Department of Vascular Surgery, St. Franziskus Hospital, Muenster, Germany; Department of Vascular Surgery, Ludwig-Maximilians-University Hospital Munich, Munich, Germany.
Department of Vascular Surgery, St. Franziskus Hospital, Muenster, Germany.
JACC Cardiovasc Interv. 2021 Mar 22;14(6):692-701. doi: 10.1016/j.jcin.2021.01.026.
The aim of this study was to evaluate the 2-year performance of a polymer-based drug-eluting stent (DES) for the treatment of complex femoropopliteal lesions.
Despite the promising early outcomes of the Eluvia DES, the long-term safety and efficacy of the device in a real-world scenario remain unclear.
Between March 2016 and December 2018, 130 patients (137 lesions) with symptomatic femoropopliteal disease were included in this study. The primary outcome measure of this analysis was primary patency. Secondary patency, freedom from target lesion revascularization, freedom from surgical conversion, and overall mortality and morbidity were additionally analyzed.
The majority of patients presented with lifestyle-limiting claudication (n = 90 [69%]). The mean lesion length was 194 ± 108 mm, 74% of the lesions (n = 101) were chronic total occlusions, and 72% (n = 99) were calcified. Moderate to severe calcification (Peripheral Arterial Calcium Scoring Scale score 3 or 4) was observed in 48% of the treated vessels (n = 67). At 24 months, the Kaplan-Meier estimate of primary patency was 71%, whereas both the secondary patency rate and freedom from target lesion revascularization were 80%. Overall survival amounted to 85%. Freedom from major amputation was 98%, while freedom from surgical conversion was 89%. Degeneration of the vessel wall was observed in 27 lesions (20%).
In this study, use of the Eluvia polymer-based DES for the treatment of complex femoropopliteal disease showed promising 2-year results. Nonetheless, a relatively high rate of vessel wall degeneration was observed after DES deployment.
本研究旨在评估聚合物药物洗脱支架(DES)治疗复杂股腘动脉病变的 2 年疗效。
尽管 Eluvia DES 的早期结果令人鼓舞,但该设备在真实世界环境中的长期安全性和疗效仍不清楚。
2016 年 3 月至 2018 年 12 月,共纳入 130 例(137 处病变)有症状股腘动脉疾病患者。本分析的主要终点为一期通畅率。此外,还分析了二级通畅率、免于靶病变血运重建、免于手术转归、总体死亡率和发病率。
大多数患者表现为生活方式受限性跛行(n=90[69%])。病变平均长度为 194±108mm,74%(n=101)的病变为慢性完全闭塞,72%(n=99)为钙化病变。48%(n=67)的治疗血管存在中度至重度钙化(外周动脉钙化评分 3 或 4 分)。24 个月时,Kaplan-Meier 估计的一期通畅率为 71%,而二级通畅率和免于靶病变血运重建率均为 80%。总体生存率为 85%。免于大截肢率为 98%,免于手术转归率为 89%。27 处病变(20%)观察到血管壁退化。
在这项研究中,使用 Eluvia 聚合物基 DES 治疗复杂股腘动脉疾病显示出有前景的 2 年结果。然而,DES 植入后观察到血管壁退化的发生率相对较高。