Wu Yizhe, Yin Jiasheng, Chen Jiahui, Yao Zhifeng, Qian Juying, Shen Li, Ge Lei, Ge Junbo
Shanghai Institute of Cardiovascular Diseases, Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China.
Ann Transl Med. 2020 Sep;8(18):1162. doi: 10.21037/atm-20-5668.
We aimed to report the 5-year outcomes of XINSORB bioresorbable sirolimus-eluting scaffolds in the treatment of single de novo coronary lesions in a first-in-human (FIM) study. This is the final report of the long-term clinical outcomes of the study. Recent studies have shown that bioresorbable scaffolds (BRSs) increase the risks of late target lesion failure (TLF) and thrombosis.
In this prospective, single-arm study, eligible patients with single de novo coronary lesions were enrolled and treated with XINSORB scaffolds. The scaffolds measured 3.0 mm in diameter and 12, 15, and 18 mm in length. The clinical endpoints included TLF [cardiac death, target vessel-related myocardial infarction (TV-MI), or ischaemia-driven target lesion revascularization (ID-TLR)], its components, major adverse cardiac events (MACE), and scaffold thrombosis.
From September 2013 to January 2014, 30 patients were enrolled and treated with XINSORB scaffolds. The procedure had a 100% success rate. None of the patients died during the 5 years of follow-up. The primary endpoint of TLF occurred in 4 patients (13.3%). Six patients were recanalized by intervention, including 4 by ID-TLR. The rate of MACE was 16.7% (5/30). One very late case of scaffold thrombosis was recorded, which led to TV-MI. No more cases of thrombosis were recorded beyond 2 years of follow-up. The rates of clinical endpoints remained steady with no changes after 3 years of follow-up.
Considering that this FIM study was launched at an early stage of the BRS era and without optimal implantation techniques, the clinical outcomes of TLF during the 5-year follow-up were acceptable. The rate of thrombosis was relatively low.
我们旨在报告XINSORB生物可吸收西罗莫司洗脱支架治疗初发单支冠状动脉病变的首次人体(FIM)研究的5年结果。这是该研究长期临床结果的最终报告。近期研究表明,生物可吸收支架(BRS)会增加晚期靶病变失败(TLF)和血栓形成的风险。
在这项前瞻性单臂研究中,纳入符合条件的初发单支冠状动脉病变患者,并用XINSORB支架进行治疗。支架直径为3.0毫米,长度为12、15和18毫米。临床终点包括TLF[心源性死亡、靶血管相关心肌梗死(TV-MI)或缺血驱动的靶病变血运重建(ID-TLR)]、其组成部分、主要不良心脏事件(MACE)和支架血栓形成。
2013年9月至2014年1月,30例患者纳入研究并用XINSORB支架进行治疗。手术成功率为100%。在5年随访期间,无患者死亡。4例患者(13.3%)发生主要终点TLF。6例患者通过干预实现血管再通,其中4例为ID-TLR。MACE发生率为16.7%(5/30)。记录到1例非常晚期的支架血栓形成病例,导致TV-MI。随访2年后未再记录到血栓形成病例。随访3年后,临床终点发生率保持稳定,无变化。
考虑到这项FIM研究是在BRS时代早期开展的,且没有最佳植入技术,5年随访期间TLF的临床结果是可以接受的。血栓形成率相对较低。