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Elixir DESolve 依维莫司洗脱生物可吸收冠状动脉支架系统的多中心上市后评估:DESolve PMCF 研究的初步结果。

A multicenter post-marketing evaluation of the Elixir DESolve Novolimus-eluting bioresorbable coronary scaffold system: First results from the DESolve PMCF study.

机构信息

Department of Cardiology and Angiology, University of Giessen, Medizinische Klinik I, Giessen, Germany.

Department of Cardiology, Deutsches Herzzentrum Muenchen, Munich, Germany.

出版信息

Catheter Cardiovasc Interv. 2018 Nov 15;92(6):1021-1027. doi: 10.1002/ccd.27550. Epub 2018 Mar 6.

DOI:10.1002/ccd.27550
PMID:29508518
Abstract

OBJECTIVES

To date, experience with bioresorbable scaffolds (BRS) that elute agents other than everolimus is limited. Thus, a post-marketing clinical follow-up study was conducted to evaluate the continued safety and effectiveness of the DESolve® NOVOLIMUS™ Eluting BRS as treatment for patients with stable coronary artery disease.

BACKGROUND

The DESolve BRS combines a poly-l-lactide-based backbone with a biodegradable polylactide-based polymer and Novolimus, a macrocyclic lactone mTOR inhibitor.

METHODS

One hundred and two patients (mean age 62 years, 77.5% male) were enrolled at 10 European sites. Comparison of baseline and post-procedural angiographic assessment was performed, and a device-oriented composite endpoint (comprising cardiac death, target vessel myocardial infarction, and clinically driven target lesion revascularization) and rate of scaffold thrombosis at 12 months were examined.

RESULTS

The device was successfully delivered and deployed in 98.2% (107/109) of the lesions, with two failures to cross the lesion. A total of 100 patients (109 lesions) were treated with a DESolve BRS. Post-procedural angiographic assessment indicated an in-scaffold acute gain of 1.54 ± 0.44 mm, with a reduction in % diameter stenosis from 61.00 ± 11.29 to 12.69 ± 0.44. At 12 months, the device-oriented composite endpoint had occurred in 3.0% (3/100) of patients, with 1.0% (1/100) experiencing scaffold thrombosis and myocardial infarction and 3.0% (3/100) undergoing target lesion revascularization. There were no cardiac deaths.

CONCLUSIONS

Results through 12 months indicate that the DESolve BRS is a safe and effective treatment for coronary lesions, though larger, long-term prospective studies are needed.

摘要

目的

迄今为止,关于洗脱其他药物而非依维莫司的生物可吸收支架(BRS)的经验有限。因此,进行了一项上市后临床随访研究,以评估 DESolve® NOVOLIMUS™洗脱 BRS 作为治疗稳定型冠状动脉疾病患者的持续安全性和有效性。

背景

DESolve BRS 结合了基于聚 L-乳酸的骨架和可生物降解的基于聚乳酸的聚合物以及依维莫司,一种大环内酯类 mTOR 抑制剂。

方法

在 10 个欧洲地点招募了 102 名患者(平均年龄 62 岁,77.5%为男性)。进行了基线和术后血管造影评估的比较,并检查了 12 个月时的器械定向复合终点(包括心脏死亡、靶血管心肌梗死和临床驱动的靶病变血运重建)和支架血栓形成率。

结果

该器械在 98.2%(107/109)的病变中成功输送和展开,有 2 次未能穿过病变。共有 100 名患者(109 个病变)接受了 DESolve BRS 治疗。术后血管造影评估显示支架内急性获得 1.54±0.44mm,%直径狭窄从 61.00±11.29 减少至 12.69±0.44。在 12 个月时,器械定向复合终点在 3.0%(3/100)的患者中发生,其中 1.0%(1/100)发生支架血栓形成和心肌梗死,3.0%(3/100)接受靶病变血运重建。没有心脏死亡。

结论

12 个月的结果表明,DESolve BRS 是治疗冠状动脉病变的一种安全有效的治疗方法,但需要更大规模、长期的前瞻性研究。

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