Nasel Christian, Kirschner Mario, Rizzi Karoline, Schweinhammer Nicola, Moser Ewald
Department of Radiology, University Hospital Tulln, Karl Landsteiner University of Health Sciences, Tulln, Austria.
Department of Medical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria.
PLoS One. 2025 Jan 24;20(1):e0313696. doi: 10.1371/journal.pone.0313696. eCollection 2025.
Treatment of peripheral artery disease (PAD) in the region below the knee (BTK) is dissatisfying as failure of treated target lesions (TLF) is frequent and diagnostic imaging is often challenging. In the BTK-region metallic drug-eluting stents (mDES) yielded best results concerning primary patency (PP), but also annihilate signal in magnetic resonance angiography (MR-A). A recently introduced non-metallic drug eluting bioresorbable Tyrocore® vascular scaffold (deBVS), that offers an option for re-treatment of lesions due to its full degradation within 3-4 years after placement, was investigated with respect to its compatibility with MR-A to unimpededly depict previously treated target lesions.
Patency of the deBVS in the BTK-region was assessed retrospectively using contrast enhanced MR-A of the lower limbs in patients with PAD of Lafontaine-grades II-IV (n = 19). Clinically driven MR-A censoring was triggered by an assumed target lesion failure (CD-TLF), which served to compute the probability of PP during the observation period of 5 years. Compatibility of this particular deBVS with MRI was additionally proven via in-vitro experiments.
The scaffold was found to be fully compatible with MRI. The normalised intra-luminal signal measured in MR-A increased significantly after successful deBVS-placement. The retrospective 5-years PP-probability was 0.87 (CI95%: [0.71,1.0]) with 2 stent-occlusions observed after 90 days. No major adverse events occurred.
Assessment of PAD in the BTK-region after placement of the Tyrocore®-deBVS using MRA is feasible. The promising high PP-probability after 5-years and the persistent full interpretability of treated target lesions by MR-A after stent-placement encourage further prospective assessment of this deBVS in treatment of PAD in the BTK-region.
膝下（BTK）区域的外周动脉疾病（PAD）治疗效果不尽人意，因为治疗的靶病变失败（TLF）很常见，而且诊断成像往往具有挑战性。在BTK区域，金属药物洗脱支架（mDES）在原发性通畅率（PP）方面取得了最佳效果，但在磁共振血管造影（MR-A）中也会消除信号。最近推出的一种非金属药物洗脱生物可吸收Tyrocore®血管支架（deBVS），因其在植入后3-4年内完全降解，为病变的再次治疗提供了一种选择，本研究对其与MR-A的兼容性进行了调查，以无阻碍地描绘先前治疗的靶病变。
对拉方丹II-IV级PAD患者（n = 19）的下肢进行对比增强MR-A，回顾性评估BTK区域deBVS的通畅情况。临床驱动的MR-A审查由假定的靶病变失败（CD-TLF）触发，用于计算5年观察期内PP的概率。此外，通过体外实验证明了这种特定deBVS与MRI的兼容性。
发现该支架与MRI完全兼容。成功植入deBVS后，MR-A中测量的标准化管腔内信号显著增加。回顾性5年PP概率为0.87（CI95%：[0.71,1.0]），90天后观察到2例支架闭塞。未发生重大不良事件。
使用MRA评估Tyrocore®-deBVS植入后BTK区域的PAD是可行的。5年后有前景的高PP概率以及支架植入后MR-A对治疗的靶病变持续的完全可解释性，鼓励对这种deBVS在BTK区域PAD治疗中的进一步前瞻性评估。
