Department of Cardiology, The Heart Institute of Japan, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
Heart Vessels. 2021 Sep;36(9):1359-1365. doi: 10.1007/s00380-021-01816-z. Epub 2021 Feb 26.
Data on the mid-term clinical outcomes after endovascular treatment (EVT) using a Crosser catheter (C. R. Bard, Inc.) as a crossing or flossing device for a heavily calcified lesion in the common femoral artery (CFA) or popliteal artery (PA) are lacking. The aim of this study was to investigate the safety and efficacy of EVT using a Crosser catheter for isolated and heavily calcified CFA or PA disease. We retrospectively analyzed 64 consecutive patients (72 lesions; CFA 30, PA 42) who underwent EVT for heavily calcified CFA or PA lesions with Crosser catheters between April 2015 and April 2019. The primary endpoint was clinically driven target lesion revascularization (CD-TLR). The median follow-up was 18.5 months. The mean age of the study population was 70 ± 9.5 years, with a male prevalence of 73.6%. The mean Proposed Peripheral Artery Calcification Scoring System grade was 2.9 ± 0.9. Procedure success, defined as 50% or less residual stenosis without suboptimal results, was achieved in 94.4% of lesions. There were no cases of bailout stenting or target lesion-related complications. After EVT, the 1-year CD-TLR-free rate for CFA and PA lesions was 87.4 and 76.8%, respectively. The corresponding rates at 2 years were 82.2 and 62.8%, respectively. In the multivariate analysis used to define CD-TLR predictors for CFA and PA lesions, hemodialysis was the only independent predictor (HR 3.35, 95% CI 1.02-13.95, P = 0.045). EVT with a Crosser device for heavily calcified CFA and PA lesions seems to be safe and feasible.
关于在股总动脉（CFA）或腘动脉（PA）重度钙化病变中使用 Crosser 导管（C.R. Bard，Inc.）作为交叉或拉丝装置进行血管内治疗（EVT）的中期临床结果的数据尚缺乏。本研究旨在探讨使用 Crosser 导管治疗孤立性和重度钙化 CFA 或 PA 疾病的安全性和有效性。我们回顾性分析了 2015 年 4 月至 2019 年 4 月期间使用 Crosser 导管治疗重度钙化 CFA 或 PA 病变的 64 例连续患者（72 处病变；CFA30，PA42）。主要终点为临床驱动的靶病变血运重建（CD-TLR）。中位随访时间为 18.5 个月。研究人群的平均年龄为 70±9.5 岁，男性患病率为 73.6%。平均提出的外周动脉钙化评分系统（Proposed Peripheral Artery Calcification Scoring System）分级为 2.9±0.9。定义为残余狭窄 50%或以下且无不理想结果的手术成功率在 94.4%的病变中达到。无 bailout 支架置入或靶病变相关并发症。EVT 后，CFA 和 PA 病变的 1 年 CD-TLR 无事件率分别为 87.4%和 76.8%。相应的 2 年无事件率分别为 82.2%和 62.8%。在用于定义 CFA 和 PA 病变 CD-TLR 预测因素的多变量分析中，血液透析是唯一的独立预测因素（HR3.35，95%CI1.02-13.95，P=0.045）。使用 Crosser 装置治疗重度钙化的 CFA 和 PA 病变似乎是安全且可行的。
