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覆膜支架与裸金属支架治疗慢性全闭塞长段复杂股腘动脉病变:单中心 2 年回顾。

Covered stent versus bare-metal stents for chronic total occluded long complicated femoropopliteal lesions: A 2-year single center review.

机构信息

Division of Cardiovascular Surgery, Heart Center, Cheng Hsin General Hospital, Taipei, Taiwan, ROC.

Department of medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.

出版信息

J Chin Med Assoc. 2019 Jan;82(1):44-49. doi: 10.1097/JCMA.0000000000000005.

DOI:10.1097/JCMA.0000000000000005
PMID:30839403
Abstract

BACKGROUND

To compare the efficacy, safety, and results of Viabahn versus bare-metal stents (BMS) in chronic total occluded (CTO) long femoropopliteal lesions.

METHODS

From April 2009 to August 2014, a total 97 patients (71.2 ± 9.7, 45-90 years old, 70 males) with occluded femo-ropopliteal lesions underwent Viabahn (55 patients) or BMS (42 patients) implantation. The clinical findings, procedural factors, and overall outcomes were collected and analyzed.

RESULTS

The average lesion length was 22.1 ± 4.8 cm in the Viabahn group and 17.8 ± 3.3 cm in the BMS group. Both groups had a 100% technical success rate. Although there was no difference between the groups in complication, mortality, and major amputation rates, the Viabahn group had a significantly better average post-operative ankle brachial index (ABI) at 1-year and 2-year follow-ups. The Viabahn group also had significantly less in-stent restenosis (ISR) and target lesion revascularization (TLR) compared with the BMS group. Nevertheless, the two groups shared similar 2-year primary patency rates (63.6% vs. 50.0%, p = .178) and 2-year secondary patency rates (85.5% vs. 81.0%, p = .554).

CONCLUSION

Both Viabahn and BMS were efficient treatments for long femoropopliteal CTO lesions. However, the Viabahn group had significantly improved results compared with the BMS group in TLR and ISR, but the difference was not sufficient enough to result in different primary and secondary patency rates.

摘要

背景

比较 Viabahn 与裸金属支架(BMS)治疗慢性完全闭塞(CTO)长股腘动脉病变的疗效、安全性和结果。

方法

2009 年 4 月至 2014 年 8 月,97 例(71.2±9.7,45-90 岁,70 例男性)闭塞性股腘动脉病变患者接受 Viabahn(55 例)或 BMS(42 例)植入术。收集并分析临床资料、手术相关因素和总体结果。

结果

Viabahn 组和 BMS 组的平均病变长度分别为 22.1±4.8cm 和 17.8±3.3cm,两组均达到 100%的技术成功率。虽然两组在并发症、死亡率和主要截肢率方面无差异,但 Viabahn 组术后 1 年和 2 年的平均踝肱指数(ABI)明显更高。Viabahn 组的支架内再狭窄(ISR)和靶病变血运重建(TLR)发生率也明显低于 BMS 组。然而,两组 2 年的原发性通畅率(63.6%比 50.0%,p=0.178)和 2 年的继发性通畅率(85.5%比 81.0%,p=0.554)相似。

结论

Viabahn 和 BMS 治疗长股腘动脉 CTO 病变均有效。然而,Viabahn 组在 TLR 和 ISR 方面的结果明显优于 BMS 组,但差异不足以导致原发性和继发性通畅率的不同。

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