Ni Qihong, Yang Shuofei, Xue Guanhua, Zhou Zhaoxiong, Zhang Lan, Ye Meng
Department of Vascular Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, P. R. China.
Department of Vascular Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, P. R. China.
Ann Vasc Surg. 2020 Jul;66:573-579. doi: 10.1016/j.avsg.2019.11.018. Epub 2019 Nov 16.
The polytetrafluoroethylene-covered Viabahn stent may be effective for the endovascular treatment of patients with femoropopliteal artery occlusive lesions. However, the long-term efficacy of Viabahn stent remains unclear. The aim of the study is to evaluate the long-term patency of Viabahn stent grafts in patients with occlusive lesions in the femoropopliteal artery.
Consecutive patients with occlusive lesions in the femoropopliteal artery who had been treated with Viabahn stent grafts during the period from June 2013 to December 2016 at our center were retrospectively included. Accumulative incidences of primary patency and secondary patency were estimated by Kaplan-Meier survival analysis, and the predictors of primary patency were evaluated by Cox regression analysis.
A total of 66 patients underwent successful endovascular treatment and were included in the study. Endovascular treatment with a Viabahn stent was associated with a complication rate of 9.1% and a 30-day mortality rate of 1.5%. Sixty-one patients were followed for a mean duration of 29.5 months. The 1-year, 2-year, 3-year, and 4-year primary patency rates were 81.7%, 74.7%, 67.6%, and 58.9%, respectively. The secondary patency rates were 94.9%, 92.9%, 90.1%, and 90.1%, respectively. The overall major amputation rate was 5.0%. The results of multivariate Cox regression analyses showed that stent location was the only independent predictor of primary patency (P = 0.001). Implantation of a Viabahn stent above the knee, compared with implantation below the knee, was associated with a higher rate of primary patency.
The Viabahn stent graft is associated with a satisfactory rate of long-term patency for the endovascular treatment of occlusive lesions in the femoropopliteal artery, especially for those located above the knee.
聚四氟乙烯覆膜Viabahn支架可能对股腘动脉闭塞性病变患者的血管内治疗有效。然而,Viabahn支架的长期疗效仍不明确。本研究的目的是评估Viabahn支架移植物在股腘动脉闭塞性病变患者中的长期通畅率。
回顾性纳入2013年6月至2016年12月期间在本中心接受Viabahn支架移植物治疗的连续股腘动脉闭塞性病变患者。采用Kaplan-Meier生存分析估计原发性通畅率和继发性通畅率的累积发生率,并通过Cox回归分析评估原发性通畅的预测因素。
共有66例患者成功接受血管内治疗并纳入研究。Viabahn支架血管内治疗的并发症发生率为9.1%,30天死亡率为1.5%。61例患者平均随访29.5个月。1年、2年、3年和4年的原发性通畅率分别为81.7%、74.7%、67.6%和58.9%。继发性通畅率分别为94.9%、92.9%、90.1%和90.1%。总体大截肢率为5.0%。多变量Cox回归分析结果显示,支架位置是原发性通畅的唯一独立预测因素(P = 0.001)。与膝下植入相比,膝上植入Viabahn支架的原发性通畅率更高。
Viabahn支架移植物对股腘动脉闭塞性病变的血管内治疗具有令人满意的长期通畅率,尤其是对于位于膝上的病变。