Hascoët Sebastien, Baruteau Alban, Jalal Zakaria, Mauri Lucia, Acar Philippe, Elbaz Meyer, Boudjemline Younes, Fraisse Alain
Groupe de cathétérisme interventionnel pédiatrique et congénital, filiale de cardiologie pédiatrique et congénitale de la Société française de cardiologie, France; M3C CHU Toulouse, Paediatric and Congenital Cardiology, Children's Hospital, Paul-Sabatier University, 31059 Toulouse, France; Inserm UMR 1048, Équipe 8, I2MC, institut des maladies métaboliques et cardiovasculaires, Paul-Sabatier University, 31432 Toulouse, France; CHU Toulouse, Department of Cardiology, Rangueil Hospital, Paul-Sabatier University, 31400 Toulouse, France.
Groupe de cathétérisme interventionnel pédiatrique et congénital, filiale de cardiologie pédiatrique et congénitale de la Société française de cardiologie, France; M3C Marie-Lannelongue Hospital, Paediatric and Congenital Cardiac Surgery, Paris Sud University, 92350 Paris, France; Inserm UMR 1087, CNRS UMR6291, institut du thorax, Nantes University, 70721 Nantes, France.
Arch Cardiovasc Dis. 2014 Aug-Sep;107(8-9):462-75. doi: 10.1016/j.acvd.2014.06.005. Epub 2014 Aug 12.
A 'stent' is a tubular meshed endoprosthesis that has contributed to the development of interventional catheterization over the past 30 years. In congenital heart diseases, stents have offered new solutions to the treatment of congenital vessel stenosis or postsurgical lesions, to maintain or close shunt patency, and to allow transcatheter valve replacement. First, stents were made of bare metal. Then, stent frameworks evolved to achieve a better compromise between radial strength and flexibility. However, almost all stents used currently in children have not been approved for vascular lesions in children and are therefore used 'off-label'. Furthermore, the inability of stents to follow natural vessel growth still limits their use in low-weight children and infants. Recently, bioresorbable stents have been manufactured and may overcome this issue; they are made from materials that may dissolve or be absorbed in the body. In this review, we aim to describe the history of stent development, the technical characteristics of stents used currently, the clinical applications and results, and the latest technological developments and perspectives in paediatric and adult congenital cardiac catheterization.
“支架”是一种管状网状腔内假体,在过去30年里推动了介入导管技术的发展。在先天性心脏病中,支架为先天性血管狭窄或术后病变的治疗提供了新的解决方案,以维持或封闭分流的通畅,并允许经导管瓣膜置换。最初,支架由裸金属制成。随后,支架框架不断演进,以在径向强度和柔韧性之间取得更好的平衡。然而,目前几乎所有用于儿童的支架都未被批准用于儿童血管病变,因此属于“超适应证”使用。此外,支架无法随天然血管生长,这仍然限制了它们在低体重儿童和婴儿中的应用。最近,可生物吸收支架已被制造出来,可能会克服这一问题;它们由可在体内溶解或吸收的材料制成。在本综述中,我们旨在描述支架的发展历程、目前使用的支架的技术特征、临床应用及结果,以及儿科和成人先天性心脏导管插入术中的最新技术进展和前景。