Foin Nicolas, Lee Renick D, Torii Ryo, Guitierrez-Chico Juan Luis, Mattesini Alessio, Nijjer Sukhjinder, Sen Sayan, Petraco Ricardo, Davies Justin E, Di Mario Carlo, Joner Michael, Virmani Renu, Wong Philip
National Heart Centre Singapore, Singapore.
National Heart Centre Singapore, Singapore.
Int J Cardiol. 2014 Dec 20;177(3):800-8. doi: 10.1016/j.ijcard.2014.09.143. Epub 2014 Oct 7.
Advances in the understanding of healing mechanisms after stent implantation have led to the recognition of stent strut thickness as an essential factor affecting re-endothelialization and overall long term vessel healing response after Percutaneous Coronary Interventions (PCI). Emergence of Drug-eluting stents (DESs) with anti-proliferative coating has contributed to reducing the incidence of restenosis and Target Lesion Revascularization (TVR), while progress and innovations in stent materials have in the meantime facilitated the design of newer platforms with more conformability and thinner struts, producing lesser injury and improving integration into the vessel wall. Recent advances in biodegradable metal and polymer materials now also allow for the design of fully biodegradable platforms, which are aimed at scaffolding the vessel only temporarily to prevent recoil and constrictive remodeling of the vessel during the initial period required, and are then progressively resorbed thereby avoiding the drawback of leaving an unnecessary implant permanently in the vessel. The aim of this article is to review recent evolution in stent material and stent strut design while understanding their impact on PCI outcomes. The article describes the different metallic alloys and biodegradable material properties and how these have impacted the evolution of stent strut thickness and ultimately outcomes in patients.
对支架植入后愈合机制认识的进展，已使人们认识到支架支柱厚度是影响经皮冠状动脉介入治疗（PCI）后再内皮化及整体长期血管愈合反应的一个重要因素。具有抗增殖涂层的药物洗脱支架（DES）的出现，有助于降低再狭窄和靶病变血运重建（TVR）的发生率，与此同时，支架材料的进展和创新促进了设计出更具顺应性且支柱更薄的新型平台，减少了损伤并改善了与血管壁的整合。可生物降解金属和聚合物材料的最新进展现在还使得完全可生物降解平台的设计成为可能，其目的是仅在所需的初始阶段临时支撑血管，以防止血管回缩和狭窄重塑，然后逐渐被吸收，从而避免了在血管中永久留下不必要植入物的缺点。本文的目的是回顾支架材料和支架支柱设计的最新进展，同时了解它们对PCI结果的影响。本文描述了不同的金属合金和可生物降解材料的特性，以及这些特性如何影响支架支柱厚度的演变以及最终对患者的治疗结果。
