SOS 试验证实TAXUS 能降低大隐静脉桥血管病变的TLR和TVF

SOS: Taxus Reduced TLR, TVF in Saphenous Vein Graft Lesions 

（北京武警总医院 韩玮 翻译）

SOS 试验结果证实和Express支架相比TAXUS 支架可以显著降低大隐静脉桥血管病变的12个月造影再狭窄、TLR和TVF。

达拉斯的北德克萨斯医疗系统心脏导管室的Emmanouil S. Brilakis发布了该试验结果，TAXUS 支架可以显著降低支架内晚期丢失(0.42 mm with Taxus vs. 1.29 mm with Express; P<.001),显著降低节段内晚期丢失(1.17 mm with Express vs. 0.36 mm with Taxus; P<.001)，显著降低支架内造影再狭窄（9% vs 51%，P<0.001）。

Express组和Taxus支架组各有12例和5例死亡(P=.27)，TLR  (28% vs. 5%; P=.003)和TVR (31% vs. 15%; P=.08)在TAXUS组更低。

该多中心随机前瞻性试验中Express组入选39例，TAXUS支架组入选41例，两组的死亡率和支架血栓发生率没有差异。

SOS评价

菲律宾Hahnemann大学医院的Sheldon Goldberg说，“对局限的大隐静脉桥血管病变患者DES 可以显著降低造影再狭窄，这一结果不能推广到较大移植桥血管、再狭窄或完全闭塞病变。”SOS 研究和RRISC 研究结果相似，RRISC 是比较CYPHER和裸支架治疗移植桥血管病变的效果，裸支架组（n=49）6个月晚期丢失是0.79mm，CYPHER（n＝47）组是0.38mm。该研究结果发表在2006年的JACC上。

Goldberg 对RRICS进行评价时说，“当我们观察到32个月时，DES 的获益消失了。”目前的研究样本量较少不足以发现主要临床终点的差异。他最后开玩笑的说“如果想保持大隐静脉的通畅，最好的办法是把它留在腿上。”

（来源：www.tctmd.com）

SOS: Taxus Reduced TLR, TVF in Saphenous Vein Graft Lesions 

By TCT Daily Staff

Stenting saphenous vein graft lesions with Taxus stents resulted in a significant reduction in 12-month binary angiographic restenosis, TLR and TVF compared with Express stents, according to the results of the SOS trial.

Emmanouil S. Brilakis, MD, PhD, director of the cardiac cath lab at VA North Texas Healthcare System in Dallas, said Taxus had greater reductions in in-stent late loss (0.42 mm with Taxus vs. 1.29 mm with Express; P<.001) and in-segment late loss (1.17 mm with Express vs. 0.36 mm with Taxus; P<.001). There also was a 51% rate of binary angiographic in-stent restenosis with Express compared vs. 9% with Taxus (P<.0001).

Five patients in the Express group died compared with 12 in the Taxus group (P=.27). TLR (28% vs. 5%; P=.003) and TVR (31% vs. 15%; P=.08) were higher in the Express vs. Taxus groups.

In the multicenter, randomized prospective trial, which included 39 patients in the Express stent group and 41 in the Taxus stent group, there was no difference in mortality and stent thrombosis between the patient cohorts.

SOS perspective

"For patients with discrete lesions in saphenous vein bypass grafts, the use of DES reduces short-term angiographic restenosis," said Sheldon Goldberg, MD, of Hahnemann University Hospital, Philadelphia. "These results cannot be extrapolated to patients with larger grafts, restenotic lesions [or] total occlusions."

The results of SOS are similar to the outcomes of the RRISC trial, Goldberg said. RRISC, which compared Cypher with bare-metal stents in saphenous vein bypass grafts, demonstrated a 0.79 mm late loss among patients with bare-metal stents (n=49) at six months compared with 0.38 mm for Cypher (n=47). That study was published in the Journal of the American College of Cardiology in 2006.

"When one examined follow-up out to 32 months, the advantage confirmed by DES was lost over that timeframe," Goldberg said of the RRISC study. Current studies are ongoing in smaller patient populations and underpowered to detect differences in major clinical endpoints, he said.

"The best way to maintain patency of a saphenous vein is probably to leave it in the leg," he said in his closing remarks.

Disclosures:

Dr. Brilakis reports no relevant conflicts of interest.
Dr. Goldberg reports receiving an educational grant from Abbott Vascular and Eli Lilly.
 

（source：www.tctmd.com）