Kum Steven, Ipema Jetty, Chun-Yin Derek Ho, Lim Darryl M, Tan Yih Kai, Varcoe Ramon L, Hazenberg Constantijn E V B, Ünlü Çağdaş
Vascular Service, Department of Surgery, Changi General Hospital, Singapore.
Department of Vascular Surgery, Northwest Clinics, Alkmaar, the Netherlands.
J Endovasc Ther. 2020 Aug;27(4):616-622. doi: 10.1177/1526602820922524. Epub 2020 May 29.
To report an experience with the Absorb bioresorbable vascular scaffold (BVS) in an Asian cohort with chronic limb-threatening ischemia (CLTI) from the DISAPEAR (rug mpregnated Bioresorbable tent in sian opulation xtremity rterial evascularization) registry. A retrospective analysis was conducted of 41 patients (median age 64 years; 23 men) with CLTI owing to >50% de novo infrapopliteal lesions (n=53) treated with the Absorb BVS between August 2012 and June 2017. The majority of patients (37, 90%) had diabetes, 24 (59%) had ischemic heart disease, and 39 (95%) had Rutherford category 5/6 ischemia with tissue loss. The mean lesion length was 22.7±17.2 mm; 10 (24%) lesions were severely calcified. Assessments included technical success, primary patency, freedom from clinically-driven target lesion revascularization (CD-TLR), amputation-free survival, limb salvage, complete wound healing, resolution of rest pain, and resolution of CLTI without TLR at 6 and 12 months after the index intervention. Overall, 69 scaffolds were implanted in the 53 lesions, with 100% technical success. There were no deaths within 30 days of the index procedure. The primary patency rates at 6 and 12 months were 95% and 86%, respectively. The corresponding rates of freedom from CD-TLR were 98% and 93%, respectively. Freedom from major amputation was 98% at both time points, and amputation-free survival was 93% and 85% at 6 and 12 months after the index procedure. Wound healing occurred in 31 patients (79%) with Rutherford category 5/6 ischemia by the end of 12 months. The Absorb BVS demonstrated good 1-year patency and clinical outcomes in CLTI patients with complex infrapopliteal disease.
报告来自DISAPEAR(亚洲人群下肢动脉血运重建中可吸收生物可吸收血管支架)注册研究的亚洲慢性肢体威胁性缺血(CLTI)队列中使用Absorb生物可吸收血管支架(BVS)的经验。对2012年8月至2017年6月期间因新发腘下病变>50%(n = 53)而接受Absorb BVS治疗的41例CLTI患者(中位年龄64岁;23例男性)进行回顾性分析。大多数患者(37例,90%)患有糖尿病,24例(59%)患有缺血性心脏病,39例(95%)患有Rutherford 5/6级缺血伴组织缺失。平均病变长度为22.7±17.2毫米;10例(24%)病变严重钙化。评估包括技术成功率、原发性通畅率、免于临床驱动的靶病变血运重建(CD-TLR)、无截肢生存率、肢体挽救、完全伤口愈合、静息痛缓解以及在索引干预后6个月和12个月时无TLR的CLTI缓解情况。总体而言,在53个病变中植入了69个支架,技术成功率为100%。索引手术30天内无死亡病例。6个月和12个月时的原发性通畅率分别为95%和86%。相应的免于CD-TLR的比率分别为98%和93%。两个时间点的免于大截肢率均为98%,索引手术后6个月和12个月时的无截肢生存率分别为93%和85%。到12个月末,31例(79%)Rutherford 5/6级缺血患者伤口愈合。Absorb BVS在患有复杂腘下疾病的CLTI患者中显示出良好的1年通畅率和临床结果。