的血管造影随访:支架内晚期管腔丢失从12个月时的0.51±0.46毫米(中位数0.28毫米)改善至0.32±0.32毫米(中位数0.20毫米)。

结论

BIOSOLVE-I研究显示三年时具有优异的长期结果,TLF率低,无心源性死亡或支架血栓形成。在377天之后未观察到TLF事件。

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