RAPCO試験の長期的な結果
Brian F Buxton1,2, Philip A Hayward2, Jai Raman1,2
1Department of Cardiac Surgery, Austin Hospital, Melbourne, Australia (B.F.B., J.R., S.C.M., S.S., G.M.).
Circulation
|October 5, 2020
まとめ
放射性動脈 (RA) は,冠動脈バイパス手術における右側内胸動脈 (RITA) とサフェノス静脈 (SV) 移植と比較して,長期間通路性が優れている. 患者の生存率の向上とも相関する可能性がある.
科学分野:
- 心血管外科
- 血管移植
- 臨床試験
背景:
- 冠動脈バイパス移植 (CABG) は通常,胸動脈内部の移植を用いる.
- CABGのための2番目のパイプの最適な選択は,議論の対象であり続けています.
- この論争に対処するために,放射線動脈パテンシーと臨床結果 (RAPCO) 試験が開始されました.
研究 の 目的:
- 放射線動脈 (RA) と右胸内動脈 (RITA) の長期的な透かしを比較する.
- 放射線動脈 (RA) と 静脈 (SV) の 長期間の透き率を比較する.
主な方法:
- RAPCO- RITA: 394人の患者がRAまたはフリーRITA移植にランダムに割り当てられました.
- RAPCO- SV: 225人の患者がRAまたはSV移植にランダムに割り当てられました.
- 主要結果: 10年後の移植不全; 副次結果: 10年後の生存率
主要な成果:
- 10年後のRAの通病率 (89%) は,自由RITA (80%) とSV (71%) よりも著しく高かった.
- RAはRITA (HR 0. 45) とSV (HR 0. 40) に比べ,移植不全のリスクが低いことを示した.
- 10年生存率は,RITA (90. 9% vs 83. 7%) とSV (72. 6% vs 65. 2%) と比較して,RA群で高かった.
結論:
- 半径動脈は自由RITAとSVの2つの移植よりも10年経つ経路率を大幅に高めている.
- これらの発見は,CABGにおける有利な第2回管として放射性動脈の使用を支持する.
- 患者の長期生存率を向上させる可能性があります.
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