亨特管筋膜切开术支架术治疗长股腘动脉闭塞的中期结果。

IF 1.5 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE
Alexey V Cheban, Olesya S Osipova, Pavel V Ignatenko, Alexandr A Gostev, Shoraan B Saaya, Andrey A Karpenko
{"title":"亨特管筋膜切开术支架术治疗长股腘动脉闭塞的中期结果。","authors":"Alexey V Cheban, Olesya S Osipova, Pavel V Ignatenko, Alexandr A Gostev, Shoraan B Saaya, Andrey A Karpenko","doi":"10.23736/S0392-9590.25.05272-1","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The present study investigates the hypothesis that fasciotomy of the Hunter's canal increases the mobility of the superficial femoral artery and reduces the risk of stent fracture. The objective of this study was to compare the long-term success of drug-eluting nitinol stents with and without a fasciotomy for patients with total femoropopliteal occlusion. The hypothesis is that fasciotomy of Hunter's canal can increase the mobility of the superficial femoral artery and reduce the incidence of stent breakage. The objective of this study was to compare the long-term patency of drug-eluting nitinol stents with and without fasciotomy in patients with total femoropopliteal occlusions.</p><p><strong>Methods: </strong>A randomized clinical trial was conducted in patients with femoral-popliteal stenococclusive lesions longer than 200 mm. Patients in group 1 (Zilver) underwent recanalization of the femoropopliteal artery occlusion with stenting. In the second group (ZilverFas), recanalization of the femoropopliteal occlusion with stenting and fasciotomy of Hunter's canal was performed. The follow-up evaluation of patency was conducted at 24 months.</p><p><strong>Results: </strong>The present study involved a total of 60 subjects. The primary patency at 24 months was 33% and 60% in the Zilver and ZilverFas groups, respectively (P=0.03). The freedom from target revascularization (TLR) in the Zilver and ZilverFas groups was 40% and 64%, respectively (P=0.1). The primary assisted patency at 24 months was 46.7% in the Zilver group versus 66.5% in the ZilverFas group (log-rank P=0.14) versus 46.7% in the Zilver group (log-rank P=0.14), while the 2-year secondary patency was 53.3% in the Zilver group compared to 69% in the ZilverFas group (log-rank P=0.24) compared to 53.3% in the Zilver group (log-rank P=0.24). In the Zilver and ZilverFas groups, the number of patients with stent failures was 14 and 7, respectively (P=0.05). In the Zilver and ZilverFas groups, the number of stents that fractured was 14 and 7, respectively (P=0.05). Multivariable Cox regression analysis revealed that fasciotomy significantly reduced the risk of reocclusion and restenosis by 2.1 times.</p><p><strong>Conclusions: </strong>The present study has demonstrated that decompression of the stented segment of the superficial femoral artery (SFA) with fasciotomy leads to a significant improvement in patency of the femoropopliteal segment and a substantial reduction in the number and severity of stent fractures.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":"44 2","pages":"150-158"},"PeriodicalIF":1.5000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Medium-term results of stenting with Hunter's canal fasciotomy for long femoropopliteal occlusions.\",\"authors\":\"Alexey V Cheban, Olesya S Osipova, Pavel V Ignatenko, Alexandr A Gostev, Shoraan B Saaya, Andrey A Karpenko\",\"doi\":\"10.23736/S0392-9590.25.05272-1\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The present study investigates the hypothesis that fasciotomy of the Hunter's canal increases the mobility of the superficial femoral artery and reduces the risk of stent fracture. The objective of this study was to compare the long-term success of drug-eluting nitinol stents with and without a fasciotomy for patients with total femoropopliteal occlusion. The hypothesis is that fasciotomy of Hunter's canal can increase the mobility of the superficial femoral artery and reduce the incidence of stent breakage. The objective of this study was to compare the long-term patency of drug-eluting nitinol stents with and without fasciotomy in patients with total femoropopliteal occlusions.</p><p><strong>Methods: </strong>A randomized clinical trial was conducted in patients with femoral-popliteal stenococclusive lesions longer than 200 mm. Patients in group 1 (Zilver) underwent recanalization of the femoropopliteal artery occlusion with stenting. In the second group (ZilverFas), recanalization of the femoropopliteal occlusion with stenting and fasciotomy of Hunter's canal was performed. The follow-up evaluation of patency was conducted at 24 months.</p><p><strong>Results: </strong>The present study involved a total of 60 subjects. The primary patency at 24 months was 33% and 60% in the Zilver and ZilverFas groups, respectively (P=0.03). The freedom from target revascularization (TLR) in the Zilver and ZilverFas groups was 40% and 64%, respectively (P=0.1). The primary assisted patency at 24 months was 46.7% in the Zilver group versus 66.5% in the ZilverFas group (log-rank P=0.14) versus 46.7% in the Zilver group (log-rank P=0.14), while the 2-year secondary patency was 53.3% in the Zilver group compared to 69% in the ZilverFas group (log-rank P=0.24) compared to 53.3% in the Zilver group (log-rank P=0.24). In the Zilver and ZilverFas groups, the number of patients with stent failures was 14 and 7, respectively (P=0.05). In the Zilver and ZilverFas groups, the number of stents that fractured was 14 and 7, respectively (P=0.05). Multivariable Cox regression analysis revealed that fasciotomy significantly reduced the risk of reocclusion and restenosis by 2.1 times.</p><p><strong>Conclusions: </strong>The present study has demonstrated that decompression of the stented segment of the superficial femoral artery (SFA) with fasciotomy leads to a significant improvement in patency of the femoropopliteal segment and a substantial reduction in the number and severity of stent fractures.</p>\",\"PeriodicalId\":13709,\"journal\":{\"name\":\"International Angiology\",\"volume\":\"44 2\",\"pages\":\"150-158\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2025-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Angiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.23736/S0392-9590.25.05272-1\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"PERIPHERAL VASCULAR DISEASE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Angiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.23736/S0392-9590.25.05272-1","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
引用次数: 0

摘要

背景:本研究调查了Hunter’s canal的筋膜切开术增加股浅动脉的活动性并降低支架骨折风险的假设。本研究的目的是比较药物洗脱镍钛诺支架伴和不伴筋膜切开术治疗全股腘动脉闭塞患者的长期成功。假设亨特氏管筋膜切开术可以增加股浅动脉的活动性,减少支架断裂的发生率。本研究的目的是比较全股腘动脉闭塞患者采用和不采用筋膜切开术的药物洗脱镍钛诺支架的长期通畅性。方法:对股骨-腘窝狭窄闭塞病变长度大于200mm的患者进行随机临床试验。组1 (Zilver)患者行股腘动脉闭塞再通支架置入。在第二组(ZilverFas)中,通过支架置入术和Hunter's管筋膜切开术对股腘动脉闭塞进行再通。随访24个月评估通畅程度。结果:本研究共涉及60名受试者。在24个月时,Zilver组和ZilverFas组的原发性通畅率分别为33%和60% (P=0.03)。Zilver组和ZilverFas组的靶血管重建自由度(TLR)分别为40%和64% (P=0.1)。在24个月时,Zilver组的初级辅助通畅率为46.7%,而ZilverFas组为66.5% (log-rank P=0.14),而Zilver组为46.7% (log-rank P=0.14),而Zilver组的2年次级通畅率为53.3%,而ZilverFas组为69% (log-rank P=0.24),而Zilver组为53.3% (log-rank P=0.24)。Zilver组和ZilverFas组支架失效患者分别为14例和7例(P=0.05)。Zilver组和ZilverFas组支架断裂数分别为14例和7例(P=0.05)。多变量Cox回归分析显示,筋膜切开术可显著降低再闭塞和再狭窄的风险2.1倍。结论:本研究表明,采用筋膜切开术对股浅动脉(SFA)支架段进行减压,可显著改善股浅动脉段的通畅,并显著降低支架骨折的数量和严重程度。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Medium-term results of stenting with Hunter's canal fasciotomy for long femoropopliteal occlusions.

Background: The present study investigates the hypothesis that fasciotomy of the Hunter's canal increases the mobility of the superficial femoral artery and reduces the risk of stent fracture. The objective of this study was to compare the long-term success of drug-eluting nitinol stents with and without a fasciotomy for patients with total femoropopliteal occlusion. The hypothesis is that fasciotomy of Hunter's canal can increase the mobility of the superficial femoral artery and reduce the incidence of stent breakage. The objective of this study was to compare the long-term patency of drug-eluting nitinol stents with and without fasciotomy in patients with total femoropopliteal occlusions.

Methods: A randomized clinical trial was conducted in patients with femoral-popliteal stenococclusive lesions longer than 200 mm. Patients in group 1 (Zilver) underwent recanalization of the femoropopliteal artery occlusion with stenting. In the second group (ZilverFas), recanalization of the femoropopliteal occlusion with stenting and fasciotomy of Hunter's canal was performed. The follow-up evaluation of patency was conducted at 24 months.

Results: The present study involved a total of 60 subjects. The primary patency at 24 months was 33% and 60% in the Zilver and ZilverFas groups, respectively (P=0.03). The freedom from target revascularization (TLR) in the Zilver and ZilverFas groups was 40% and 64%, respectively (P=0.1). The primary assisted patency at 24 months was 46.7% in the Zilver group versus 66.5% in the ZilverFas group (log-rank P=0.14) versus 46.7% in the Zilver group (log-rank P=0.14), while the 2-year secondary patency was 53.3% in the Zilver group compared to 69% in the ZilverFas group (log-rank P=0.24) compared to 53.3% in the Zilver group (log-rank P=0.24). In the Zilver and ZilverFas groups, the number of patients with stent failures was 14 and 7, respectively (P=0.05). In the Zilver and ZilverFas groups, the number of stents that fractured was 14 and 7, respectively (P=0.05). Multivariable Cox regression analysis revealed that fasciotomy significantly reduced the risk of reocclusion and restenosis by 2.1 times.

Conclusions: The present study has demonstrated that decompression of the stented segment of the superficial femoral artery (SFA) with fasciotomy leads to a significant improvement in patency of the femoropopliteal segment and a substantial reduction in the number and severity of stent fractures.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
International Angiology
International Angiology 医学-外周血管病
CiteScore
2.80
自引率
28.60%
发文量
89
审稿时长
6-12 weeks
期刊介绍: International Angiology publishes scientific papers on angiology. Manuscripts may be submitted in the form of editorials, original articles, review articles, special articles, letters to the Editor and guidelines. The journal aims to provide its readers with papers of the highest quality and impact through a process of careful peer review and editorial work. Duties and responsibilities of all the subjects involved in the editorial process are summarized at Publication ethics. Manuscripts are expected to comply with the instructions to authors which conform to the Uniform Requirements for Manuscripts Submitted to Biomedical Editors by the International Committee of Medical Journal Editors (ICMJE).
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信