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CIT2018:国产生物可降解支架对于冠脉单支病变患者安全有效,支架厚度薄,材料降解周期短

2018-03-26 佚名 中国循环杂志

CIT 2018上,来自中国医学科学院阜外医院的徐波教授公布了FUTURE-I研究的两年随访结果:国产Firesorb西罗莫司靶向洗脱生物可吸收血管支架,对于冠脉单支病变患者安全有效。

CIT 2018上,来自中国医学科学院阜外医院的徐波教授公布了FUTURE-I研究的两年随访结果:国产Firesorb西罗莫司靶向洗脱生物可吸收血管支架,对于冠脉单支病变患者安全有效。


国产Firesorb生物可降解支架,是以体内可降解的高分子材料聚左旋乳酸(PLLA)为骨架材料,以聚D,L- 丙交酯(PDLLA)为表层材料的厚度仅为100~25 μm的球囊扩张药物洗脱支架,西罗莫司作为洗脱药物,与其他生物可吸收支架相比载药量低60%。整体而言,支架厚度薄,材料降解周期短。

FUTURE-Ⅰ研究是首个关于Firesorb生物可降解支架的人体研究,该研究为一项前瞻性的单中心研究,共计纳入了45例冠状动脉单支病变(病变长度≤25 mm,血管直径在3.0 mm~3.5 mm之间)患者。

研究显示,患者术后30天、6个月、1年和2年主要终点靶病变失败率(TLF)发生率均为0%,面向患者的复合次要终点患者水平复合终点(包括死亡、心肌梗死及血运重建)发生率为2.2%,全因死亡、靶血管MI及支架内血栓发生率均为0%。

队列1受试者的2年支架内和节段内晚期管腔丢失(LLL)分别为(0.42±0.34)mm和(0.28±0.28)mm。IVUS结果显示,支架内管腔阻塞为(19.5%±10.3)%。OCT结果显示:支架覆盖率达99.7%,平均管腔直径为(2.65±0.45) mm,修复指数为(0.82±2.77)。

在晚期支架回缩方面,6个月、1年和2年的晚期支架回缩面积分别为0.18、0.17、0.17,回缩率分别为2.01、1.94、1.94,对比队列1中的6个月和2年的支架回缩面积和发生率,没有明显的统计学差异。但对于新生内膜厚度和面积,则是2年明显高于6个月。

研究结果提示,2年内的管腔丢失程度是可以接受的,经IVUS和OCT证实造成管腔丢失的主要原因是内膜的增生。

所有的受试者均在冠脉支架植入术前接受造影和IVUS 检查,在术后接受造影、IVUS和OCT检查,随后进行为期2年的随访,同时将患者分为2个队列,分别在术后6个月、2年(队列1,n = 30)和术后1年、3年(队列2,n = 30)再次接受造影、IVUS和OCT检查。研究的主要终点事件为靶病变治疗失败。

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    2018-03-28 虈亣靌

    学习了.谢谢作者分享!

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