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专用分叉西罗莫司洗脱钴铬支架治疗左主干冠状动脉远端病变的研究(POLBOS LM 研究):理论基础和设计。

Treatment with a dedicated bifurcation sirolimus-eluting cobalt-chromium stent for distal left main coronary artery disease: rationale and design of the POLBOS LM study.

机构信息

Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.

出版信息

EuroIntervention. 2020 Oct 23;16(8):654-662. doi: 10.4244/EIJ-D-19-00361.

Abstract

AIMS

The aim of this study is to demonstrate the non-inferiority of the BiOSS LIM C sirolimus-eluting cobalt-chromium bifurcation dedicated stent against the XIENCE stent regarding the patient-oriented composite endpoint (POCE) at 12 months among patients with left main coronary artery disease (LMCA).

METHODS AND RESULTS

The POLBOS LM study is a single-arm, prospective, multicentre study enrolling 260 patients (SYNTAX score ≤32) with a pre-specified performance goal based on the results of the EXCEL trial with contemporary percutaneous coronary intervention (PCI) for LMCA disease. Patient enrolment will comply with objective inclusion criteria of diameter stenosis ≥50% in the LMCA based on off-line quantitative coronary angiography (QCA) analysed by an independent core laboratory using dedicated bifurcation QCA software. The BiOSS LIM C is used for the treatment of LMCA disease with the same specific technical classification as for the BiOSS LIM (modified MADS classification) and the stent implantation is optimised by using pre-specified intravascular ultrasound criteria. The primary endpoint is POCE (a composite of all-cause death, stroke, any myocardial infarction, and any revascularisation) at 12 months.

CONCLUSIONS

The POLBOS LM study will indicate the efficacy of the BiOSS LIM C stent with contemporary PCI for distal left main bifurcation lesions in comparison with the XIENCE stent from the recent EXCEL trial, as a performance index.

摘要

目的

本研究旨在证明 BiOSS LIM C 西罗莫司洗脱钴铬分叉专用支架在 12 个月时的患者导向复合终点(POCE)方面不劣于 XIENCE 支架,用于治疗左主干冠状动脉疾病(LMCA)患者。

方法和结果

POLBOS LM 研究是一项单臂、前瞻性、多中心研究,共纳入 260 例患者(SYNTAX 评分≤32),根据 EXCEL 试验结果,采用当代经皮冠状动脉介入治疗(PCI)对 LMCA 疾病进行了预先规定的性能目标。患者入组将符合基于离线定量冠状动脉造影(QCA)的 LMCA 直径狭窄≥50%的客观纳入标准,该 QCA 由独立核心实验室使用专用分叉 QCA 软件进行分析。BiOSS LIM C 用于治疗 LMCA 疾病,与 BiOSS LIM 相同的特定技术分类(改良 MADS 分类),并通过预先规定的血管内超声标准优化支架植入。主要终点是 12 个月时的 POCE(全因死亡、卒中和任何心肌梗死和任何血运重建的复合终点)。

结论

POLBOS LM 研究将表明,与最近的 EXCEL 试验中的 XIENCE 支架相比,BiOSS LIM C 支架与当代 PCI 联合治疗远端左主干分叉病变的疗效,作为性能指标。

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