From the Cardiovascular Institute of the South, Houma, LA (P.K.N.); Cardiovascular Associates of East Texas, Tyler (J.G.C.); Heart Center of Indiana, Indianapolis (B.B.); Brigham and Women's Hospital, Harvard Medical School, Boston, MA (D.L.B.); 3DT Holdings, LLC, San Diego, CA (Z.C.B.); and North Carolina Heart and Vascular Research Center, Raleigh (G.A.).
Circ Cardiovasc Interv. 2018 Jan;11(1):e005333. doi: 10.1161/CIRCINTERVENTIONS.117.005333.
Proper vessel sizing during endovascular interventions is crucial to avoid adverse procedural and clinical outcomes. LumenRECON (LR) is a novel, nonimaging, 0.035-inch wire-based technology that uses the physics-based principle of Ohm's law to provide a simple, real-time luminal size while also providing a platform for therapy delivery. This study evaluated the accuracy, reliability, and safety of the LR system in patients presenting for a femoropopliteal artery intervention.
This multicenter, prospective pilot study of 24 patients presenting for peripheral intervention compared LR measurements of femoropopliteal artery size to angiographic visual estimation, duplex ultrasound, quantitative angiography, and intravascular ultrasound. The primary effectiveness and safety end point was comparison against core laboratory adjudicated intravascular ultrasound values and major adverse events, respectively. Additional preclinical studies were also performed in vitro and in vivo in swine to determine the accuracy of the LR guidewire system. No intra- or postprocedure device-related adverse events occurred. A balloon or stent was successfully delivered in 12 patients (50%) over the LR wire. Differences in repeatability between successive LR measurements was 2.5±0.40% (=0.96) with no significant bias. Differences in measurements of LR to other modalities were 0.5±1.7%, 5.0±1.8%, -1.5±2.0%, and 6.8±3.4% for intravascular ultrasound core laboratory, quantitative angiography, angiographic, and duplex ultrasound, respectively.
This study demonstrates that through a physics-based principle, LR provides a real-time, safe, reproducible, and accurate vessel size of the femoropopliteal artery during intervention and can additionally serve as a conduit for therapy delivery over its wire-based platform.
血管内介入治疗时,正确的血管尺寸选择对于避免不良的手术和临床结果至关重要。LumenRECON(LR)是一种新颖的、非成像的、0.035 英寸线基技术,它利用基于物理的欧姆定律原理,提供实时的管腔尺寸,同时也为治疗提供输送平台。本研究评估了 LR 系统在股腘动脉介入治疗患者中的准确性、可靠性和安全性。
这项多中心、前瞻性的 24 例患者股腘动脉介入治疗的研究,将 LR 对股腘动脉尺寸的测量与血管造影视觉估计、双功超声、定量血管造影和血管内超声进行比较。主要有效性和安全性终点分别是与核心实验室裁定的血管内超声值和主要不良事件进行比较。还在体外和猪体内进行了额外的临床前研究,以确定 LR 导丝系统的准确性。没有发生与器械相关的术中或术后不良事件。在 12 例患者(50%)中成功地在 LR 导丝上输送了球囊或支架。LR 重复测量的重复性差异为 2.5±0.40%(=0.96),无显著偏差。LR 与其他模态的测量值之间的差异分别为血管内超声核心实验室、定量血管造影、血管造影和双功超声为 0.5±1.7%、5.0±1.8%、-1.5±2.0%和 6.8±3.4%。
这项研究表明,通过基于物理的原理,LR 在介入过程中提供实时、安全、可重复和准确的股腘动脉尺寸,并可通过其线基平台额外作为治疗输送的通道。