Rathore Sudhir, Kaul Upendra
Department of Cardiology, St. George's Healthcare NHS Trust, London, UK.
Indian Heart J. 2011 May-Jun;63(3):228-33.
Small vessel (< 3 mm) coronary artery disease is common and has been identified as independent predictor of restenosis after percutaneous coronary intervention. It remains controversial whether bare metal stent (BMS) implantation in small vessels has an advantage over balloon angioplasty in terms of angiographic and clinical outcomes. Introduction of drug-eluting stent (DES) has resulted in significant reduction in restenosis and the need for repeat revascularisation. Several DESs have been introduced resulting in varying reduction in outcomes as compared to BMS. However, their impact on outcomes in small vessels is not clearly known. It is expected that DES could substantially reduce restenosis in smaller vessels. Large, randomised studies are warranted to assess the impact of different DES on outcomes in patients with small coronary arteries.
小血管（<3毫米）冠状动脉疾病很常见，并且已被确定为经皮冠状动脉介入治疗后再狭窄的独立预测因素。在小血管中植入裸金属支架（BMS）在血管造影和临床结果方面是否优于球囊血管成形术仍存在争议。药物洗脱支架（DES）的引入已使再狭窄和重复血管重建的需求显著减少。几种DES已被引入，与BMS相比，其在降低再狭窄方面效果各异。然而，它们对小血管患者预后的影响尚不清楚。预计DES可大幅降低较小血管中的再狭窄。有必要开展大型随机研究，以评估不同DES对小冠状动脉患者预后的影响。
