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用于弥漫性钙化股浅动脉狭窄病变的聚合物涂层紫杉醇洗脱支架的临床性能:来自一名血液透析患者的见解

Clinical performance of polymer-coated paclitaxel-eluting stent implanted for diffuse and calcified superficial femoral artery stenotic lesions: Insights from a patient on hemodialysis.

作者信息

Yoshioka Naoki, Takagi Kensuke, Tokuda Takahiro, Morita Yasuhiro, Morishima Itsuro

机构信息

Department of Cardiology, Ogaki Municipal Hospital, Ogaki, Japan.

Department of Cardiology, Nagoya Heart Center, Nagoya, Japan.

出版信息

SAGE Open Med Case Rep. 2021 Jun 14;9:2050313X211025929. doi: 10.1177/2050313X211025929. eCollection 2021.

Abstract

In recent years, various devices have been approved for peripheral artery disease with femoropopliteal lesions. However, treatment of long, calcified, and diffused lesions is still challenging because these lesions are associated with restenosis. This report described the case of an 82-year-old man with bilateral severely calcified and diffused long lesions in the superficial femoral artery that was treated using polymer-coated paclitaxel-eluting stent and interwoven nitinol stent. After 6 months, in-stent restenosis was observed at the implantation site of the interwoven nitinol stents. Polymer-coated paclitaxel-eluting stents were deployed at the in-stent restenosis site. After another 6 months, angiography and intravascular ultrasound imaging revealed no restenosis at the polymer-coated paclitaxel-eluting stent site. Optical coherence tomography was also performed, revealing that the stent struts were well covered by neointima, which was very thin at approximately 0.1 mm. This representative case demonstrated substantial differences in the effects of devices; in other words, the superiority of polymer-coated paclitaxel-eluting stent in treating long, diffuse, and calcified lesions indicated that its implantation is a reasonable option when the initial gain was obtained following sufficient vessel preparation.

摘要

近年来,各种设备已被批准用于治疗伴有股腘病变的外周动脉疾病。然而,治疗长段、钙化且弥漫性病变仍然具有挑战性,因为这些病变与再狭窄相关。本报告描述了一名82岁男性的病例,其双侧股浅动脉存在严重钙化且弥漫的长段病变,采用了聚合物涂层紫杉醇洗脱支架和编织镍钛诺支架进行治疗。6个月后,在编织镍钛诺支架的植入部位观察到支架内再狭窄。在支架内再狭窄部位部署了聚合物涂层紫杉醇洗脱支架。又过了6个月,血管造影和血管内超声成像显示聚合物涂层紫杉醇洗脱支架部位无再狭窄。还进行了光学相干断层扫描,结果显示支架支柱被新生内膜很好地覆盖,新生内膜非常薄,约为0.1毫米。这个典型病例展示了不同设备效果的显著差异;换句话说,聚合物涂层紫杉醇洗脱支架在治疗长段、弥漫性和钙化病变方面的优越性表明,在经过充分的血管准备获得初始疗效后,植入该支架是一个合理的选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d56/8207276/5f861d4e5bfd/10.1177_2050313X211025929-fig1.jpg

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