Lowe Harry C, Schwartz Robert S, Mac Neill Briain D, Jang Ik-Kyung, Hayase Motoya, Rogers Campbell, Oesterle Stephen N
Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Catheter Cardiovasc Interv. 2003 Dec;60(4):515-23. doi: 10.1002/ccd.10705.
Drug-eluting stents are revolutionizing interventional cardiology. Sirolimus-eluting stents are in widespread clinical use, associated with well-documented remarkably low restenosis rates, and a number of other agents appear promising in clinical trials. These human studies have been preceded by numerous animal studies, foremost among them the pig coronary model of in-stent restenosis (ISR). The histologic response to porcine coronary stenting was described over a decade ago. Porcine stenting studies now provide examinations not only of histology, but also mechanisms of action, toxicity, and biocompatibility. This review therefore examines the current status of this porcine coronary model of ISR. Contemporary methods of pig coronary stenting are discussed. The morphometric, cellular, and molecular analyses of the responses to stent injury are then described. Finally, recent pig coronary drug-eluting stent studies are examined, with a discussion of their advantages, limitations, and possible future modifications.
药物洗脱支架正在彻底改变介入心脏病学。西罗莫司洗脱支架已在临床广泛应用，其再狭窄率极低且有充分的文献记载，还有许多其他药物在临床试验中显示出前景。在这些人体研究之前有大量动物研究，其中最重要的是支架内再狭窄（ISR）的猪冠状动脉模型。对猪冠状动脉支架置入术的组织学反应在十多年前就有描述。现在猪支架置入术研究不仅提供组织学检查，还包括作用机制、毒性和生物相容性研究。因此，本综述探讨了这种猪冠状动脉ISR模型的现状。讨论了当代猪冠状动脉支架置入术的方法。然后描述了对支架损伤反应的形态计量学、细胞和分子分析。最后，研究了近期猪冠状动脉药物洗脱支架的研究，讨论了其优点、局限性以及未来可能的改进。
