Burket Mark W, Brodmann Marianne, Metzger Christopher, Tan Kongteng, Jaff Michael R
University of Toledo Medical Center, 3000 Arlington Ave, Toledo, OH 43614.
Clinical Division of Angiology, Medical University Graz, Graz, Austria.
J Vasc Interv Radiol. 2016 Nov;27(11):1650-1656.e1. doi: 10.1016/j.jvir.2016.06.008. Epub 2016 Aug 16.
To evaluate the safety and efficacy of a self-expanding bare-metal nitinol stent (Astron; BIOTRONIK AG, Bülach, Switzerland) for the treatment of atherosclerotic lesions in the common and external iliac arteries. This study tested the hypothesis that the major adverse event (MAE) rate at 12 months was less than or equal to a performance goal of 15%.
In a prospective study that began in November 2011, 161 patients with symptomatic iliac lesions were treated with an Astron stent in the United States, Canada, and Austria. The primary endpoint was a composite rate of procedure- and stent-related MAEs at 12 months that included 30-day mortality, clinically indicated target lesion revascularization (TLR), and index limb amputation.
The MAE rate at 12 months was 2.1% (3/146; [95% CI: 0.4% to 5.9%]; p < 0.001). The acute procedural success and 30-day clinical success outcomes were both 95% (153/161). The primary patency rate at 12 months was 89.8% (115/128). The comparison of baseline and 12-month Ankle Brachial Index (ABI) measurements showed a mean increase of 0.23 ± 0.19 (p < 0.001). The Walking Impairment Questionnaire (WIQ) PAD specific score, walking distance score, walking speed score and stair climbing score paired each showed a significant increase from baseline to 12 months (p<0.001).
The Astron stent system was shown to be safe and effective in the treatment of patients with atherosclerotic disease. The observed MAE rate met the pre-specified performance goal of 15%. The stent demonstrated a high 12-month primary patency rate and showed improvement in quality of life measures.
评估自膨式裸金属镍钛合金支架(Astron;百多力公司,瑞士比拉赫)治疗髂总动脉和髂外动脉粥样硬化病变的安全性和有效性。本研究检验了以下假设:12个月时的主要不良事件(MAE)发生率小于或等于15%的性能目标。
在一项于2011年11月开始的前瞻性研究中,美国、加拿大和奥地利的161例有症状的髂动脉病变患者接受了Astron支架治疗。主要终点是12个月时与手术和支架相关的MAE复合发生率,包括30天死亡率、临床指征的靶病变血运重建(TLR)和患肢截肢。
12个月时的MAE发生率为2.1%(3/146;[95%置信区间:0.4%至5.9%];p<0.001)。急性手术成功率和30天临床成功率均为95%(153/161)。12个月时的主要通畅率为89.8%(115/128)。基线和12个月时踝臂指数(ABI)测量值的比较显示平均增加0.23±0.19(p<0.001)。步行障碍问卷(WIQ)PAD特定评分、步行距离评分、步行速度评分和爬楼梯评分从基线到12个月均显著增加(p<0.001)。
Astron支架系统在治疗动脉粥样硬化疾病患者中显示出安全有效。观察到的MAE发生率达到了预先设定的15%的性能目标。该支架显示出较高的12个月主要通畅率,并在生活质量指标方面有所改善。