Ju M H, Rodríguez H E
Division of Vascular Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL 60661, USA.
J Cardiovasc Surg (Torino). 2012 Aug;53(4):459-63.
The aim of this article was to review the available literature on the use of drug-coated balloons (DCB) for endovascular treatment of femoropopliteal arterial stenosis.
Manual searches of articles, presentations, and clinical trials were performed. Selected references were reviewed and summarized.
Due to the high morbidity associated with femoropopliteal bypass, endovascular approaches, such as balloon angioplasty and stent placement, have become the first line of therapy for isolated, de novo femoral atherosclerosis. However, percutaneous interventions have been limited by restenosis. In an effort to overcome this obstacle, the use of antiproproliferative drugs to inhibit hyperplasia has been attempted. The success of drug-eluting stents (DES) in the coronary circulation has not been reproduced in the femoropopliteal segment. Animal and human experiments have shown prolonged inhibition of intimal hyperplasia with single delivery of large doses of paclitaxel during balloon angioplasty. Recent randomized trials have shown significant advantages at 12 and 24 month angiographic follow-up with the use of DCB when compared to standard balloon angioplasty.
Several clinical trials have demonstrated promising early results with the use of DCB in treating femoropopliteal stenosis. However, long term results, exact indications, and optimal applications are yet to be determined.
本文旨在综述有关药物涂层球囊（DCB）用于股腘动脉狭窄血管内治疗的现有文献。
对手工检索的文章、报告和临床试验进行了研究。对选定的参考文献进行了综述和总结。
由于股腘动脉旁路移植术相关的高发病率，血管内治疗方法，如球囊血管成形术和支架置入术，已成为孤立性、原发性股动脉粥样硬化的一线治疗方法。然而，经皮介入治疗一直受到再狭窄的限制。为了克服这一障碍，人们尝试使用抗增殖药物来抑制增生。药物洗脱支架（DES）在冠状动脉循环中的成功尚未在股腘动脉段重现。动物和人体实验表明，在球囊血管成形术期间单次给予大剂量紫杉醇可延长对内膜增生的抑制作用。最近的随机试验表明，与标准球囊血管成形术相比，使用DCB在12个月和24个月血管造影随访时有显著优势。
多项临床试验表明，使用DCB治疗股腘动脉狭窄取得了令人鼓舞的早期结果。然而，长期结果、确切适应症和最佳应用仍有待确定。
