Goicolea Ruigómez F J, Macaya Miguel C
Laboratorio de Hemodinámica y Cardiología Intervencionista, Hospital Clínico San Carlos, Madrid.
Rev Esp Cardiol. 1999 Feb;52(2):85-94.
In the last 3 years there has been a tenfold increase in stent use during percutaneous coronary angioplasty. In many laboratories the prevailing strategy is to implant a stent whenever there are no contraindications to its use. The authors argue that this strategy of generalized stenting is not founded on solid scientific data, and that part of the actual growth in stent use is due to procedural reasons as simplicity, predictability and time economy. Accordingly they analyze the main trials comparing balloon angioplasty with elective stenting as well as the actual limitations and complications of stent use. Finally they point out alternative solutions to generalized stenting like the identification of subsets of patients who could benefit from stenting after balloon angioplasty (provisional stenting strategy).
在过去3年中，经皮冠状动脉腔内血管成形术期间支架的使用增加了10倍。在许多实验室中，普遍的策略是只要没有使用支架的禁忌症，就植入支架。作者认为，这种普遍使用支架的策略并非基于确凿的科学数据，而且支架使用实际增长的部分原因是出于操作方面的原因，如操作简单、可预测性和节省时间。因此，他们分析了比较球囊血管成形术与选择性支架植入术的主要试验以及支架使用的实际局限性和并发症。最后，他们指出了普遍使用支架的替代解决方案，比如识别那些在球囊血管成形术后可能从支架植入术中获益的患者亚组（临时支架植入策略）。
