Tsuchida Yasuyuki, Hayakawa Naoki, Miwa Hiromi, Ichihara Shinya, Maruta Shunsuke, Kushida Shunichi
Department of Cardiovascular Medicine, Asahi General Hospital, I-1326 Asahi, Chiba, 289-2511, Japan.
Heart Vessels. 2025 Jul 1. doi: 10.1007/s00380-025-02562-2.
Transradial intervention (TRI) is increasingly used for EVT in these lesions, and the Misago bare nitinol stent (BNS) is compatible with this approach. However, clinical outcomes of the Misago stent via TRI have not yet been reported. Therefore, we evaluated the 3-year clinical outcomes of the Misago stent via TRI. We demonstrated the retrospective, single-center observational study included 348 aorto-iliac arteries in 255 patients treated between October 2019 and May 2023, with Rutherford classifications ranging from categories 1 to 6. The patients were divided into groups: those treated with other stent types via TFI (n = 231) and those treated with Misago stents (n = 117). Additionally, outcomes of patients treated with Misago stents via TRI (n = 72) were compared to those treated with Misago stents via TFI (n = 45). The primary endpoint was 3-year primary patency, and the secondary endpoints were clinically driven target lesion revascularization (CD-TLR), all-cause mortality, major amputation, cerebral infarction, and procedure-associated complications during hospitalization. The 3-year primary patency rate was not significantly different between the Misago stent and other stents (93.2% versus 91.8%, respectively; P = 0.78). Similarly, the 3-year primary patency rate of the Misago stent via TRI was comparable to that of the Misago stent via TFI (91.7% versus 95.6%, respectively; P = 0.44). The competing risks model with multivariate analysis showed that the Misago stent and TRI were not associated with 3-year TLR (hazard ratio [HR], 0.80; 95% confidence interval [CI],0.24-0.64; P = 0.71 and HR, 1.94; 95% CI,0.47-8.07; P = 0.36, respectively). Dialysis and TSAC II C-D were independent predictors of 3-year TLR (HR, 3.28; 95% CI, 1.50-7.18; P = 0.003 and HR, 2.70; 95% CI, 1.28-5.69; P = 0.009, respectively). The Misago stent via TRI for aorto-iliac arterial disease demonstrated acceptable 3-year clinical outcomes. Dialysis and TSAC II C-D were identified as predictors of 3-year TLR.
经桡动脉介入治疗（TRI）越来越多地用于这些病变的血管内治疗（EVT），而Misago裸镍钛合金支架（BNS）与这种方法兼容。然而，经TRI使用Misago支架的临床结果尚未见报道。因此，我们评估了经TRI使用Misago支架的3年临床结果。我们进行的这项回顾性、单中心观察性研究纳入了2019年10月至2023年5月期间治疗的255例患者的348条主-髂动脉，卢瑟福分级为1至6级。患者被分为两组：经股动脉入路（TFI）使用其他支架类型治疗的患者（n = 231）和使用Misago支架治疗的患者（n = 117）。此外，将经TRI使用Misago支架治疗的患者（n = 72）与经TFI使用Misago支架治疗的患者（n = 45）的结果进行了比较。主要终点是3年的原发通畅率，次要终点是临床驱动的靶病变血管重建（CD-TLR）、全因死亡率、大截肢、脑梗死以及住院期间与手术相关的并发症。Misago支架和其他支架的3年原发通畅率无显著差异（分别为93.2%和91.8%；P = 0.78）。同样，经TRI使用Misago支架的3年原发通畅率与经TFI使用Misago支架的相当（分别为91.7%和95.6%；P = 0.44）。多变量分析的竞争风险模型显示，Misago支架和TRI与3年的TLR无关（风险比[HR]，0.80；95%置信区间[CI]，0.24 - 0.64；P = 0.71和HR，1.94；95% CI, 0.47 - 8.07；P = 0.36）。透析和TSAC II C - D是3年TLR的独立预测因素（HR，3.28；95% CI，1.50 - 7.18；P = 0.
