Alibegovic Zaza J, Zaza S
Rev Med Suisse. 2015 Mar 4;11(464):546, 548-52.
The new generation drug eluting stents have improved the results of coronary angioplasty by reducing the rate of instent restenosis and stent thrombosis compared to earlier devices, due to the thinner stent struts and improved or bioresorbable polymers. But permanent metallic stent struts may have some long term harmful effects such as inducing late thrombosis, neoatherosclerosis, restenosis and also impairing vasomotion and endothelial function. This was the rationale for introducing bioresorbable stents which offer radial support to the artery during the period needed (scaffolding) and then disappear, (liberating the vessels and restoring its physiological vasomotion. New randomized studies have shown their non-inferiority compared to new generation metallic drug eluting stents, but there are still some challenges to be overcome.
新一代药物洗脱支架通过与早期器械相比减少支架内再狭窄和支架血栓形成的发生率,改善了冠状动脉血管成形术的效果,这得益于更薄的支架小梁以及改良的或可生物吸收的聚合物。但是永久性金属支架小梁可能会有一些长期有害影响,如诱发晚期血栓形成、新生动脉粥样硬化、再狭窄,还会损害血管运动和内皮功能。这就是引入可生物吸收支架的基本原理,可生物吸收支架在所需时间段内为动脉提供径向支撑(支架作用),然后消失(解放血管并恢复其生理血管运动)。新的随机研究表明,与新一代金属药物洗脱支架相比,它们并不逊色,但仍有一些挑战有待克服。