Geiger Martin Andreas, Guillaumon Ana Terezinha
Universidade Estadual de Campinas - UNICAMP, Hospital de Clínicas, Disciplina de Moléstias Vasculares, Campinas, SP, Brasil.
J Vasc Bras. 2019 Jan 30;18:e20160104. doi: 10.1590/1677-5449.010416. eCollection 2019.
Primary stenting is a well-established treatment option for femoropopliteal arterial obstructive disease. There is a shortage of Brazilian studies of the subject.
To evaluate short and mid-term clinical and radiological outcomes in patients classified as Rutherford 3-6 and treated with stenting of femoropopliteal lesions.
Analysis based on a prospectively populated database of patients treated from July 2012 to July 2015. The primary endpoint was primary patency. Secondary endpoints were clinical and ankle/brachial index changes. Target Vessel Revascularization, limb salvage rate and death, within a 24-month follow-up period.
64 patients were enrolled, including 61 TASC II A / B lesions (95%). The primary patency rates at 6, 12, and 24 months were 95.2%, 79.1% and 57.9%, respectively. Cox regression analysis revealed lower patency rates in patients with occlusive disease (hazard ratio [HR], 6.64; 95% confidence interval [CI], 1.52-28,99, p = 0.02), as well as patency loss about 6 times higher in TASC B than in TASC A patients ([HR], 5.95, 95% CI, 1.67-21.3, p = 0.0061). At 12 months, 90.38% of the patients remained asymptomatic. The limb salvage rate at 24 months was 94.3% (95% CI, 87.9-100%). Freedom from TVR at 24 months was 90.5% (95% CI 82.8-98.9%).
Results of primary patency were compatible with international studies, despite the more advanced stage of the vascular disease observed in our group. Occlusive disease and complex lesions were both associated with worse outcomes.
原发性支架置入术是股腘动脉阻塞性疾病一种成熟的治疗选择。巴西关于该主题的研究较少。
评估被分类为卢瑟福3 - 6级并接受股腘病变支架置入术的患者的短期和中期临床及影像学结果。
基于2012年7月至2015年7月接受治疗患者的前瞻性数据库进行分析。主要终点是原发性通畅率。次要终点是临床及踝肱指数变化。在24个月随访期内的靶血管再血管化、肢体挽救率和死亡率。
纳入64例患者,其中61例为TASC II A / B级病变(95%)。6个月、12个月和24个月时的原发性通畅率分别为95.2%、79.1%和57.9%。Cox回归分析显示,闭塞性疾病患者的通畅率较低(风险比[HR],6.64;95%置信区间[CI],1.52 - 28.99,p = 0.02),并且TASC B级患者的通畅率丧失比TASC A级患者高约6倍([HR],5.95,95% CI,1.67 - 21.3,p = 0.0061)。12个月时,90.38%的患者无症状。24个月时的肢体挽救率为94.3%(95% CI,87.9 - 100%)。24个月时无靶血管再血管化的比例为90.5%(95% CI 82.8 - 98.9%)。
尽管在我们的研究组中观察到血管疾病处于更晚期阶段,但原发性通畅率的结果与国际研究结果相符。闭塞性疾病和复杂病变均与较差的结果相关。