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西罗莫司涂层球囊在冠状动脉介入治疗中的中期临床结果;真实世界人群数据。

Mid-term clinical outcomes from use of Sirolimus coated balloon in coronary intervention; data from real world population.

机构信息

Heartlands Hospital, University Hospitals Birmingham, Birmingham, UK.

Harefield Hospital, London, UK.

出版信息

Catheter Cardiovasc Interv. 2021 Jul 1;98(1):57-65. doi: 10.1002/ccd.28998. Epub 2020 May 30.

Abstract

BACKGROUND

Use of drug coated balloons (DCBs) in coronary intervention is escalating. There is a plethora of data on Paclitaxcel-DCB. However, when it comes of stents, Limus-drugs are preferred over Paclitaxel. There is very limited data on Sirolimus coated balloons (SCB). MagicTouch-SCB (Concept Medical, FL) elutes Sirolimus via nano-technology and have been used in our centers since March 2018. We report a mid-term follow-up with this relatively novel-technology.

METHODS AND RESULTS

We retrospectively analyzed all patients treated with MagicTouch-SCB between March-2018 and February-2019. Results are reported as cardiac-death, target-vessel myocardial-infarction (TVMI), target lesion revascularization (TLR) and Major Adverse Cardiac Events (MACE). During the study period, 288-patients (373-lesions) with a mean age of 65.8 were treated with MagicTouch-SCB. 84% (n = 241) were male, 155 (54%) were in the setting of acute coronary syndrome, 38% (n = 110) had diabetes and 62% (n = 233) were in de-novo lesions. Most lesions treated were in the LAD/diagonal-system (n = 170; 46%). Pre-dilatation was performed in 92% (n = 345) of cases. Bailout stenting was required in 9% lesions (n = 35). The mean diameter and length of SCBs were 2.64 ± 0.56 mm and 24 ± 8.9 mm respectively. During a median follow-up of 363 days (IQR: 278-435), cardiac death and TVMI occurred in 5-patients (1.7%) and 10-patients (3.4%) respectively, TLR per-lesion was 12%. The MACE rate was 10%. There were no documented cases of acute vessel closure.

CONCLUSIONS

The results from mid-term follow-up with this relatively new technology SCB is encouraging with a low rates of hard endpoints and acceptable MACE rates despite complex group of patients and lesion subsets.

摘要

背景

药物涂层球囊(DCB)在冠状动脉介入治疗中的应用正在不断增加。关于紫杉醇 DCB 的数据很多。但是,在涉及支架时,雷帕霉素药物优于紫杉醇。关于雷帕霉素涂层球囊(SCB)的数据非常有限。MagicTouch-SCB(Concept Medical,FL)通过纳米技术洗脱雷帕霉素,自 2018 年 3 月以来已在我们中心使用。我们报告了这项相对较新的技术的中期随访结果。

方法和结果

我们回顾性分析了 2018 年 3 月至 2019 年 2 月期间接受 MagicTouch-SCB 治疗的所有患者。结果以心脏死亡、靶血管心肌梗死(TVMI)、靶病变血运重建(TLR)和主要不良心脏事件(MACE)报告。在研究期间,288 例(373 处病变)患者接受了 MagicTouch-SCB 治疗,平均年龄为 65.8 岁。84%(n=241)为男性,155 例(54%)为急性冠状动脉综合征患者,38%(n=110)患有糖尿病,62%(n=233)为初发病变。治疗的大多数病变位于 LAD/对角系统(n=170;46%)。92%(n=345)的病例进行了预扩张。9%的病变(n=35)需要紧急支架置入。SCB 的平均直径和长度分别为 2.64±0.56mm 和 24±8.9mm。在中位数为 363 天(IQR:278-435)的随访期间,5 例患者(1.7%)发生心脏死亡,10 例患者(3.4%)发生 TVMI,每例病变的 TLR 为 12%。MACE 发生率为 10%。没有记录到急性血管闭塞的病例。

结论

尽管患者群体和病变亚组复杂,但这项相对较新的 SCB 技术的中期随访结果令人鼓舞,硬终点发生率低,MACE 发生率可接受。

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