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.
J Vasc Interv Radiol. 2019 Jun;30(6):822-829.e4. doi: 10.1016/j.jvir.2018.12.707. Epub 2019 Apr 25.
To evaluate safety and effectiveness of the iCAST Covered Stent for treatment of iliac artery atherosclerotic lesions.
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.
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.
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.
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。
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。
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。
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。