Arjomand Heidar, Turi Zoltan G, McCormick Daniel, Goldberg Sheldon
Department of Medicine, Drexel University College of Medicine, Philadelphia, Pa, USA.
Am Heart J. 2003 Nov;146(5):787-96. doi: 10.1016/S0002-8703(03)00153-4.
In the twenty-six years since Gruntzig introduced a simple balloon angioplasty technique, percutaneous coronary intervention has undergone extraordinary growth and has now surpassed bypass surgery in frequency of performance. Several critical breakthrough technologies account for this remarkable progress: intracoronary stents have increased success rates and reduced restenosis, adjunctive antiplatelet therapy has reduced periprocedural complications, and restenosis after stent placement has been effectively treated with local radiation. Most recently, drug-eluting stents coated with cell-cycle inhibitors have shown great promise for further reducing restenosis, possibly to negligible levels.
自格伦齐格引入简单的球囊血管成形术技术以来的26年里,经皮冠状动脉介入治疗取得了非凡的发展,目前其实施频率已超过搭桥手术。几项关键的突破性技术促成了这一显著进展:冠状动脉内支架提高了成功率并减少了再狭窄,辅助抗血小板治疗降低了围手术期并发症,支架置入后的再狭窄已通过局部放射有效治疗。最近,涂有细胞周期抑制剂的药物洗脱支架在进一步降低再狭窄方面显示出巨大前景,有可能将再狭窄降低到可忽略不计的水平。