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紫杉醇洗脱自膨胀Stentys支架系统治疗严重肢体缺血患者腘下病变的一年期结果

One-Year Outcomes of the Paclitaxel-Eluting, Self-Expanding Stentys Stent System in the Treatment of Infrapopliteal Lesions in Patients With Critical Limb Ischemia.

作者信息

Bosiers Marc, Callaert Joren, Keirse Koen, Hendriks Jeroen M H, Peeters Patrick, Verbist Jürgen, Maene Lieven, Beelen Roel, Deloose Koen

机构信息

1 Department of Vascular Surgery, AZ Sint-Blasius, Dendermonde, Belgium.

2 Department of Vascular Surgery, Heilig Hart Hospital, Tienen, Belgium.

出版信息

J Endovasc Ther. 2017 Jun;24(3):311-316. doi: 10.1177/1526602817697319. Epub 2017 Mar 9.

Abstract

PURPOSE

To investigate the efficacy of the paclitaxel-coated, self-expanding, nitinol Stentys Stent System in tibioperoneal lesions ≤50 mm long.

METHODS

The prospective, single-arm, multicenter PES-BTK-70 trial ( ClinicalTrials.gov identifier NCT01630070) evaluated the safety and efficacy of the coronary Stentys Stent System in the treatment of a stenotic or occlusive lesion ≤50 mm long in the tibioperoneal arteries of patients with critical limb ischemia (CLI). Between January 2012 and May 2013, 70 patients (mean age 74.6±9.4 years; 45 men) with CLI [Rutherford category 4 (37, 52.9%) or 5 (33, 47.1%)] received a Stentys drug-eluting stent for the treatment of infrapopliteal stenosis (60, 85.7%) or occlusion (10, 14.3%). The mean lesion length was 17.2 mm (4.0-58.5). The primary outcome measures were primary patency at 6 months (duplex ultrasound) and 12 months (angiography). Secondary outcomes included limb salvage and freedom from target lesion revascularization (TLR). Kaplan-Meier estimates of the outcomes are given with the 95% confidence intervals (CI).

RESULTS

Technical and procedure success (<30% residual stenosis without major complications) was achieved in 68 (97.1%) of 70 cases. Primary patency was 87.6% (95% CI 83.5% to 91.7%) at 6 months and 72.6% (95% CI 66.9% to 78.3%) at 1 year. Freedom from TLR was 79.1% at 1 year (95% CI 73.9% to 84.3) and limb salvage was 98.5% (95% CI 97.0 to 100.0). No stent fractures were found by core laboratory review of all follow-up imaging data available up to 12 months.

CONCLUSION

In this study, the self-expanding, nitinol, paclitaxel-eluting, coronary Stentys stent was found to be safe and effective in the below-the-knee region, with results similar to the most recent limus-eluting stent trials.

摘要

目的

研究紫杉醇涂层、自膨胀镍钛合金的Stentys支架系统治疗长度≤50mm的胫腓动脉病变的疗效。

方法

前瞻性、单臂、多中心的PES-BTK-70试验(ClinicalTrials.gov标识符NCT01630070)评估了冠状动脉Stentys支架系统治疗严重肢体缺血(CLI)患者胫腓动脉长度≤50mm的狭窄或闭塞性病变的安全性和疗效。在2012年1月至2013年5月期间,70例CLI患者(平均年龄74.6±9.4岁;45例男性)[卢瑟福分级为4级(37例,52.9%)或5级(33例,47.1%)]接受了Stentys药物洗脱支架治疗腘下狭窄(60例,85.7%)或闭塞(10例,14.3%)。平均病变长度为17.2mm(4.0 - 58.5)。主要结局指标为6个月时(双功超声)和12个月时(血管造影)的原发性通畅率。次要结局包括肢体挽救和免于靶病变血管重建(TLR)。给出了结局的Kaplan-Meier估计值及95%置信区间(CI)。

结果

7例患者中的例(97.1%)获得技术和手术成功(残余狭窄<30%且无重大并发症)。6个月时原发性通畅率为87.6%(95%CI 83.5%至91.7%),一年时为72.6%(95%CI 66.9%至78.3%)。一年时免于TLR率为79.1%(95%CI 73.9%至84.3),肢体挽救率为98.5%(95%CI 97.0至100.0)。通过对截至12个月的所有可用随访影像数据进行核心实验室评估,未发现支架断裂情况。

结论

在本研究中,自膨胀镍钛合金紫杉醇洗脱冠状动脉Stentys支架在膝下区域被发现是安全有效的,结果与最近西罗莫司洗脱支架试验相似。

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