Primary stenting of femoropopliteal atherosclerotic lesions using new helical interwoven nitinol stents
Primary stenting of femoropopliteal atherosclerotic lesions using new helical interwoven nitinol stents
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DOI：
10.1016/j.jvs.2013.08.037
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发表时间：
2014-02-01
影响因子：
4.3
通讯作者：
Cheung, Grace C.
中科院分区：
文献类型：
--
作者：
Chan, Yiu Che;Cheng, Stephen W.;Cheung, Grace C.
背景资料：Supera螺旋交织镍钛合金支架置入股腘动脉时，可增强抵抗骨折的灵活性，并可改善通畅性。本研究的目的是评估Supera支架在有症状的股腘动脉粥样硬化病变患者中的早期结果。方法：从2011年10月至2013年4月，对有症状的股腘动脉病变患者进行血管成形术和使用Supera支架的初次支架植入术。在1、3、6和12个月时对他们进行随访，进行临床、双功和影像学评估。结果：共纳入78例患者（男46例，女32例），82条下肢，平均年龄78.5岁（57-97岁）。跛行、静息痛和组织缺损症状分别为48例（59%）、8例（10.1%）和30例（37%）。共插入96枚Supera支架。在44条腿（53.7%）中，支架延伸至腘段。平均支架长度为12.6 cm（范围：4.0-38.0 cm）。6个月和12个月时的一期通畅率分别为83.5%和78.6%。踝臂指数从术前0.58 +/- 0.16增加到术后0.87 +/- 0.14。无支架断裂。通畅率不受症状严重程度、支架长度、股动脉/腘动脉支架的影响（对数秩检验，P = 0.50、0.13、0.52）。所有患者均报告症状改善。有没有程序或设备相关的发病率或死亡率，没有大截肢后血运重建，和10例患者死于无关的心肺/肾causes on follow-up.Conclusions：我们的早期经验表明，Supera支架是有效的，在我们的队列中的老年患者，可接受的通畅率。到目前为止，即使在腘动脉段植入支架，也没有支架断裂。
Background: The Supera helical interwoven nitinol stent has enhanced flexibility in counteracting fractures when placed in the femoropopliteal arteries and may improve patency. The aim of this study is to assess the early results of the Supera stent in symptomatic patients with femoropopliteal atherosclerotic lesions.Methods: From October 2011 to April 2013, patients with symptomatic femoropopliteal lesions were treated with angioplasty and primary stenting using the Supera stent. They were followed up at 1, 3, 6, and 12 months with clinical, duplex, and radiographic assessments. Failure was defined as >50% restenosis of the target lesion on duplex ultrasound imaging or stent fracture on X rays.Results: A total of 78 consecutive patients (46 males, 32 females) with 82 legs, mean age of 78.5 years (range, 57-97 years) were included. Symptoms of claudication, rest pain, and tissue loss were 48 (59%), 8 (10.1%), and 30 (37%), respectively. Ninety-six Supera stents were inserted in total. In 44 (53.7%) of the legs, stents were extended to the popliteal segments. The mean stented length was 12.6 cm (range, 4.0-38.0 cm). The primary patency rates at 6 and 12 months were 83.5% and 78.6%, respectively. The ankle brachial index increased from 0.58 +/- 0.16 preoperative to 0.87 +/- 0.14 postoperative. There were no stent fractures. Patency rate was not affected by severity of symptoms, stent lengths, femoro/popliteal stents (log-rank test, P = .50, .13, .52). All the patients reported symptomatic improvement. There was no procedural-or device-related morbidity or mortality, no major amputation after revascularization, and 10 patients died of unrelated cardiopulmonary/renal causes on follow-up.Conclusions: Our early experience shows that the Supera stents are effective in our cohort of elderly patients, with acceptable patency rates. There were no stent fractures so far even with stenting of the popliteal segments.