Saito Shigeru, Ando Kenji, Ito Yoshiaki, Tobaru Tetsuya, Yajima Junji, Kimura Takeshi, Kadota Kazushige
Department of Cardiology and Catheterization Laboratories, Shonan Kamakura General Hospital, Okamoto 1370-1, Kamakura, 247 8533, Japan.
Division of Cardiology, Kokura Memorial Hospital, Kokura, Japan.
Cardiovasc Interv Ther. 2019 Jan;34(1):25-33. doi: 10.1007/s12928-018-0511-3. Epub 2018 Jan 18.
Percutaneous coronary intervention (PCI) in coronary artery disease (CAD) with very small vessels remains challenging. The aim of this study is to evaluate the safety and effectiveness of the 2.25-mm diameter Ultimaster sirolimus-eluting stent in the treatment of Japanese patients with CAD due to lesions in very small vessels. The CENTURY JSV study is a prospective, multicentre, single-arm study. Seventy patients with lesions deemed suitable for implantation of a 2.25-mm diameter stent were enrolled at seven hospitals in Japan. Patients underwent clinical follow-up at 1-, 9-month, 1-, and 2-year after the PCI procedure. The primary endpoint was the major adverse cardiac event (MACE), a composite of cardiac death, target vessel myocardial infarction (MI), and clinically driven target lesion revascularization (TLR) free rate at 9-month following the procedure. The MACE-free rate was 97.1%, and the lower limit of the two-sided 95% confidence interval (CI) was 90.1%, which exceeded the threshold of 80% set as the performance goal. Angiographic in-stent and in-segment late loss at 9-month were 0.22 ± 0.31 and - 0.02 ± 0.34 mm, respectively. Between 9 months and 2 years, two additional TLRs occurred. Stent thrombosis, bleeding and vascular complication did not occur throughout 2 years. The 2.25-mm diameter Ultimaster bioresorbable-polymer sirolimus-eluting stent is safe and effective for treating lesions in very small coronary arteries throughout 2 years after stent implantation.Clinical trial registration: UMIN000012928.
在患有非常小血管的冠状动脉疾病(CAD)中进行经皮冠状动脉介入治疗(PCI)仍然具有挑战性。本研究的目的是评估直径2.25毫米的Ultimaster西罗莫司洗脱支架治疗因非常小血管病变所致CAD日本患者的安全性和有效性。CENTURY JSV研究是一项前瞻性、多中心、单臂研究。在日本七家医院招募了70例被认为适合植入直径2.25毫米支架的病变患者。患者在PCI术后1个月、9个月、1年和2年接受临床随访。主要终点是主要不良心脏事件(MACE),即术后9个月时心脏死亡、靶血管心肌梗死(MI)和临床驱动的靶病变血运重建(TLR)的复合无事件发生率。无MACE发生率为97.1%,双侧95%置信区间(CI)的下限为90.1%,超过了设定为性能目标的80%阈值。术后9个月时支架内和节段内造影剂晚期丢失分别为0.22±0.31和 -0.02±0.34毫米。在9个月至2年之间,又发生了2例TLR。在整个2年期间未发生支架血栓形成、出血和血管并发症。直径2.25毫米的Ultimaster生物可吸收聚合物西罗莫司洗脱支架在支架植入后2年内治疗非常小冠状动脉病变是安全有效的。临床试验注册:UMIN000012928。