Di Mario Carlo, Griffiths Huw, Goktekin Omer, Peeters Nicolas, Verbist Jan, Bosiers Marc, Deloose Koen, Heublein Bernhard, Rohde Roland, Kasese Victor, Ilsley Charles, Erbel Raimund
Royal Brompton Hospital, London, UK.
J Interv Cardiol. 2004 Dec;17(6):391-5. doi: 10.1111/j.1540-8183.2004.04081.x.
Current stent technology is based on the use of permanent implants that remain life long in the vessel wall, far beyond the time required for the prosthesis to accomplish its main goals of sealing dissection and preventing wall recoil. With the possibility to implant long vessel segments using antiproliferative drugs to prevent restenosis, the practice of transforming the coronary vessels into stiff tubes with a full metal jacket covering all side branches and being unable to adjust to the long-term wall changes, including wall remodeling with lumen ectasia becomes a serious concern. In this article, we describe the first biodegradable stent based on a magnesium alloy that allows controlled corrosion with release to the vessel wall and the blood stream of a natural body component such as magnesium with beneficial antithrombotic, antiarrhythmic, and antiproliferative properties. We also discuss the animal experiments and the initial clinical applications in 20 patients with implants below the knee, with final results soon to be released, and the plans for the first coronary study. The results of these last two studies will indicate whether the absence of a permanent implant and the antiproliferative properties shown in animals are sufficient to prevent the restenotic process in humans or whether the prosthesis must be modified by adding the biodegradable coating with conventional antiproliferative drugs.
当前的支架技术基于使用永久性植入物，这些植入物会长期留存于血管壁中，远远超过假体实现其封闭夹层和防止血管壁回缩这两个主要目标所需的时间。随着使用抗增殖药物植入长血管段以预防再狭窄成为可能，将冠状动脉转变为被完整金属套覆盖所有侧支且无法适应长期血管壁变化（包括伴有管腔扩张的血管重塑）的坚硬管道这种做法，成为了一个严重问题。在本文中，我们描述了首个基于镁合金的可生物降解支架，该支架能实现可控腐蚀，并向血管壁和血流释放诸如镁这种具有有益抗血栓形成、抗心律失常和抗增殖特性的天然身体成分。我们还讨论了动物实验以及在20名膝下植入患者中的初步临床应用，最终结果即将公布，以及首个冠状动脉研究计划。这最后两项研究的结果将表明，无永久性植入物以及在动物实验中显示的抗增殖特性是否足以预防人类的再狭窄过程，或者假体是否必须通过添加含有传统抗增殖药物的可生物降解涂层进行改进。
