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使用WRAPSODY™细胞不可渗透型腔内修复装置治疗顽固性肾通路循环功能障碍后的通畅率:来自澳大利亚一家三级中心的结果。

Patency rates following treatment with the WRAPSODY™ Cell-Impermeable Endoprosthesis for recalcitrant renal access circuit dysfunction: Results from a tertiary Australian centre.

作者信息

Bond Richard G, Arasu Rohan, Jantzen Troy M, Alley Richard P

机构信息

Department of Vascular Surgery, Fiona Stanley Hospital, Perth, WA, USA.

Territory management department, Merit Medical Australia Pty Ltd, Braeside, VIC, Australia.

出版信息

Vascular. 2024 Aug 12:17085381241273147. doi: 10.1177/17085381241273147.

DOI:10.1177/17085381241273147
PMID:39132802
Abstract

OBJECTIVE

To describe clinical outcomes associated with the use of the WRAPSODY Cell-Impermeable Endoprosthesis at a tertiary center in Western Australia.

METHODS

Patients with recalcitrant occlusive disease in the venous outflow of their arteriovenous access circuits were treated with WRAPSODY. Patients were prospectively followed up to 12-month post-procedure. Study measures included 30-day adverse events, technical success, target lesion primary patency, access circuit primary patency, and assisted access circuit primary patency.

RESULTS

Twenty-seven WRAPSODY devices were used to treat 15 consecutive patients. The technical success rate was 100%. No device-related adverse events were observed during the follow-up period. Two patients did not complete the full follow up. Patency rates at 3-, 6-, and 12 months for target lesion primary patency were 100% (15/15), 100% (15/15), and 100% (13/13), respectively. Rates for access circuit primary patency at 3-, 6-, and 12 months were 73.3% (11/15), 46.7 % (7/15), and 46.2% (6/13), respectively. Edge stenosis was observed in 33.3% (5/15) of cases and accounted for 5 of the 8 patients who experienced failed access circuit primary patency on angiogram. Primary assisted functional patency was 100% at 12 months.

CONCLUSION

WRAPSODY can be utilized safely and has durable patency in real-world patients with complex anatomical renal access stenotic lesions. The therapeutic benefits associated with the device may encourage broader use in clinical practice.

摘要

目的

描述在西澳大利亚一家三级医疗中心使用WRAPSODY细胞不可渗透内支架的临床结果。

方法

采用WRAPSODY治疗动静脉通路静脉流出道顽固性闭塞性疾病患者。对患者进行前瞻性随访,直至术后12个月。研究指标包括30天不良事件、技术成功率、靶病变原发通畅率、通路初级通畅率和辅助通路初级通畅率。

结果

使用27个WRAPSODY装置连续治疗15例患者。技术成功率为100%。随访期间未观察到与装置相关的不良事件。2例患者未完成全部随访。靶病变原发通畅率在3个月、6个月和12个月时分别为100%(15/15)、100%(15/15)和100%(13/13)。通路初级通畅率在3个月、6个月和12个月时分别为73.3%(11/15)、46.7%(7/15)和46.2%(6/13)。33.3%(5/15)的病例观察到边缘狭窄,在血管造影显示通路初级通畅失败的8例患者中,有5例是由边缘狭窄导致。12个月时初级辅助功能通畅率为100%。

结论

WRAPSODY在患有复杂解剖性肾通路狭窄病变的真实患者中可以安全使用,并且具有持久的通畅性。该装置相关的治疗益处可能会促使其在临床实践中得到更广泛的应用。

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KDOQI 2019 Vascular Access Guidelines: What Is New.《KDOQI 2019血管通路指南:新内容有哪些》
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First Clinical Results of the Merit WRAPSODY™ Cell-Impermeable Endoprosthesis for Treatment of Access Circuit Stenosis in Haemodialysis Patients.Merit WRAPSODY™ 细胞不可渗透内假体治疗血液透析患者动静脉内瘘狭窄的初步临床结果。
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