在真实临床实践中验证直径缩小、螺旋形状、血流障碍或不良形态分类系统的有用性。

Validation of the Usefulness of the Diameter Reduction, Spiral Shape, Flow Impairment, or Adverse Morphology Classification System in Real-World Clinical Practice.

机构信息

Division of Cardiology, Central Japan International Medical Center.

Division of Cardiology, Nagoya Heart Center.

出版信息

J Atheroscler Thromb. 2024 Feb 1;31(2):148-157. doi: 10.5551/jat.64335. Epub 2023 Aug 9.

AIM

The accuracy of the DISFORM (diameter reduction, spiral shape, flow impairment, or adverse morphology) classification system has not been validated.

METHODS

This retrospective multicenter observational study enrolled 288 consecutive patients with lower extremity artery disease who underwent endovascular therapy with drug-coated balloons for femoropopliteal lesions between January 2018 and December 2021. Patients were classified into DISFORM I-IV groups. Primary patency (PP) and freedom from clinically driven target lesion revascularization (CD-TLR) at 12 months, and recurrence predictors at 12 months were investigated.

RESULTS

In total, 183, 66, 11, and 28 patients were classified into DISFORM I, II, III, and IV groups, respectively. In the DISFORM I, II, III, and IV groups, the PP rates were 75.3%, 91.1%, 87.5%, and 50.0%, respectively, and freedom from CD-TLR rates were 86.0%, 91.6%, 88.9%, and 76.7%, respectively, at 12 months. In the DISFORM I-III and IV groups, the PP rates were 79.4% and 50.0%, respectively, and freedom from CD-TLR rates were 87.5% and 76.7%, respectively, at 12 months. Multivariate analysis showed that chronic limb-threatening ischemia, DISFORM IV, and Lutonix™ use were independent predictors of PP loss at 12 months.

CONCLUSION

DISFORM IV had a lower PP rate than DISFORM I-III in midterm phase.

目的

DISFORM（直径减小、螺旋形状、血流受损或不良形态）分类系统的准确性尚未得到验证。

方法

本回顾性多中心观察性研究纳入了 2018 年 1 月至 2021 年 12 月期间接受药物涂层球囊治疗股腘病变的 288 例下肢动脉疾病连续患者。患者被分为 DISFORM I-IV 组。研究调查了 12 个月时的主要通畅率（PP）和免于临床驱动的靶病变血运重建（CD-TLR）、以及 12 个月时的复发预测因素。

结果

共有 183、66、11 和 28 例患者分别归入 DISFORM I、II、III 和 IV 组。在 DISFORM I、II、III 和 IV 组中，12 个月时的 PP 率分别为 75.3%、91.1%、87.5%和 50.0%，CD-TLR 无复发率分别为 86.0%、91.6%、88.9%和 76.7%。在 DISFORM I-III 和 IV 组中，12 个月时的 PP 率分别为 79.4%和 50.0%，CD-TLR 无复发率分别为 87.5%和 76.7%。多变量分析显示，慢性肢体威胁性缺血、DISFORM IV 和 Lutonix™ 使用是 12 个月时 PP 丢失的独立预测因素。