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Luminor®紫杉醇涂层药物洗脱球囊治疗腘动脉粥样硬化病变的疗效及一年随访结果。

Efficacy and one-year outcomes of Luminor® paclitaxel-coated drug-eluting balloon in the treatment of popliteal artery atherosclerosis lesions.

机构信息

Department of Surgical Oncological and Oral Sciences, University of Palermo, Palermo, Italy; Vascular Surgery Unit, AOUP "P. Giaccone", Palermo, Italy.

Vascular Surgery Unit, AOUP "P. Giaccone", Palermo, Italy.

出版信息

Ann Vasc Surg. 2021 Oct;76:370-377. doi: 10.1016/j.avsg.2021.04.015. Epub 2021 May 2.

Abstract

PURPOSE

Reporting outcomes with a new generation paclitaxel eluting balloon (Luminor®; iVascular, Vascular, S.L.U., Barcelona, Spain) in the popliteal district. Endovascular treatment of popliteal artery atherosclerotic disease is still debated without definitive evidences.

METHODS

From January to June 2019, patients' data presenting popliteal artery atherosclerotic diseases and treated with the Luminor® (iVascular) drug eluting balloon (DEB) were prospectively collected. Critical limb ischemia (CLI) or severe claudication associated with popliteal artery stenosis >50% were the inclusion criteria. Measured outcomes were technical success, early and late results; including mortality, morbidity, symptoms recurrence, amputation, ankle-brachial index (ABI), survival, primary patency, secondary patency, freedom from restenosis. Median follow-up was 22.43 ± 4 (mean:21.58; IQR:20-24) months.

RESULTS

Of the 33 included patients, 28 (85%) were diagnosed with CLI, with a mean preoperative run-off score of 5.39 (r:0-10; SD:3) and a chronic popliteal occlusion in 21 (64%). Technical success was achieved in all cases. Perioperative mortality was observed in 1 (3%) patient and perioperative complications in 2 (6%). During the follow-up were reported 2 symptoms recurrence; a significant ABI increase (0.57; IQR:0.41-0.47 vs. 0.69; IQR:0.50-0.67; P < 0.01); 1 (3%) major and 2 (6%) minor amputations. Estimated 24 months survival, primary patency, secondary patency, and freedom from restenosis were 97%, 96.9%, 100%, and 93.8% respectively.

CONCLUSIONS

In this prospective study, the use of the Luminor® (iVascular) was safe and effective in addressing atherosclerotic popliteal artery lesions. Larger studies with longer term-outcomes are required to assess the durability of this device in the popliteal artery.

摘要

目的

报告使用新一代紫杉醇洗脱球囊(Luminor®;iVascular,S.L.U.,巴塞罗那,西班牙)治疗腘动脉病变的结果。腘动脉粥样硬化疾病的血管内治疗仍存在争议,尚无明确证据。

方法

2019 年 1 月至 6 月,前瞻性收集了 Luminor®(iVascular)药物洗脱球囊(DEB)治疗的腘动脉粥样硬化疾病患者的数据。纳入标准为:伴有腘动脉狭窄>50%的临界肢体缺血(CLI)或严重跛行。测量的结果包括技术成功率、早期和晚期结果,包括死亡率、发病率、症状复发、截肢、踝肱指数(ABI)、生存率、原发性通畅率、继发性通畅率、无再狭窄率。中位随访时间为 22.43±4(平均:21.58;IQR:20-24)个月。

结果

33 例患者中,28 例(85%)诊断为 CLI,术前流出道评分平均为 5.39(r:0-10;SD:3),21 例(64%)为慢性腘动脉闭塞。所有病例均达到技术成功。1 例(3%)患者围手术期死亡,2 例(6%)患者围手术期并发症。随访期间报告了 2 例症状复发,ABI 显著升高(0.57;IQR:0.41-0.47 比 0.69;IQR:0.50-0.67;P<0.01),1 例(3%)为主要截肢,2 例(6%)为次要截肢。估计 24 个月生存率、原发性通畅率、继发性通畅率和无再狭窄率分别为 97%、96.9%、100%和 93.8%。

结论

在这项前瞻性研究中,Luminor®(iVascular)的使用在治疗腘动脉粥样硬化病变方面是安全有效的。需要更大规模、更长期的研究来评估该设备在腘动脉中的耐久性。

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