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肾脏病与透析肾移植杂志 ›› 2026, Vol. 35 ›› Issue (2): 141-146.DOI: 10.3969/j.issn.1006-298X.2026.02.007

• 论著 • 上一篇    下一篇

SINUOUS 肝素涂层覆膜支架治疗血液透析通路流出道静脉狭窄 / 闭塞的多中心临床试验 1 年随访结果

  

  • 出版日期:2026-04-28 发布日期:2026-04-23

SINUOUS heparin-coated stent graft for the treatment of hemodialysis access outflow vein stenosis/occlusion:one-year follow-up results of multicenter clinical trial

  • Online:2026-04-28 Published:2026-04-23

摘要: 目的:评估国产 SINUOUS 肝素涂层覆膜支架治疗血液透析通路流出道静脉狭窄或闭塞的安全性与有效性。方法:采用前瞻性、多中心、单臂临床试验设计,共纳入 151 例血液透析通路流出道静脉狭窄 / 闭塞患者。以术后 12 个月靶病变初级通畅率 (TLPP) 为主要终点,同时评估其安全性。结果:技术成功率和手术成功率均为 100%。术后 12 个月 TLPP 在全分析集和符合方案集分别为 54.67% 和 58.16%。器械相关严重不良事件为 6.00%,9 例死亡病例均与器械无关。亚组分析显示,合并糖尿病、靶病变性质及通路类型对 TLPP 无显著影响,但病变位于中心静脉时通畅率优于外周静脉 (66.67% vs49.20%,P<0.05)。结论:SINUOUS 肝素涂层覆膜支架治疗安全性与有效性明确,术后 12 个月 TLPP 与国外同类产品相当。亚组分析显示其在中心静脉病变中疗效更优,为临床个体化治疗提供参考,对推动该领域国产替代具有重要意义。

关键词: 透析通路, 流出道静脉狭窄, 覆膜支架

Abstract: Objective:To evaluate the safety and efficacy of the dometic SINUOUS heparin-coated stent graft in treating stenosis or occlusion of the hemodialysis access outflow vein. Methods:A prospective,multicenter,single-arm study was conducted,with 151 patients enrolled.The primary endpoint was the target lesion primary patency (TLPP) at 12 months postoperation.The safety was also assessed. Results:The device and procedural success rates were 100%.The TLPP at 12 months was 54.67% in the full analysis set and 58.16% in the per-protocol set.Device-related serious adverse events was 6.00%,and all deaths were unrelated to the device. Conclusion:The SINUOUS heparin-coated stent graft demonstrated good efficacy and safety with patency comparable to those of similar imported devices.The subgroup analysis showed a better efficacy in cases of arteriovenous fistula and central venous lesions,providing a reference for individualized clinical treatment.It is of great significance for the domestic substitution.