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球囊扩张式血管覆膜支架治疗髂动脉闭塞性疾病:BOLSTER 多中心研究 9 个月结果。

Balloon-Expandable Vascular Covered Stent in the Treatment of Iliac Artery Occlusive Disease: 9-Month Results from the BOLSTER Multicenter Study.

机构信息

Adventist St. Helena Hospital Heart and Vascular Institute, 6 Woodland Road, Suite 304, St. Helena, CA 94574.

Heart Center Bad Krozingen, Bad Krozingen, Germany.

出版信息

J Vasc Interv Radiol. 2019 Jun;30(6):836-844.e1. doi: 10.1016/j.jvir.2018.12.031. Epub 2019 Apr 5.

Abstract

PURPOSE

This study sought to assess the performance of the LIFESTREAM balloon-expandable covered stent for the treatment of iliac artery atherosclerotic lesions.

METHODS

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).

RESULTS

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.

CONCLUSIONS

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.

摘要

目的

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。

方法

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)。

结果

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。

结论

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。

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