Adventist St. Helena Hospital Heart and Vascular Institute, 6 Woodland Road, Suite 304, St. Helena, CA 94574.
Heart Center Bad Krozingen, Bad Krozingen, Germany.
J Vasc Interv Radiol. 2019 Jun;30(6):836-844.e1. doi: 10.1016/j.jvir.2018.12.031. Epub 2019 Apr 5.
This study sought to assess the performance of the LIFESTREAM balloon-expandable covered stent for the treatment of iliac artery atherosclerotic lesions.
A total of 155 patients were treated in a prospective, single-arm study at 17 centers in the United States, Europe, and New Zealand. The primary endpoint was a composite of device- or procedure-related death or myocardial infarction (MI) over the course of 30 days, or target lesion revascularization (TLR), major amputation of the target limb, or re-stenosis through 9-months. Secondary endpoints included primary patency, TLR, sustained clinical success, quality of life, and major adverse events (MAE).
At 9 months, the primary composite endpoint rate was 16.2% (93.5% confidence interval [CI]: 10.6%-23.2%), primary patency was 89.1% (95% CI: 82.6%-93.7%), and freedom from TLR was 96%. There was a cumulative clinical improvement of at least one Rutherford category from baseline to 9 months of 90.5% (95% CI: 84.3%-94.9%). Quality of life, assessed by using the Walking Impairment Questionnaire (WIQ), demonstrated a mean change in total score from baseline through 9 months of 32.1 ± 26.84; overall, improvements were noted from baseline in each WIQ category. Seven of one-hundred fifty patients (4.7%; 95% CI: 1.9%-9.4%) experienced MAEs, but none were determined to be related to device or procedure.
The LIFESTREAM balloon-expandable covered stent provided satisfactory 9-month clinical outcomes including a low rate of target lesion revascularization for the treatment of stenotic and occlusive lesions of the iliac arteries.
本研究旨在评估 LIFESTREAM 球囊扩张式覆膜支架治疗髂动脉粥样硬化病变的疗效。
在美国、欧洲和新西兰的 17 个中心,一项前瞻性、单臂研究共纳入 155 例患者。主要终点是 30 天内器械或操作相关的死亡或心肌梗死(MI),或靶病变血运重建(TLR)、靶肢主要截肢或再狭窄,或 9 个月时的复合终点。次要终点包括一期通畅率、TLR、持续临床成功率、生活质量和主要不良事件(MAE)。
9 个月时,主要复合终点发生率为 16.2%(95%置信区间:10.6%-23.2%),一期通畅率为 89.1%(95%置信区间:82.6%-93.7%),TLR 无事件率为 96%。从基线到 9 个月时,至少有一个 Rutherford 分类的临床改善累计发生率为 90.5%(95%置信区间:84.3%-94.9%)。通过行走障碍问卷(WIQ)评估的生活质量显示,总评分从基线到 9 个月时平均变化为 32.1 ± 26.84;总体而言,每个 WIQ 类别在基线时都有所改善。155 例患者中有 7 例(4.7%;95%置信区间:1.9%-9.4%)发生 MAE,但均与器械或操作无关。
LIFESTREAM 球囊扩张式覆膜支架治疗髂动脉狭窄和闭塞性病变,9 个月时临床结果满意,靶病变血运重建率较低。