Kim Hyun Kuk, Jeong Myung Ho
The Heart Research Center Nominated by Korea Ministry of Health and Welfare, Chonnam National University Hospital, Gwangju, Korea. ; Korea Cardiovascular Stent Research Institute, Chonnam National University, Gwangju, Korea.
Chonnam Med J. 2012 Dec;48(3):141-9. doi: 10.4068/cmj.2012.48.3.141. Epub 2012 Dec 21.
The advances of interventional cardiology have been achieved by new device development, finding appropriate drug regimes, and understanding of pathomechanism. Drug-eluting stents (DES) implantation with dual anti-platelet therapy reduced revascularization without increasing mortality or myocardial infarction compared with bare-metal stenting. However, late-term stent thrombosis (ST) and restenosis limited its value and raised the safety concern. Main mechanisms of this phenomenon are impaired endothelialization and hypersensitivity reaction with polymer. The second generation DES further improved safety and/or efficacy by using thinner stent strut and biocompatible polymer. Recently, new concept DES with biodegradable polymer, polymer-free and bioabsorbable scaffold are under investigation in the quest to minimize the risk of ST.
介入心脏病学的进展得益于新设备的研发、合适药物治疗方案的探索以及病理机制的深入理解。与裸金属支架植入相比，药物洗脱支架（DES）植入联合双联抗血小板治疗可减少血管重建，且不增加死亡率或心肌梗死发生率。然而，晚期支架血栓形成（ST）和再狭窄限制了其价值，并引发了安全性担忧。这一现象的主要机制是内皮化受损和对聚合物的过敏反应。第二代DES通过使用更薄的支架小梁和生物相容性聚合物进一步提高了安全性和/或有效性。最近，为将ST风险降至最低，正在研究具有可生物降解聚合物、无聚合物和可生物吸收支架的新概念DES。
