Habara Seiji, Mitsudo Kazuaki, Kadota Kazushige, Goto Tsuyoshi, Fujii Satoki, Yamamoto Hiroyuki, Katoh Harumi, Oka Naoki, Fuku Yasushi, Hosogi Shingo, Hirono Akitoshi, Maruo Takeshi, Tanaka Hiroyuki, Shigemoto Yoshikazu, Hasegawa Daiji, Tasaka Hiroshi, Kusunose Mana, Otsuru Suguru, Okamoto Yoji, Saito Naoki, Tsujimoto Yuki
Department of Cardiology, Kurashiki Central Hospital, Miwa, Kurashiki, Okayama, Japan.
Int Heart J. 2011;52(2):88-91. doi: 10.1536/ihj.52.88.
The efficacy of drug-eluting stents (DES) has been proven, but concerns about late complications after DES have been raised. Polymers that do not increase inflammatory or hypersensitivity reactions which may contribute to late complications are needed for new generation DES. To evaluate the safety and efficacy of phosphorylcholine-polymer coating, we investigated serial clinical and angiographic outcomes after phosphorylcholine-coated stent placement. Seventy-five consecutive patients treated with a BiodivYsio phosphorylcholine-coated stent for de novo lesions at our institute between October 2001 and August 2002 were enrolled. Six-month follow-up angiography was performed in 71 lesions (94.7%), and angiographic restenosis was found in 19 lesions (26.8%). Target lesion revascularization (TLR) was performed in 10 lesions (14.1%). Eighteen-month follow-up angiography was performed in 58 (95.1%) of the remaining 61 lesions (excluding TLR lesions), and angiographic restenosis was found in only 3 lesions. The cumulative MACE-free survival rate was 86.3%, 83.6%, and 78.6% at 6-month, 18-month, and 8-year follow-up, respectively. There were no episodes of stent thrombosis. Late loss decreased significantly from 0.74 ± 0.40 mm (6-months) to 0.51 ± 0.46 mm (18-months) (P < 0.0001). Phosphorylcholine-coated stent implantation was associated with acceptable clinical and angiographic results. Phosphorylcholine-coating may be an ideal polymer for new generation DESs.
药物洗脱支架(DES)的疗效已得到证实,但人们对DES术后的晚期并发症也有所担忧。新一代DES需要使用不会增加可能导致晚期并发症的炎症或过敏反应的聚合物。为了评估磷酸胆碱聚合物涂层的安全性和疗效,我们研究了磷酸胆碱涂层支架置入术后的系列临床和血管造影结果。纳入了2001年10月至2002年8月期间在我院连续接受BiodivYsio磷酸胆碱涂层支架治疗初发病变的75例患者。对71处病变(94.7%)进行了6个月的随访血管造影,发现19处病变(26.8%)存在血管造影再狭窄。对10处病变(14.1%)进行了靶病变血管重建术(TLR)。对其余61处病变(不包括TLR病变)中的58处(95.1%)进行了18个月的随访血管造影,仅发现3处病变存在血管造影再狭窄。在6个月、18个月和8年随访时,无主要不良心血管事件(MACE)生存率分别为86.3%、83.6%和78.6%。未发生支架血栓形成事件。晚期管腔丢失从6个月时的0.74±0.40mm显著降至18个月时的0.51±0.46mm(P<0.0001)。磷酸胆碱涂层支架植入术的临床和血管造影结果均可接受。磷酸胆碱涂层可能是新一代DES的理想聚合物。