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药物涂层球囊血管成形术在临床治疗下肢、腘动脉和小腿动脉病变致严重肢体缺血中的应用:西班牙Luminor注册研究的1年结果

Drug-Coated Balloon Angioplasty in Clinical Practice for Below-the-Knee, Popliteal, and Crural Artery Lesions Causing Critical Limb Ischemia: 1-Year Results from the Spanish Luminor Registry.

作者信息

Riambau Vicente, Acín Francisco, de Blas Mariano Juan, Alonso Manuel, Giménez-Gaibar Antonio

机构信息

Vascular Surgery Division, Hospital Clínic, University of Barcelona, Barcelona, Spain.

Angiology and Vascular Surgery Division, Hospital Universitario de Getafe, Getafe, Madrid, Spain.

出版信息

Ann Vasc Surg. 2020 Jan;62:387-396. doi: 10.1016/j.avsg.2019.06.035. Epub 2019 Aug 23.

Abstract

BACKGROUND

Luminor is a new drug-coated angioplasty balloon, which is approved by the European Conformity market. The aim of the present study is to analyze the 1-year results, in terms of effectiveness and safety, of the Luminor® 14/14M and 35 drug-coated balloons (iVascular, Sant Vicenç dels Horts, Barcelona, Spain) in a special cohort of critical limb ischemia (CLI) of the Luminor registry.

METHODS

Luminor is phase IV, nonrandomized, prospective, observational, and multicenter clinical study. The present study includes patients with CLI to analyze the effectiveness, in terms of primary patency, and the safety defined by the major adverse effects: any cause mortality, major amputation, and/or clinically driven target lesion revascularization (TLR). Both femoropopliteal and below-the-knee infrapopliteal lesions were treated. All the end points were assessed after the procedure, at 30 days, 6 and 12 months thereafter.

RESULTS

About 148 patients (101 males; mean age, 73.2 ± 11.4 years) with CLI were included. About 83.3% were classified as Rutherford's class 5. Diabetes mellitus was diagnosed in 71.6%; hypertension, hyperlipidemia, renal insufficiency, and coronary disease were present in 87.2%, 57.4%, 29.7%, and 39.2% of the sample, respectively. The average follow-up was 11.2 ± 3.27 months. The primary patency and the freedom of clinically driven TLR, at 1 year, were 87.7% and 92.1%, respectively. Survival and freedom from major amputations were 85.1% and 84.7%, respectively.

CONCLUSIONS

Even with a very sick population, the results at 12 months are highly satisfactory with reference to survival, freedom from amputation, patency, and the absence of reintervention.

摘要

背景

Luminor是一种新型药物涂层血管成形术球囊,已获欧洲合格市场批准。本研究的目的是分析Luminor® 14/14M和35药物涂层球囊(iVascular,西班牙巴塞罗那圣维森特德尔索尔茨)在Luminor注册研究的一个特殊严重肢体缺血(CLI)队列中的1年有效性和安全性结果。

方法

Luminor是一项IV期、非随机、前瞻性、观察性多中心临床研究。本研究纳入CLI患者,以分析主要通畅率方面的有效性以及由主要不良事件定义的安全性:任何原因导致的死亡、大截肢和/或临床驱动的靶病变血管重建(TLR)。股腘动脉和膝下腘动脉病变均接受治疗。所有终点在术后、术后30天、此后6个月和12个月进行评估。

结果

纳入了约148例CLI患者(101例男性;平均年龄73.2±11.4岁)。约83.3%被分类为卢瑟福5级。71.6%的患者被诊断为糖尿病;样本中分别有87.2%、57.4%、29.7%和39.2%存在高血压、高脂血症、肾功能不全和冠心病。平均随访时间为11.2±3.27个月。1年时主要通畅率和临床驱动的TLR无发生率分别为87.7%和92.1%。生存率和无大截肢率分别为85.1%和84.7%。

结论

即使是病情非常严重的人群,12个月时在生存、无截肢、通畅率和无需再次干预方面取得的结果也非常令人满意。

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