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戈尔特斯球囊扩张型覆膜内支架治疗髂动脉闭塞性疾病的首例人体经验

First-in-Human Experience With the Gore Balloon-Expandable Covered Endoprosthesis in Iliac Artery Occlusive Disease.

作者信息

Holden Andrew, Merrilees Stephen, Buckley Brendan, Connor Brigid, Colgan Frances, Hill Andrew

机构信息

1 Department of Interventional Radiology, Auckland Hospital, Auckland, New Zealand.

2 Department of Vascular Surgery, Auckland Hospital, Auckland, New Zealand.

出版信息

J Endovasc Ther. 2017 Feb;24(1):11-18. doi: 10.1177/1526602816680570. Epub 2016 Nov 21.

Abstract

PURPOSE

To report the first-in-human iliac artery experience of a new balloon-expandable covered endoprosthesis.

METHODS

A prospective, single-center pilot study recruited 30 symptomatic patients (mean age 64 years; 18 men) to evaluate the safety and early efficacy of the new Gore balloon-expandable covered endoprosthesis for the treatment of de novo or restenotic common and/or external iliac artery lesions. According to protocol, up to 2 discrete lesions could be treated with a maximum total treated length ≤110 mm. Follow-up included clinical evaluation with duplex ultrasound at 1, 6, and 12 months. Data are presented through 12-month follow-up. The primary safety endpoint was a composite of device- or procedure-related death, myocardial infarction, or amputation in the treated leg within 30 days of the index procedure. Multiple performance outcomes were also evaluated.

RESULTS

The primary 30-day safety endpoint was 0%. Per-subject estimates of primary patency, freedom from target lesion revascularization, and freedom from target vessel revascularization were 100% at 1 and 6 months and 96.6% at 12 months. Estimates of assisted primary and secondary patency were both 100% at 12 months. Freedom from major adverse events at 12 months was 100%. Most patients experienced improvements in Rutherford category, ankle-brachial index, and functional status that were sustained to 12 months.

CONCLUSION

This positive first-in-human experience with the Gore balloon-expandable covered endoprosthesis suggests this device will have an important role in the management of aortoiliac occlusive disease.

摘要

目的

报告一种新型球囊扩张式覆膜血管内支架在人体髂动脉的首次应用经验。

方法

一项前瞻性、单中心的试点研究招募了30例有症状的患者(平均年龄64岁;18例男性),以评估新型戈尔球囊扩张式覆膜血管内支架治疗初发或再狭窄的髂总动脉和/或髂外动脉病变的安全性和早期疗效。根据方案,最多可治疗2个离散病变,最大总治疗长度≤110毫米。随访包括在1、6和12个月时用双功超声进行临床评估。数据呈现至12个月随访期。主要安全终点是在首次手术30天内发生的与器械或手术相关的死亡、心肌梗死或治疗侧下肢截肢的复合事件。还评估了多个性能结果。

结果

30天主要安全终点发生率为0%。在1个月和6个月时,每位受试者的主要通畅率、免于靶病变血运重建率和免于靶血管血运重建率估计均为100%,在12个月时为96.6%。12个月时辅助主要通畅率和次要通畅率估计均为100%。12个月时免于主要不良事件的发生率为100%。大多数患者的卢瑟福分级、踝肱指数和功能状态有所改善,并持续至12个月。

结论

戈尔球囊扩张式覆膜血管内支架在人体的首次应用取得了积极成果,表明该器械在主髂动脉闭塞性疾病的治疗中将发挥重要作用。

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