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支架设计的工程学方面及其向临床实践的转化。

Engineering aspects of stents design and their translation into clinical practice.

作者信息

Sangiorgi Giuseppe, Melzi Gloria, Agostoni Pierfrancesco, Cola Clarissa, Clementi Fabrizio, Romitelli Paolo, Virmani Renu, Colombo Antonio

机构信息

Ospedale San Raffaele, Via Olgettina 64, 20132 Milan, Italy.

出版信息

Ann Ist Super Sanita. 2007;43(1):89-100.

Abstract

The implantation of coronary stents is a relevant part of interventional procedures for percutaneous revascularization. The wide acceptance of coronary stenting was based on the results of two highly significant trials which have shown the superiority of stenting over balloon angioplasty in terms of reduction of angiographic restenosis and need for repeated intervention in focal lesions and large coronary arteries. Since then, the growing use of stent market was impressive. A rapidly increasing number of different stent type with different material and designs has been introduced in the market both for bare metal stent and drug eluting stent. This review will summarize the different components of stent design that are important in term of biological response of the arterial wall and clinical outcome. In addition, new stent platforms, mainly represented by the biodegradable stent will be shortly reviewed since it may provide in the near future a more "physiological" answer to stent implantation, reducing vascular injury and accelerating vessel healing with consequent improving in clinical outcome.

摘要

冠状动脉支架植入是经皮血管重建介入手术的一个重要组成部分。冠状动脉支架的广泛应用基于两项具有高度显著性的试验结果,这些试验表明,在减少血管造影再狭窄以及减少对局限性病变和大冠状动脉进行重复干预的必要性方面,支架植入优于球囊血管成形术。从那时起,支架市场的使用量增长令人印象深刻。市场上已经推出了越来越多不同类型、具有不同材料和设计的支架,包括裸金属支架和药物洗脱支架。本综述将总结支架设计的不同组成部分,这些部分在动脉壁的生物学反应和临床结果方面具有重要意义。此外,将简要回顾主要以可生物降解支架为代表的新支架平台,因为在不久的将来,它可能为支架植入提供更“生理性”的解决方案,减少血管损伤并加速血管愈合,从而改善临床结果。

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