Circulation:股浅动脉支架内再狭窄,使用药物涂层气囊血管成形术效果更佳

2015-10-27 崔倩 译 MedSci原创

关于股浅动脉(SFA)疾病的再狭窄预防,药物涂层气囊血管成形术(DCBA)被证明是优于标准气囊血管成形术(POBA)的。对于支架内再狭窄(ISR),DCBA由于POBA的证据仍然不明朗。研究人员在德国5个临床中心超过34个月的时间招募了119例SFA ISR和慢性下肢缺血患者,这些患者被前瞻性的随机分配接受DCBA(n=62)或POBA(n=57)。平均病变长度为82.2±68.4毫米。34个(2

关于股浅动脉(SFA)疾病的再狭窄预防,药物涂层气囊血管成形术(DCBA)被证明是优于标准气囊血管成形术(POBA)的。对于支架内再狭窄(ISR),DCBA优于POBA的证据仍然不明朗。

研究人员在德国5个临床中心超过34个月的时间招募了119例SFA ISR和慢性下肢缺血患者,这些患者被前瞻性的随机分配接受DCBA(n=62)或POBA(n=57)。平均病变长度为82.2±68.4mm。其中34例(28.6%)病灶完全闭塞,30例(25.2%)为中度或严重钙化。临床和多普勒超声随访在6个月和12个月时进行。主要终点是评估复发性ISR,在6个月时通过超声完成:DCBA组为15.4%(8/52),POBA组为44.7%(21/47)(P=0.002)。两组中在6个月和12个月时没有靶病变血运重建(TLR)的分别为96.4% vs 81.0%(P=0.0117)和90.8% vs 52.6%(P<0.0001)。在12个月时,不需要血运重建的患者中DCBA组35/45(77.8%)和POBA组23/44(52.3%,P=0.015)出现了临床改善(Rutherford分类≥1)。无重大截肢需要。DCBA组的两例患者和POBA组的3例患者死亡。死亡与手术无关。

对于顾浅动脉的支架内再狭窄,与POBA相比,DCBA有较少的再狭窄复发率和更好的临床结果,在安全方面没有的明显差异。

原始出处:

Hans Krankenberg,Thilo Tübler,Maja Ingwersen,et al.Drug-Coated Balloon Versus Standard Balloon for Superficial Femoral Artery In-Stent Restenosis, Circulation, 2015.10.7

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    2015-10-28 sanshengshi

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