Department of Surgery, Changi General Hospital, Singapore.
Department of Vascular Surgery, Northwest Clinics, Alkmaar, The Netherlands.
Vasc Med. 2021 Jun;26(3):267-272. doi: 10.1177/1358863X20987894. Epub 2021 Mar 18.
The fluoropolymer-coated, paclitaxel-eluting Eluvia stent has shown promising results for the endovascular treatment of femoropopliteal artery lesions in patients with claudication. The aim of the current study was to evaluate efficacy and safety outcomes of the Eluvia stent for the treatment of long femoropopliteal lesions in Asian patients. This is a single-center, retrospective study. The primary endpoint was primary patency at 1 year. Secondary outcomes were 30-days complication rate, technical success, 1-year freedom from clinically driven target lesion revascularization (CD-TLR), limb salvage, survival, amputation-free survival (AFS), wound healing, and clinical improvement. A total of 64 patients with 67 femoropopliteal lesions were included; 78% suffered from diabetes and 84% had chronic limb-threatening ischemia (CLTI). Of those with ischemic wounds, 79% did not have run-off to the foot. Mean lesion length was 193 ± 128 mm and 52% were severely calcified. Primary patency at 1 year was 84% in the overall cohort and 91% in patients with complete lesion coverage with the Eluvia stent. Technical success was achieved in 100% of the cases and 30-day complications occurred in six patients. Twelve-month freedom from CD-TLR, limb salvage, survival, and AFS were 92%, 93%, 85%, and 80%, respectively. In 80% of patients, complete wound healing was experienced and 84% had clinical improvement after 1 year. The Eluvia stent showed promising 12-month patency and clinical results for femoropopliteal treatment in this CLTI-dominant patient population with severely calcified, long lesions. Patient numbers were, however, small; larger trials are required to validate these findings. Aneurysmal change seen in some cases also needs further investigation.
氟聚合物涂层紫杉醇洗脱 Eluvia 支架在治疗有间歇性跛行的患者股腘动脉病变的血管腔内治疗中显示出良好的效果。本研究旨在评估 Eluvia 支架治疗亚洲患者长段股腘动脉病变的疗效和安全性。这是一项单中心回顾性研究。主要终点为 1 年时的一期通畅率。次要终点为 30 天并发症发生率、技术成功率、1 年免于临床驱动的靶病变血运重建(CD-TLR)、保肢率、生存率、无截肢生存率(AFS)、创面愈合和临床改善。共纳入 64 例 67 处股腘动脉病变患者;78%患有糖尿病,84%患有慢性肢体威胁性缺血(CLTI)。有缺血性创面的患者中,79%足部无流出。平均病变长度为 193±128mm,52%严重钙化。总队列的 1 年一期通畅率为 84%,完全覆盖 Eluvia 支架的患者为 91%。100%的病例达到了技术成功,6 例患者发生 30 天并发症。12 个月时免于 CD-TLR、保肢、生存和 AFS 的比例分别为 92%、93%、85%和 80%。80%的患者创面完全愈合,84%的患者在 1 年后临床改善。在以 CLTI 为主、严重钙化、长病变的患者人群中,Eluvia 支架治疗股腘动脉病变显示出良好的 12 个月通畅率和临床效果。然而,患者数量较少,需要更大规模的试验来验证这些发现。一些病例中出现的动脉瘤样改变也需要进一步研究。