Twelve-Month Results From the MAJESTIC Trial of the Eluvia Paclitaxel-Eluting Stent for Treatment of Obstructive Femoropopliteal Disease

被引:82
作者
Mueller-Huelsbeck, Stefan [1 ]
Keirse, Koen [2 ]
Zeller, Thomas [3 ]
Schroe, Herman [4 ]
Diaz-Cartelle, Juan [5 ]
机构
[1] Ev Luth Diakonissenanstalt Flensburg, Flensburg, Germany
[2] Reg Hosp Heilig Hart Tienen, Tienen, Belgium
[3] Univ Herzzentrum Freiburg Bad Krozingen, Bad Krozingen, Germany
[4] Ziekenhuis Oost Limburg, Genk, Belgium
[5] Boston Sci Corp, Marlborough, MA USA
关键词
claudication; drug-eluting stent; paclitaxel; peripheral artery disease; popliteal artery; restenosis; superficial femoral artery; target lesion revascularization; SUPERFICIAL FEMORAL-ARTERY; RESILIENT RANDOMIZED-TRIAL; MUSCLE-CELL PROLIFERATION; PROXIMAL POPLITEAL; BALLOON ANGIOPLASTY; NITINOL STENTS; ZILVER PTX; OCCLUSIVE DISEASE; FOLLOW-UP; IN-VITRO;
D O I
10.1177/1526602816650206
中图分类号
R61 [外科手术学];
学科分类号
摘要
Purpose: To report the 12-month results of the MAJESTIC clinical study of the self-expanding Eluvia paclitaxel-eluting stent in the treatment of femoropopliteal lesions. Methods: The prospective, single-arm, multicenter trial (clinicaltrials.gov identifier NCT01820637) enrolled 57 patients (mean age 69 +/- 9 years; 47 men) with chronic lower limb ischemia referable to de novo or restenotic lesions in the native superficial femoral and/or proximal popliteal arteries. A third of the patients had diabetes. Mean lesion length was 70.8 +/- 28.1 mm, and diameter stenosis was 86.3%+/- 16.2%; 26 (46%) lesions were occluded. Primary patency was defined as duplex ultrasound peak systolic velocity ratio 2.5 and the absence of target lesion revascularization (TLR) or bypass. Major adverse events (MAEs) included all-cause death through 1 month and target limb major amputation and TLR through 12 months. Results: All 57 patients had a single Eluvia stent implanted, employing pre- and postdilation in 93% (53/57) and 95% (54/57) of cases, respectively. Technical success was 97% (55/57; 2 failures due to residual stenosis >30%). At 12 months, primary patency was 96% (49/51) and the MAE rate was 4% (2/53); both MAEs were TLRs. No stent fractures were identified. There were no major amputations. One death occurred 368 days postprocedure, unrelated to the device or procedure. Improvements in the Rutherford category were sustained through 1 year, with 81% (43/53) exhibiting no symptoms (category 0) and 13% (7/53) presenting with mild claudication (category 1). Mean ABI improved from 0.73 +/- 0.22 at baseline to 1.02 +/- 0.20 at 12 months. Conclusion: MAJESTIC results showed that patients whose femoropopliteal arteries were treated with the Eluvia drug-eluting stent sustained high patency and low MAE rates through 12 months.
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页码:701 / 707
页数:7
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