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日本患者在 IMPERIAL 随机试验中接受 Eluvia 和 Zilver PTX 支架治疗。

Japanese Patients Treated in the IMPERIAL Randomized Trial Comparing Eluvia and Zilver PTX Stents.

机构信息

Kokura Memorial Hospital, 3-2-1 Asano, Kokurakita-ku, Kitakyushu, Fukuoka, 802-0001, Japan.

Kishiwada Tokushukai Hospital, Osaka, Japan.

出版信息

Cardiovasc Intervent Radiol. 2020 Feb;43(2):215-222. doi: 10.1007/s00270-019-02355-x. Epub 2019 Nov 5.

Abstract

PURPOSE

The purpose of the study is to report 12-month efficacy and safety results from the subgroup of Japanese patients in the prospective IMPERIAL 2:1 randomized controlled trial (RCT).

METHODS

The global IMPERIAL RCT was designed to compare performance of the Eluvia Drug-Eluting Vascular Stent System (Boston Scientific, Marlborough, MA, USA) with the Zilver PTX Drug-Eluting Peripheral Stent (Cook Medical, Bloomington, IN, USA) for treatment of femoropopliteal artery lesions. Patients with symptomatic (Rutherford category 2-4) disease were included. Post-procedural technical success was defined as delivery and deployment of the assigned study stent to the target lesion to achieve residual angiographic stenosis no greater than 30% by visual assessment. Twelve-month assessments included primary patency (core laboratory-assessed duplex ultrasound peak systolic velocity ratio ≤ 2.4 in the absence of clinically driven TLR or bypass of the target lesion) and major adverse events (MAEs).

RESULTS

Fifty-six patients in the Eluvia group and 28 in the Zilver PTX group were treated at Japanese centers. Mean lesion length was 91.8 ± 38.0 mm for Eluvia and 87.4 ± 41.7 mm for Zilver PTX. Technical success was 100% for both groups. At 12 months, the observed primary patency rate was 90.9% for Eluvia and 84.6% for Zilver PTX. The 12-month MAE rate was 1.8% for Eluvia and 7.7% for Zilver PTX. All MAEs were clinically driven TLRs.

CONCLUSION

The results show excellent vessel patency and a good safety profile up to 1 year in the subgroup of Japanese patients in IMPERIAL treated with Eluvia for femoropopliteal artery disease.

LEVEL OF EVIDENCE

Level 3; subgroup analysis of randomized trial.

CLINICAL TRIAL REGISTRATION

ClinicalTrials.gov, identifier NCT02574481.

摘要

目的

本研究旨在报告前瞻性 IMPERIAL 2:1 随机对照试验(RCT)中日本患者亚组的 12 个月疗效和安全性结果。

方法

全球 IMPERIAL RCT 旨在比较 Eluvia 药物洗脱血管支架系统(波士顿科学公司,马萨诸塞州马尔伯勒)与 Zilver PTX 药物洗脱外周支架(库克医疗公司,印第安纳州布鲁明顿)治疗股腘动脉病变的疗效。纳入有症状(Rutherford 分类 2-4 级)疾病的患者。术后技术成功定义为将指定的研究支架输送至目标病变,通过视觉评估使残余血管造影狭窄程度不超过 30%。12 个月评估包括主要通畅率(核心实验室评估的双功能超声峰值收缩速度比≤2.4,且不存在临床驱动的 TLR 或目标病变旁路)和主要不良事件(MAEs)。

结果

56 例 Eluvia 组和 28 例 Zilver PTX 组患者在日本中心接受治疗。Eluvia 组的平均病变长度为 91.8±38.0mm,Zilver PTX 组为 87.4±41.7mm。两组的技术成功率均为 100%。12 个月时,Eluvia 的观察到的主要通畅率为 90.9%,Zilver PTX 为 84.6%。Eluvia 的 12 个月 MAE 发生率为 1.8%,Zilver PTX 为 7.7%。所有 MAEs 均为临床驱动的 TLR。

结论

在 IMPERIAL 中接受 Eluvia 治疗股腘动脉疾病的日本患者亚组中,1 年时的血管通畅率极佳,安全性良好。

证据水平

3 级;随机试验的亚组分析。

临床试验注册

ClinicalTrials.gov,标识符 NCT02574481。

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