Beatt K J, Serruys P W, Hugenholtz P G
Thoraxcenter, Erasmus University, Rotterdam, The Netherlands.
J Am Coll Cardiol. 1990 Feb;15(2):491-8. doi: 10.1016/s0735-1097(10)80081-6.
With the high initial success rates for coronary angioplasty that are reported regularly, it has become increasingly difficult to demonstrate methods or techniques that are able to provide more beneficial early results than can be achieved by conventional angioplasty. On the other hand, the incidence of late restenosis has remained much the same over the 10 years that angioplasty has been part of clinical practice, and there is still no proved intervention that modifies the restenosis process. Therefore, the problem of restenosis has assumed increasing relevance in determining the clinical value of coronary angioplasty and, accordingly, studies that address the problem of restenosis need to become more exacting. Although numerous articles have addressed the problem of restenosis in the clinical setting, many defining certain factors associated with restenosis and possible interventions to reduce the incidence of restenosis, there is surprisingly little consensus. Most of the discrepancies can be attributed to three factors: 1) the selection of patients, 2) the method of analysis, and 3) the definition of restenosis employed. This review shows how these three factors influence the outcome and conclusions of restenosis studies.
随着冠状动脉血管成形术经常报告的高初始成功率，越来越难以证明哪些方法或技术能够提供比传统血管成形术更有益的早期结果。另一方面，在血管成形术成为临床实践一部分的10年里，晚期再狭窄的发生率基本保持不变，而且仍然没有经过证实的干预措施能够改变再狭窄过程。因此，再狭窄问题在确定冠状动脉血管成形术的临床价值方面变得越来越重要，相应地，解决再狭窄问题的研究需要变得更加严格。尽管有许多文章探讨了临床环境中的再狭窄问题，许多文章确定了与再狭窄相关的某些因素以及降低再狭窄发生率的可能干预措施，但令人惊讶的是，几乎没有达成共识。大多数差异可归因于三个因素：1）患者的选择，2）分析方法，3）所采用的再狭窄定义。这篇综述展示了这三个因素如何影响再狭窄研究的结果和结论。
