Toklu Bora, Bangalore Sripal
Virginia Commonwealth University School of Medicine, Richmond, VA, USA.
Curr Cardiol Rep. 2014 Apr;16(4):469. doi: 10.1007/s11886-014-0469-4.
Research and development in the field of coronary stent design is a fast-evolving and fascinating journey. A device that was once introduced to salvage acute closure associated with balloon angioplasty is now the standard of care for many patients with coronary artery disease. Newer generation stents are the product of remarkable progress in technology and innovation, driven by the need to make the stents easier to deliver and to improve their safety and efficacy. As such, the design of these stents has become quite sophisticated and complex. The number of available stents has increased giving patients and physicians more choices on one hand, but also created confusion in selecting the optimal stent for a given patient. Although a 'one size fits all' approach may not be reasonable, several randomized trials have attested to the efficacy and safety of newer generation durable polymer drug eluting stents. This article discusses the evidence base to support various stent choices in contemporary practice.
冠状动脉支架设计领域的研发是一段快速发展且引人入胜的历程。一种曾经用于挽救与球囊血管成形术相关的急性闭塞的装置,如今已成为许多冠心病患者的标准治疗手段。新一代支架是技术与创新取得显著进步的产物,这是出于使支架更易于输送以及提高其安全性和有效性的需求。因此,这些支架的设计变得相当精密和复杂。可用支架的数量增加了,一方面为患者和医生提供了更多选择,但同时也在为特定患者选择最佳支架时造成了困惑。尽管“一刀切”的方法可能不合理,但多项随机试验已证实新一代耐用聚合物药物洗脱支架的有效性和安全性。本文讨论了支持当代实践中各种支架选择的证据基础。