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Serranator 装置治疗股浅动脉和腘动脉粥样硬化病变的前瞻性研究。

PRELUDE Prospective Study of the Serranator Device in the Treatment of Atherosclerotic Lesions in the Superficial Femoral and Popliteal Arteries.

机构信息

1 Auckland Hospital, Auckland, New Zealand.

2 Polish-American PAKS Heart Clinic, Chrzanów, Poland.

出版信息

J Endovasc Ther. 2019 Feb;26(1):18-25. doi: 10.1177/1526602818820787. Epub 2018 Dec 24.

Abstract

PURPOSE

To evaluate the safety and efficacy of the Serranator Alto PTA Serration Balloon Catheter in subjects with peripheral artery disease in the superficial femoral and popliteal arteries.

MATERIALS AND METHODS

A prospective, multicenter, single-arm feasibility study enrolled 25 patients (mean age 66 years; 18 men) to evaluate Serranator inflation and postinflation effects under monitoring by independent core laboratories. Inclusion criteria were claudication or ischemic rest pain, de novo lesions or native artery restenosis, >70% stenosis, lesion length <10 cm, and a reference vessel diameter of 4 to 6 mm. Chronic total occlusions (CTO) up to 6 cm in length were allowed (n=8). The primary safety endpoint was 30-day major adverse events. Primary efficacy outcome was device success with final diameter stenosis <50%. The secondary objective was to confirm the presence of serrations across the lesions using optical coherence tomography (OCT) or intravascular ultrasound (IVUS) following treatment in a subset of 10 subjects. Follow-up evaluations were conducted at 30 days and 6 months.

RESULTS

Technical success of device delivery and retrieval was 100%. The primary safety endpoint was met, with no patients experiencing a major adverse event in the first 30 days. Pretreatment stenosis of 88% was reduced to 23%. One stent was implanted for grade D dissection in a CTO. The core laboratory-adjudicated primary patency was 100% at 1 month and 64% at 6 months. Serrations were confirmed in all 10 OCT/IVUS images reviewed by the core laboratory. The Rutherford category showed significant and sustained improvement at 6 months.

CONCLUSION

The Serranator is a safe and efficacious angioplasty balloon catheter system. This new design provides an exciting potential for optimizing vessel preparation and aiding drug delivery.

摘要

目的

评估 Serranator Alto PTA 锯齿球囊导管在股浅动脉和腘动脉的外周动脉疾病患者中的安全性和疗效。

材料和方法

一项前瞻性、多中心、单臂可行性研究纳入了 25 名患者(平均年龄 66 岁;18 名男性),由独立核心实验室监测评估 Serranator 球囊的膨胀和膨胀后效果。纳入标准为跛行或缺血性静息痛、新发病变或原生动脉再狭窄、>70%狭窄、病变长度<10cm 和参考血管直径 4 至 6mm。允许存在长达 6cm 的慢性完全闭塞(CTO)(n=8)。主要安全性终点为 30 天内主要不良事件。主要疗效终点为最终直径狭窄率<50%的器械成功。次要目标是在 10 名患者的亚组中,通过光学相干断层扫描(OCT)或血管内超声(IVUS)确认治疗后病变处存在锯齿。随访评估在 30 天和 6 个月进行。

结果

器械输送和回收的技术成功率为 100%。达到了主要安全性终点,在最初的 30 天内,没有患者发生重大不良事件。术前狭窄率为 88%,降低至 23%。在 CTO 中,有 1 例植入支架治疗 D 级夹层。核心实验室判定的 1 个月和 6 个月的主要通畅率分别为 100%和 64%。核心实验室对 10 张 OCT/IVUS 图像进行了审查,确认了锯齿。Rutherford 分类在 6 个月时显示出显著且持续的改善。

结论

Serranator 是一种安全有效的血管成形术球囊导管系统。这种新设计为优化血管准备和辅助药物输送提供了令人兴奋的潜在可能性。

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