Cardiovascular Center, Tokeidai Memorial Hospital, Sapporo, Japan.
Department of Diabetes Care Medicine, Osaka University Graduate School of Medicine, Suita, Japan.
Angiology. 2022 Mar;73(3):244-251. doi: 10.1177/00033197211042685. Epub 2021 Sep 8.
The aim of this study was to evaluate midterm clinical outcomes after implantation of LifeStent self-expanding nitinol stents for the treatment of femoropopliteal lesions. This retrospective, multicenter, non-randomized study examined 260 femoropopliteal lesions in 250 consecutive patients with peripheral artery disease implanted with LifeStents from April 2016 to April 2017. The prevalence of chronic total occlusion (CTO), lesion length ≥25 cm, and distal reference vessel diameter (RVD) <5 mm was 58%, 35%, and 50%, respectively. The 3-year restenosis rate in the overall population was estimated to be 72.9% and a major adverse limb event was observed in 36.9%. Multivariate analysis revealed that chronic limb-threatening ischemia (CLTI) (odds ratio [OR]: 8.04; 95% confidence interval [CI]: 1.86-34.7), CTO (OR: 4.87; 95% CI: 1.43-16.6), lesion length ≥25 cm (OR: 5.95; 95% CI: 1.11-32.0), and distal RVD <5 mm (OR: 4.43; 95% CI: 1.34-14.6) were independent risk factors for 3-year restenosis. The present study demonstrated the midterm clinical outcomes and risk factors for restenosis after implantation of the LifeStent in femoropopliteal artery lesions. CLTI, CTO, lesion length ≥25 cm, and distal RVD <5 mm predicted decreased patency after a 3-year follow-up.
本研究旨在评估 LifeStent 自膨式镍钛合金支架治疗股腘动脉病变的中期临床结果。这是一项回顾性、多中心、非随机研究,纳入了 2016 年 4 月至 2017 年 4 月期间 250 例连续外周动脉疾病患者的 260 处股腘动脉病变,所有患者均植入 LifeStent。慢性完全闭塞(CTO)、病变长度≥25cm 和远端参考血管直径(RVD)<5mm 的比例分别为 58%、35%和 50%。全人群 3 年再狭窄率估计为 72.9%,36.9%观察到主要肢体不良事件。多变量分析显示,慢性肢体严重缺血(CLTI)(比值比[OR]:8.04;95%置信区间[CI]:1.86-34.7)、CTO(OR:4.87;95% CI:1.43-16.6)、病变长度≥25cm(OR:5.95;95% CI:1.11-32.0)和远端 RVD<5mm(OR:4.43;95% CI:1.34-14.6)是 3 年再狭窄的独立危险因素。本研究表明,LifeStent 植入股腘动脉病变的中期临床结果和再狭窄的危险因素。CLTI、CTO、病变长度≥25cm 和远端 RVD<5mm 预测 3 年随访后通畅率降低。