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首页> 外文期刊>Journal of endovascular therapy: an official journal of the International Society of Endovascular Specialists >Vessel Calcification as a Risk Factor for In-Stent Restenosis in Complex Femoropopliteal Lesions After Zilver PTX Paclitaxel-Coated Stent Placement
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Vessel Calcification as a Risk Factor for In-Stent Restenosis in Complex Femoropopliteal Lesions After Zilver PTX Paclitaxel-Coated Stent Placement

机译：血管钙化作为在Zilver PTX Paclitaxel涂层支架放置后复杂股骨质模板病变中的支架再狭窄的危险因素

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Purpose: To evaluate the effect of vessel calcification on in-stent restenosis (ISR) after drug-coated stent (DCS) placement in the femoropopliteal segment. Materials and Methods: A retrospective multicenter study was undertaken involving 220 consecutive symptomatic patients (mean age 73.1 +/- 8.3 years; 175 men) with femoropopliteal lesions in 230 limbs treated with the Zilver PTX DCS and having duplex surveillance after the endovascular procedures. Mean lesion length was 16.4 +/- 9.8 cm (range 2-40); there were 104 (45.2%) total occlusions and 68 (29.6%) in-stent restenoses (ISR). Twenty (8.7%) vessels had no runoff. The majority of lesions (148, 64.3%) were calcified according to the peripheral arterial calcium scoring system (PACSS). Primary patency was evaluated by duplex. Lesions were classified as either PACSS 0-2 (none or unilateral wall calcification) or PACSS 3 and 4 (bilateral wall calcification). Multivariate analysis was performed to identify variables associated with ISR; the results are given as the hazard ratio (HR) and 95% confidence interval (CI). Results: The 1-, 2-, and 5-year primary patency and freedom from clinically-driven target lesion revascularization estimates were 75.9%, 63.6%, and 45.0%, and 84.7%, 73.7%, and 54.2%, respectively. Major amputations were performed on 4 limbs during follow-up. In multivariate analysis, vessel calcification (adjusted HR 1.718, 95% CI 1.035 to 2.851, p=0.036) was significantly correlated with the occurrence of ISR, along with lesion length (adjusted HR 1.041, 95% CI 1.013 to 1.070, p=0.003), and cilostazol administration (adjusted HR 0.476, 95% CI 0.259 to 0.876, p=0.017). Conclusion: This study suggested that bilateral vessel wall calcification was an independent risk factor for ISR in complex femoropopliteal lesions after Zilver PTX DCS placement, along with lesion length; cilostazol administration had a protective effect.
机译：目的：评价血管涂层支架（DCS）在股骨质面板段涂层后支架钙化（ISR）对支架再狭窄（ISR）的影响。材料和方法：涉及220例连续症状患者的回顾性多中心研究（平均73.1 +/- 8.3岁; 175名男性），在230只肢体中，用Zilver PTX DC治疗并在血管内程序后具有双链运动监测。平均病变长度为16.4 +/- 9.8厘米（范围2-40）;总闭塞104例（45.2％），68（29.6％）替换（ISR）。二十（8.7％）船没有径流。大部分病变（148,64.3％）根据外周动脉钙评分系统（PACSS）进行钙化。通过双相评估初级通畅。病变被归类为PACSS 0-2（无或单侧壁钙化）或PACSS 3和4（双侧壁钙化）。进行多变量分析以识别与ISR相关的变量;结果作为危害比（HR）和95％置信区间（CI）给出。结果：临床驱动的目标病变血运重建估计的1-，2-和5年的主要普及和自由度分别为75.9％，63.6％和45.0％，分别为84.7％，73.7％和54.2％。在随访期间对4只肢体进行了主要截肢。在多变量分析中，血管钙化（调节的HR 1.718,95％CI 1.035至2.851，P = 0.036）与ISR的发生显着相关，以及病变长度（调节的HR 1.041,95％CI 1.013至1.070，P = 0.003 ）和西洛司唑给药（调节HR 0.476,95％CI 0.259至0.876，P = 0.017）。结论：本研究表明，双侧血管壁钙化是在Zilver PTX DCS放置后复杂股骨头造质病变中的ISR的独立危险因素，以及病变长度;西洛司唑醇给药具有保护作用。

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