Drug-eluting Tibial Stents: Objective Patency Determination
Drug-eluting Tibial Stents: Objective Patency Determination
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DOI：
10.1016/j.jvir.2010.09.011
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发表时间：
2010-12-01
影响因子：
2.9
通讯作者：
Schultz, Scott R.
中科院分区：
文献类型：
--
作者：
McMillan, William D.;Leville, Chris D.;Schultz, Scott R.
目的：血管内治疗危及肢体的缺血通常需要治疗胫骨闭塞性疾病。本研究是预先检查药物洗脱胫骨stents.MATERIALS和方法的通畅性：所有患者的病历进行药物洗脱胫骨支架置入术的肢体威胁缺血从2004年6月至2008年6月进行了回顾性分析。术后抗血小板治疗包括氯吡格雷和阿司匹林。对患者进行连续动脉多普勒超声检查，并根据无创性结果进行选择性血管造影评价。靶病变的一期通畅率，保肢率和生存率reported.RESULTS：共240例患者进行了283胫骨血管成形术治疗肢体缺血在4年期间。52例患者（22%）的球囊结果不理想，并接受了药物洗脱胫骨支架治疗。所有患者均使用了可扩张紫杉醇洗脱支架（每例患者1.2枚支架;范围：1-3枚;中位直径：2.75 mm;范围：2.5-3.5 mm;中位长度：24 mm;范围：20-32 mm）。这52例患者中的48例（92%）同时接受了近端病变的血管内治疗。平均随访14.3个月（范围：1-48个月）。24个月时，药物洗脱胫骨支架的靶病变通畅率为73%（SE < 10%）。药物洗脱胫骨支架治疗的患者在26个月时的保肢率为86%（SE < 10%），24个月时的生存率为65%（SE <10%.CONCLUSIONS：药物洗脱胫骨支架是血管内治疗威胁肢体缺血的可行选择，具有可接受的通畅率。大多数患者需要多节段血管内治疗，并且需要对保肢进行密切监测。
PURPOSE: Endovascular management of limb-threatening ischemia often requires treatment of tibial occlusive disease. This study was preformed to examine the patency of drug-eluting tibial stents.MATERIALS AND METHODS: The medical records of all patients undergoing drug-eluting tibial stent placement for limb-threatening ischemia from June 2004 to June 2008 were retrospectively reviewed. Postprocedural antiplatelet therapy included clopidogrel and aspirin. Patients were followed with serial arterial duplex ultrasonography and had selective subsequent angiographic evaluation based on noninvasive findings. Primary patency of the target lesion, limb salvage, and survival rates were reported.RESULTS: A total of 240 patients underwent 283 tibial angioplasty procedures to treat limb-threatening ischemia during the 4-year period. Fifty-two patients (22%) had a suboptimal balloon result and were treated with a drug-eluting tibial stent. Balloon-expandable paclitaxel-eluting stents were used in all patients (1.2 stents per patient; range, 1-3; median diameter, 2.75 mm; range, 2.5-3.5 mm; median length, 24 mm; range, 20-32 mm). Forty-eight of those 52 patients (92%) had simultaneous endovascular treatment of proximal lesions. Mean follow-up was 14.3 months (range, 1-48 months). Target lesion patency of the drug-eluting tibial stent was 73% at 24 months (SE < 10%). Limb salvage rate in patients treated with drug-eluting tibial stents was 86% at 26 months (SE < 10%), and the survival rate was 65% at 24 months (SE < 10%).CONCLUSIONS: Drug-eluting tibial stents are a viable option for the endovascular management of limb-threatening ischemia and have acceptable patency rates. The majority of patients require multilevel endovascular treatment, and close surveillance is required for limb salvage.