Raja Shahzad G, Berg Geoffrey A
Department of Cardiothoracic Surgery, Western Infirmary Glasgow, Glasgow, UK.
Curr Drug Saf. 2007 Sep;2(3):212-9. doi: 10.2174/157488607781668918.
Coronary artery stenting is currently the most frequently performed percutaneous coronary intervention for the treatment of coronary artery disease. Recently, drug- eluting stents, loaded with anti-inflammatory, anti-migratory, anti-proliferative or pro-healing drugs, have revolutionized the management of coronary artery disease by markedly reducing in-stent restenosis. Despite the excellent short- and mid-term results of randomized controlled trials observed with drug-eluting stents, there remain a number of unresolved issues and valid concerns about long-term safety and efficacy of this revolutionary technology. Important safety issues such as thrombosis, late stent malapposition, aneurysm formation, edge effect, late inflammation due to choice of polymer used to bind the drug, the release of toxins, and potential interactions with brachytherapy and drugs have not been completely addressed. This review article evaluates current available scientific evidence on the various safety issues related to the use of drug-eluting stents.
冠状动脉支架置入术是目前治疗冠状动脉疾病最常用的经皮冠状动脉介入治疗方法。最近，装载有抗炎、抗迁移、抗增殖或促进愈合药物的药物洗脱支架，通过显著降低支架内再狭窄，彻底改变了冠状动脉疾病的治疗方式。尽管药物洗脱支架在随机对照试验中观察到了优异的短期和中期结果，但对于这项革命性技术的长期安全性和有效性，仍存在一些未解决的问题和合理的担忧。重要的安全问题，如血栓形成、晚期支架贴壁不良、动脉瘤形成、边缘效应、因用于结合药物的聚合物选择导致的晚期炎症、毒素释放以及与近距离放射治疗和药物的潜在相互作用，尚未得到完全解决。这篇综述文章评估了目前关于使用药物洗脱支架相关各种安全问题的现有科学证据。
