Mid-term clinical outcome and predictors of vessel patency after femoropopliteal stenting with self-expandable nitinol stent
Mid-term clinical outcome and predictors of vessel patency after femoropopliteal stenting with self-expandable nitinol stent
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DOI：
10.1016/j.jvs.2010.03.050
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发表时间：
2010-09-01
影响因子：
4.3
通讯作者：
Nobuyoshi, Masakiyo
中科院分区：
文献类型：
--
作者：
Soga, Yoshimitsu;Iida, Osamu;Nobuyoshi, Masakiyo
背景资料。股动脉(FP)支架置入术后的长期临床结果尚不清楚。方法：本研究是一项多中心的回顾性研究。从2004年4月至2008年12月，在这项多中心研究中，连续511名患者(639条肢体；平均年龄71.7岁；71%男性)接受了镍钛醇胸骨支架置入术治疗新发病变，并进行了回顾性分析。所有患者至少随访6个月。再狭窄定义为超声心动图收缩峰值血流速度比为-gt；2.4或血管造影术为-gt；50%狭窄。潜伏期定义为无再狭窄和重复血运重建的已处理血管。继发性血管再通定义为靶血管完全闭塞并通过重复血管再通重新开放。结果：61%的患者有糖尿病，76%的患者行动迟缓，20%的患者正在进行血液透析。病变平均长度为151.75 mm。平均随访期22~11个月。1、3、5年一期通畅率分别为79.8%、66.7%和63.1%，二次通畅率分别为90.4%、87.3%和86.2%。在随访期内，53例患者(10%)死亡。其中心血管死亡占38%，支架断裂占14%。COX比例风险比多因素分析显示，西洛他唑的应用(危险比[Hill，0.52；P<；0.0001)、茎干骨折(HR，1.6；P=.03)、血液透析(HR，1.7；P=.01)、跨大西洋社会共识II级C/D(HR，2.4；P<；.0001)是FP置入成功后原发并发症的独立预测因素。结论：镍钛合金支架置入治疗FP病的临床疗效可长达S年。(《花瓶外科杂志》2010；52：608-15。)
Background. Long-term clinical outcomes after femoropopliteal (FP) stentmg with nitmol stems have not yet been clear. We investigated the mid-term efficacy of FP stenting with mtinol steins.Methods: This study was a multicenter retrospective study. From April 2004 to December 2008, 511 consecutive patients (639 limbs; mean age 71 7 years; 71% male) who underwent successful FP stenting with nitinol sterns for de novo lesions were retrospectively selected and analyzed in this multicenter study. All patients had a minimum follow-up of 6 months. Restenosis was defined as >2.4 of peak systolic velocity ratio by duplex or >50% stenosis by angiogram. Primary [latency was defined as treated vessels without restenoms and repeat revasculanzation. Secondary patency was defined as target vessels that become totally occluded and are reopened by repeat revascularizanon.Results: Sixty-one percent of the patients had diabetes, 76% were claudicant, and 20% were on hemodialysis. Mean lesion length was 151 75 mm. Mean follow-up period was 22 11 months. Primary patency was 79.8%, 66.7%, and 63.1%, and secondary pay was 90.4%, 87.3%, and 86.2% at 1, 3, and 5 years, respectively. During the follow-up period, 53 patients (10%) died. Of them, cardiovascular death was 38% and stent fracture had occurred in 14%. On multivariate analysis by Cox proportional hazard ratio, cilostazol administration (hazard ratio [Hill, 0.52;P < .0001), stem fracture (HR, 1.6; P = .03), hemodialysis (HR, 1.7; P = .01), and Trans Atlantic Inter-Society Consensus (TASC) II class C/D (HR, 2.4; P < .0001) were the independent predictors of primary paten after successful FP stoning.Conclusion: Clinical efficacy of nitinol stent implantation for FP disease was favorable for up to S years. (J Vase Surg 2010;52:608-15.)