指南与共识心血管介入CTMR

胸主动脉修复临床试验标准化终点定义共识

Standardized End Point Definitions for Clinical Trials in Thoracic Aortic Repair: A Consensus Report From the ARCH-Academic Research Consortium.
指南 / 共识 · Circulation · 2026-06-01

ARCH-ARC 由多学科国际专家与 FDA、产业界代表组成,于 2021—2025 年召开会议,针对升主动脉及主动脉弓病变的腔内、杂交和开放手术临床试验制定统一临床终点与定义。该共识借鉴既往心脏、神经、肾脏及出血终点工作,重点规范弓部解剖、病理、操作及影像相关终点,以促进事件判定与研究间比较。

要点

  • 临床报告中可参照 ARCH-ARC 标准统一描述弓部血管事件与终点。
  • 影像相关终点需按共识定义区分升主动脉与弓部解剖分区。
  • 多中心研究判读时优先采用共识推荐的标准化影像终点。

核心结论

  • ARCH-ARC 共识为升主动脉及弓部病变的腔内、杂交和开放手术临床试验提供了统一的临床终点与标准化定义模板。

研究设计与样本

  • 共识由心脏外科、血管外科、血管医学、心脏科、神经科、放射科及临床试验专家与 FDA、产业界代表制定。
  • 2021 至 2025 年通过线上会议讨论,采用共识方法确定适用终点并标准化定义。

关键影像表现/征象

  • 共识聚焦主动脉弓特有解剖、病理、操作及影像相关终点定义。

诊断标准与关键数值

  • 共识标准化了升主动脉及弓部腔内、杂交与开放手术临床试验的临床终点与定义。

临床应用与阅片要点

  • 采用 ARCH-ARC 共识定义可作为统一事件判定与报告模板。
  • 影像科报告弓部病变时可参考该共识进行一致的解剖与病理描述。

以上解读依据论文摘要(全文未开放获取或许可不允许翻译转载)。

英文原文(摘要)· 点击展开

Innovation in the treatment of ascending aorta and arch pathology with novel catheter-based and hybrid procedures has driven the need for a strategy to guide their safe application. The ARCH-ARC (Aortic Arch Academic Research Consortium) was established to pragmatically develop consistent clinical end points and to standardize definitions for use in studies of these new technologies. The ARCH-ARC team, consisting of independent international specialists in cardiac surgery, vascular surgery, vascular medicine, cardiology, neurology, radiology, and clinical trials, along with US Food and Drug Administration, industry, and contract research organization representatives, held virtual meetings from 2021 to 2025. Consensus was used to identify appropriate clinical end points and to standardize definitions of end points for endovascular, hybrid, and open surgical procedures in clinical trials in the ascending aorta and arch. Drawing on previous ARC work in cardiac, neurological, renal, and bleeding end points, the ARCH-ARC focused on definitions and end points related to aortic arch-specific anatomy, pathology, and procedures and clinical, device, and imaging. The adoption of the ARCH-ARC consensus definitions and end points will provide a template for consistent adjudication and event reporting and facilitate comparisons of clinical research studies involving devices for ascending aorta and arch pathology.

来源:Circulation,查看原文。版权归原作者所有。

引用

  1. Beck, Desai, Abel, et al. Standardized End Point Definitions for Clinical Trials in Thoracic Aortic Repair: A Consensus Report From the ARCH-Academic Research Consortium. Circulation. 2026. PMID: 42224373. doi:10.1161/CIRCULATIONAHA.125.078803

供执业医师工作参考,不替代临床判断;数值与分级以指南原文为准。