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用于治疗股腘动脉疾病的兰花药物涂层球囊与标准经皮腔内血管成形术:随机对照试验的12个月结果

Orchid drug-coated balloon versus standard percutaneous transluminal angioplasty for the treatment of femoropopliteal artery disease: 12-month result of the randomized controlled trial.

作者信息

Liao Chuan-Jun, Song Sheng-Han, Li Tan, Zhang Yang Zhang And Wang-de

机构信息

Department of Vascular Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.

出版信息

Vascular. 2022 Jun;30(3):448-454. doi: 10.1177/17085381211013968. Epub 2021 May 22.

DOI:10.1177/17085381211013968
PMID:34024196
Abstract

PURPOSE

To assess the efficacy and safety of the Orchid drug-coated balloon (coated with paclitaxel) for the treatment of femoropopliteal artery disease versus percutaneous transluminal angioplasty in Chinese population.

METHODS

This is a prospective, single center, single-blinded, randomized controlled trial that randomized (1:1) 60 patients (38 men; mean age 68.7 ± 8.8) to drug-coated balloon group ( = 30) or percutaneous transluminal angioplasty group ( = 30). The primary efficacy endpoint was primary patency of the target lesion and clinically driven target lesion revascularization (CD-TLR) at 12 months. The primary safety end point was freedom from perioperative death at 30 days and freedom from limb-related death and major amputation at 12 months.

RESULTS

Baseline characteristics were similar between the two groups. Drug-coated balloon group resulted in higher primary patency (82.8% vs. 48.3%,  = 0.005) and lower CD-TLR rates (3.5% vs. 27.6%;  = 0.001) versus percutaneous transluminal angioplasty group at 12 months. The ABI was significantly higher in drug-coated balloon group than percutaneous transluminal angioplasty group (0.86 ± 0.13 vs. 0.72 ± 0.18,  = 0.025). There were no perioperative death at 30 days, no limb-related death and no major amputation at 12 months in either group.

CONCLUSIONS

The randomized controlled trial showed superior treatment effect with drug-coated balloon versus percutaneous transluminal angioplasty, with remarkably higher patency and lower CD-TLR rates. The result is consistent with other study and demonstrates the safety and efficacy of the Orchid drug-coated balloon for the treatment of femoropopliteal artery disease.

摘要

目的

评估兰花药物涂层球囊(涂有紫杉醇)在中国人群中治疗股腘动脉疾病相对于经皮腔内血管成形术的疗效和安全性。

方法

这是一项前瞻性、单中心、单盲、随机对照试验,将60例患者(38例男性;平均年龄68.7±8.8岁)按1:1随机分为药物涂层球囊组(n = 30)或经皮腔内血管成形术组(n = 30)。主要疗效终点是12个月时靶病变的原发性通畅率和临床驱动的靶病变血运重建(CD-TLR)。主要安全终点是30天时无围手术期死亡,12个月时无肢体相关死亡和无大截肢。

结果

两组的基线特征相似。与经皮腔内血管成形术组相比,药物涂层球囊组在12个月时原发性通畅率更高(82.8%对48.3%,P = 0.005),CD-TLR率更低(3.5%对27.6%;P = 0.001)。药物涂层球囊组的踝臂指数明显高于经皮腔内血管成形术组(0.86±0.13对0.72±0.18,P = 0.025)。两组在30天时均无围手术期死亡,12个月时均无肢体相关死亡和无大截肢。

结论

随机对照试验表明,与经皮腔内血管成形术相比,药物涂层球囊具有更好的治疗效果,通畅率显著更高,CD-TLR率更低。结果与其他研究一致,证明了兰花药物涂层球囊治疗股腘动脉疾病的安全性和有效性。

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