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在三个意大利高容量中心使用新一代双网支架进行颈动脉支架置入术:多学科方法的临床结果。

Carotid artery stenting with a new-generation double-mesh stent in three high-volume Italian centres: clinical results of a multidisciplinary approach.

机构信息

Interventional Cardiology Unit, Maria Cecilia Hospital, Cotignola, Italy.

出版信息

EuroIntervention. 2016 Aug 5;12(5):e677-83. doi: 10.4244/EIJV12I5A109.

Abstract

AIMS

Carotid artery stenting (CAS) is still associated with higher periprocedural cerebrovascular events (CEs) compared to vascular surgery. The Roadsaver carotid artery stent is a double layer micromesh stent which reduces plaque prolapse and embolisation by improving plaque coverage. Its clinical impact on neurological outcome was unknown. The aim of this study was therefore to report the clinical results of a large real-world population from three different centres receiving a Roadsaver stent to treat carotid artery disease.

METHODS AND RESULTS

One hundred and fifty (150) patients (age 74±8 yrs, 75% male, symptomatic 29%) treated with CAS using the Roadsaver carotid stent in three high-volume Italian centres were included in the study. Intraprocedural optical coherence tomography (OCT) evaluation was performed in 26 patients, with an off-line analysis by a dedicated core laboratory. All patients underwent duplex ultrasound and neurological evaluation at 24 hours and at 30 days. CAS was technically successful in all cases (stent diameter: 8.6±0.8 mm, stent length: 25.0±4.5 mm). No in-hospital or 30-day CEs were observed. OCT evaluation detected a low rate of plaque prolapse (two patients, 7.7%). Duplex ultrasound showed stent and external carotid artery patency in all cases both before discharge and at 30-day follow-up.

CONCLUSIONS

The Roadsaver stent is a safe and promising technology for CAS, with a low percentage of plaque prolapse and good short-term clinical outcome. Larger studies with longer follow-up are necessary to confirm this favourable clinical outcome.

摘要

目的

与血管外科相比,颈动脉支架置入术(CAS)仍然与更高的围手术期脑血管事件(CEs)相关。Roadsaver 颈动脉支架是一种双层微网支架,通过改善斑块覆盖,减少斑块脱垂和栓塞。但其对神经功能结局的临床影响尚不清楚。因此,本研究旨在报告三个不同中心使用 Roadsaver 支架治疗颈动脉疾病的大样本真实世界人群的临床结果。

方法和结果

本研究纳入了三个意大利高容量中心的 150 例(年龄 74±8 岁,75%为男性,29%有症状)接受 Roadsaver 颈动脉支架置入术的患者。26 例患者进行了术中光学相干断层扫描(OCT)评估,并由专门的核心实验室进行离线分析。所有患者均在 24 小时和 30 天进行了双功能超声和神经学评估。所有病例均成功完成了 CAS(支架直径:8.6±0.8mm,支架长度:25.0±4.5mm)。无住院期间或 30 天内 CEs 发生。OCT 评估发现低比例的斑块脱垂(两例患者,7.7%)。双功能超声显示所有病例在出院前和 30 天随访时均有支架和颈外动脉通畅。

结论

Roadsaver 支架置入术是一种安全且有前途的 CAS 技术,其斑块脱垂发生率低,短期临床结果良好。需要更大规模、更长随访时间的研究来证实这一有利的临床结果。

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