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iCAST 球囊扩张式覆膜支架治疗髂动脉病变:iCARUS 多中心研究 3 年结果。

iCAST Balloon-Expandable Covered Stent for Iliac Artery Lesions: 3-Year Results from the iCARUS Multicenter Study.

机构信息

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

East Bay Cardiovascular and Thoracic Associates, Danville, California.

出版信息

J Vasc Interv Radiol. 2019 Jun;30(6):822-829.e4. doi: 10.1016/j.jvir.2018.12.707. Epub 2019 Apr 25.

Abstract

PURPOSE

To evaluate safety and effectiveness of the iCAST Covered Stent for treatment of iliac artery atherosclerotic lesions.

MATERIALS AND METHODS

The iCARUS trial (ClinicalTrials.gov Identifier: NCT00593385) was a single-arm, prospective, multicenter study that enrolled 152 per protocol subjects at 25 sites in the United States and Germany. Subjects with multiple lesions and/or stents were eligible. The primary endpoint was the composite rate of death within 30 days, target lesion revascularization (TLR) within 9 months, or restenosis at 9 months after procedure. Secondary endpoints included major adverse vascular events (MAVEs), primary patency, freedom from TLR, and clinical success.

RESULTS

Device and acute procedural success were achieved in 98.7% and 92.7% of cases, respectively. MAVE rate was 4.6% at 30 days. The 9-month primary composite endpoint rate was 8.1% (10/123), which was below the performance goal of 16.57%. Nine-month primary patency, defined as continuous flow without revascularization, bypass, or target limb amputation, was 96.4%. Freedom from TLR at 9 months and 3 years was 97.2% and 86.6%, respectively. Early clinical success was seen in 88.7% of subjects at 30 days with sustained clinical benefit in 72.4% of subjects at 3 years.

CONCLUSIONS

The iCARUS study demonstrated that the iCAST Covered Stent was safe and effective for treatment of atherosclerotic iliac artery lesions with sustained clinical benefit out to 3 years.

摘要

目的

评估 iCAST 覆膜支架治疗髂动脉粥样硬化病变的安全性和有效性。

材料与方法

iCARUS 试验(ClinicalTrials.gov 标识符:NCT00593385)是一项在美国和德国的 25 个中心进行的单臂、前瞻性、多中心研究,共纳入 152 名符合方案的受试者。符合条件的受试者为存在多发性病变和/或支架的患者。主要终点为 30 天内死亡、9 个月内靶病变血运重建(TLR)或术后 9 个月内再狭窄的复合发生率。次要终点包括主要血管不良事件(MAVE)、一级通畅率、免于 TLR 和临床成功率。

结果

分别有 98.7%和 92.7%的病例实现了器械和急性手术成功。30 天时 MAVE 发生率为 4.6%。9 个月时的主要复合终点发生率为 8.1%(10/123),低于 16.57%的性能目标。9 个月时的一级通畅率定义为无再血管化、旁路或靶肢截肢的持续血流,为 96.4%。9 个月和 3 年时免于 TLR 的比例分别为 97.2%和 86.6%。30 天时,88.7%的受试者早期临床成功,72.4%的受试者在 3 年内持续临床获益。

结论

iCARUS 研究表明,iCAST 覆膜支架治疗髂动脉粥样硬化病变是安全有效的,且具有持续的临床获益,可维持至 3 年。

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