药物洗脱支架：当前问题
Drug-eluting stents: current issues.
作者信息
Ong Andrew T L, Serruys Patrick W
机构信息
Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands.
出版信息
Tex Heart Inst J. 2005;32(3):372-7.
Early stent thrombosis occurs in about 1% to 1.5% of patients with drug-eluting stents, very similar to the rate with bare-metal stents. Late stent thrombosis is more of a concern with drug-eluting stents, with an incidence of at least 0.35%. I would urge caution if you feel you have to stop antiplatelet therapy in patients with drug-eluting stents. While neointima formation peaks at 6 months and then may actually regress with bare-metal stents, it continues to grow with drug-eluting stents--although this process appears to plateau by 4 years with sirolimus. With the others, we have to wait and see. We still don't know the best drug-eluting stent. Trials are under way to compare stents with surgery, and the future brings the arrival of a number of exciting new devices and approaches that are now entering clinical trials.
药物洗脱支架植入患者中，早期支架血栓形成的发生率约为1%至1.5%，与裸金属支架的发生率非常相似。晚期支架血栓形成在药物洗脱支架方面更值得关注，发生率至少为0.35%。如果觉得必须停用药物洗脱支架植入患者的抗血小板治疗，我强烈建议谨慎行事。虽然裸金属支架植入后新生内膜形成在6个月时达到峰值，随后可能会消退，但药物洗脱支架植入后新生内膜仍会持续生长——不过西罗莫司洗脱支架植入后这一过程在4年后似乎趋于平稳。对于其他药物洗脱支架，我们还需拭目以待。我们仍不清楚哪种药物洗脱支架最佳。目前正在进行试验以比较支架与手术治疗效果，未来会有许多令人兴奋的新设备和方法进入临床试验阶段。
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