Division of Vascular & Endovascular Surgery, Department of Surgery, University of Hong Kong Medical Centre, South Wing, Queen Mary Hospital, Hong Kong, China.
Division of Vascular & Endovascular Surgery, Department of Surgery, University of Hong Kong Medical Centre, South Wing, Queen Mary Hospital, Hong Kong, China.
J Vasc Surg. 2020 Jun;71(6):2048-2055. doi: 10.1016/j.jvs.2019.08.284. Epub 2020 Feb 17.
The aim of this study was to report midterm outcomes (up to 72 months) of patients who received femoropopliteal helical interwoven nitinol stents (Supera Peripheral Stent System, Abbott Laboratories, Inc, Webster, Tex).
Prospectively collected data on patients treated with femoropopliteal non-drug-eluting angioplasty and helical interwoven nitinol stents were retrospectively analyzed. Patients were followed up with 6, 12, 18, 24, 36, 48, 60, and 72 months clinical, duplex, and radiographic assessments. Restenosis is defined as 50% or greater restenosis of the target lesion on duplex ultrasound imaging.
From October 2011 to September 2018, 315 patients (198 males) with 360 legs and a median age of 78 years (range, 46-100 years) were included. Symptoms of claudication, rest pain, and tissue loss were found in 212 (58.9%), 53 (14.7%), and 150 (41.7%) legs, respectively. In 176 (48.9%) legs, stents were placed in the popliteal segments. The mean stented lesion length was 119.0 mm (range, 40-450 mm). The overall primary patency rates at 6, 12, 24, 36, 48, 60, and 72 months were 90.6%, 80.5%, 73.8%, 68.9%, 65.3%, 63.1%, and 63.1%, respectively. The ankle-brachial pressure index increased from 0.58 ± 0.18 preoperatively to 0.87 ± 0.16 postoperatively. There were no stent fractures on follow-up. Patency rate was not statistically affected by indication of treatment, lesion calcification, or diabetes, but the length of stents and involvement of popliteal arteries were statistically significantly worse (log-rank test, P = .011 and P = .005). Stents with inner diameters of 4-mm had an initial lower patency compared with 5-mm stents, but the patency rates merged and crossed over at 46 months (log-rank test, P = .131). There was no procedural- or device-related morbidity or mortality, and there were nine major amputations after revascularization.
This study provides long-term clinical data demonstrating that Supera stents are effective and durable.
本研究旨在报告接受股腘螺旋编织 Nitinol 支架(Supera 外周支架系统,雅培实验室公司,德克萨斯州韦伯斯特)治疗的患者的中期结果(最长达 72 个月)。
回顾性分析接受股腘非药物洗脱血管成形术和螺旋编织 Nitinol 支架治疗的患者的前瞻性收集数据。患者接受了 6、12、18、24、36、48、60 和 72 个月的临床、双功超声和影像学随访。再狭窄定义为双功超声成像上靶病变 50%或以上的再狭窄。
2011 年 10 月至 2018 年 9 月,共纳入 315 例(198 例男性)360 条肢体,中位年龄 78 岁(范围 46-100 岁)。212 条(58.9%)、53 条(14.7%)和 150 条(41.7%)肢体分别出现间歇性跛行、静息痛和组织丧失症状。176 条(48.9%)肢体的支架放置在腘段。支架置入病变的平均长度为 119.0mm(范围 40-450mm)。6、12、24、36、48、60 和 72 个月的总体一期通畅率分别为 90.6%、80.5%、73.8%、68.9%、65.3%、63.1%和 63.1%。踝肱压指数从术前的 0.58±0.18 增加到术后的 0.87±0.16。随访时无支架断裂。通畅率不受治疗适应证、病变钙化或糖尿病的影响,但支架长度和腘动脉受累程度有统计学意义(log-rank 检验,P=0.011 和 P=0.005)。4mm 内支架初始通畅率低于 5mm 支架,但 46 个月时通畅率合并并超过 5mm 支架(log-rank 检验,P=0.131)。无手术或器械相关的发病率或死亡率,血管重建后有 9 例大截肢。
本研究提供了长期的临床数据,表明 Supera 支架是有效和持久的。