Klinik und Poliklinik für Innere Medizin I, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
EuroIntervention. 2019 Dec 20;15(12):e1107-e1114. doi: 10.4244/EIJ-D-19-00187.
The aims of this study were to assess the incidence and predictors of superficial femoral artery (SFA) stent thrombosis (ST) in a large patient cohort.
A total of 984 stented SFA lesions were retrospectively analysed in 717 patients. We observed an overall ST rate of 7.5% (74/984): 14% occurred early within 30 days after stenting, 51% during the first year thereafter and 35% later than one year. The estimated five-year probability of ST was 13.4% (95% confidence interval [CI]: 10.0% to 16.7%). Significant predictors of ST were stent length (hazard ratio [HR] 1.09, 95% CI: 1.06 to 1.11, p<0.001), lesion length (HR 1.10, 95% CI: 1.08 to 1.13, p<0.001), female gender (HR 1.79, 95% CI: 1.12 to 2.86, p=0.015), chronic total occlusion (CTO) (HR 4.21, 95% CI: 2.51 to 7.05, p<0.001), implantation of more than one stent (two stents: HR 6.06, 95% CI: 3.35 to 11.0, p<0.001; three or more stents: HR 16.83, 95% CI: 9.43 to 30.0, p<0.001) as well as lesion complexity criteria as expressed by TASC II C/D (HR 17.7, 95% CI: 5.56 to 56.1, p<0.001).
ST after SFA stenting was a common adverse event in our cohort and peaked during the first year after stent implantation. Independent predictors of ST included lesion length and stent length, female gender, presence of CTO, number of implanted stents and lesion complexity.
本研究旨在评估大样本患者人群中股浅动脉(SFA)支架血栓形成(ST)的发生率和预测因素。
回顾性分析了 717 例患者的 984 例支架置入 SFA 病变。我们观察到总体 ST 发生率为 7.5%(74/984):14%发生在支架置入后 30 天内,51%发生在随后的 1 年内,35%发生在 1 年以后。预计 5 年 ST 发生率为 13.4%(95%置信区间[CI]:10.0%至 16.7%)。ST 的显著预测因素包括支架长度(风险比[HR]1.09,95%CI:1.06 至 1.11,p<0.001)、病变长度(HR 1.10,95%CI:1.08 至 1.13,p<0.001)、女性(HR 1.79,95%CI:1.12 至 2.86,p=0.015)、慢性完全闭塞(CTO)(HR 4.21,95%CI:2.51 至 7.05,p<0.001)、植入超过 1 个支架(两个支架:HR 6.06,95%CI:3.35 至 11.0,p<0.001;三个或更多支架:HR 16.83,95%CI:9.43 至 30.0,p<0.001)以及 TASC II C/D 表达的病变复杂性标准(HR 17.7,95%CI:5.56 至 56.1,p<0.001)。
本研究队列中 SFA 支架置入后 ST 是一种常见的不良事件,在支架置入后 1 年内达到高峰。ST 的独立预测因素包括病变长度和支架长度、女性、CTO、植入支架数量和病变复杂性。