Müller-Hülsbeck Stefan, Keirse Koen, Zeller Thomas, Schroë Herman, Diaz-Cartelle Juan
Department of Diagnostic and Interventional Radiology/Neuroradiology, Ev. Luth. Diakonissenanstalt Flensburg, Knuthstr. 1, 24939, Flensburg, Germany.
Regional Hospital Heilig Hart Tienen, Tienen, Belgium.
Cardiovasc Intervent Radiol. 2017 Dec;40(12):1832-1838. doi: 10.1007/s00270-017-1771-5. Epub 2017 Sep 25.
To report the 3-year results of the MAJESTIC first-in-human study of the Eluvia Drug-Eluting Vascular Stent System for treating femoropopliteal artery lesions.
The prospective, single-arm, multicenter clinical trial enrolled 57 patients with symptomatic lower limb ischemia (Rutherford category 2, 3, or 4) and lesions in the superficial femoral artery or proximal popliteal artery. Mean lesion length was 70.8 ± 28.1 mm, and 46% of lesions were occluded. Efficacy measures at 2 years included primary patency, defined as duplex ultrasound peak systolic velocity ratio of ≤2.5 and the absence of target lesion revascularization (TLR) or bypass. Safety monitoring through 3 years included adverse events and TLR.
Primary patency was estimated as 83.5% (Kaplan-Meier analysis) at 24 months, and 90.6% (48/53) of patients maintained an improvement in Rutherford class. At 36 months, the Kaplan-Meier estimate of freedom from TLR was 85.3%. No stent fractures were identified, and no major target limb amputations occurred.
MAJESTIC results demonstrated long-term treatment durability among patients whose femoropopliteal arteries were treated with the paclitaxel-eluting Eluvia stent.
Level 2b, cohort study.
报告Eluvia药物洗脱血管支架系统治疗股腘动脉病变的MAJESTIC首次人体研究的3年结果。
这项前瞻性、单臂、多中心临床试验纳入了57例有症状的下肢缺血患者(卢瑟福分级为2、3或4级),病变位于股浅动脉或腘动脉近端。平均病变长度为70.8±28.1毫米,46%的病变为闭塞性病变。2年时的疗效指标包括主要通畅率,定义为双功超声收缩期峰值流速比≤2.5且无靶病变血管重建(TLR)或旁路手术。3年的安全性监测包括不良事件和TLR。
24个月时主要通畅率经Kaplan-Meier分析估计为83.5%,90.6%(48/53)的患者卢瑟福分级有所改善。36个月时,Kaplan-Meier法估计的无TLR发生率为85.3%。未发现支架断裂,也未发生主要的靶肢体截肢。
MAJESTIC研究结果表明,使用紫杉醇洗脱的Eluvia支架治疗股腘动脉病变的患者具有长期治疗持久性。
2b级,队列研究。