Panoulas Vasileios F, Mastoris Ioannis, Konstantinou Klio, Tespili Maurizio, Ielasi Alfonso
National Heart and Lung Institute, Imperial College London, London, UK.
Interventional Cardiovascular Research and Clinical Trials, The Zena and Michael A Wiener Cardiovascular Institute, The Icahn School of Medicine at Mount Sinai, New York NY, USA.
Med Devices (Auckl). 2015 Jul 24;8:317-29. doi: 10.2147/MDER.S66360. eCollection 2015.
Despite the remarkable benefits obtained following the introduction of the first-generation drug-eluting stent (DES), concerns were raised over its long-term safety, particularly with regard to very late (beyond 1 year) stent thrombosis. Newer-generation DESs have been developed to overcome this limitation using novel stent platforms, new drugs, more biocompatible durable polymers, and bioabsorbable polymers or backbones. To date, new-generation DESs have virtually replaced the use of first-generation DESs worldwide. In this review article, we discuss in detail the design, pharmacology, and mechanism of action of the newer-generation permanent and bioresorbable everolimus-eluting platforms. Furthermore, we present and evaluate the current evidence on the performance and safety of these devices compared to those of other available stent platforms.
尽管第一代药物洗脱支架(DES)问世后带来了显著益处,但人们对其长期安全性提出了担忧,尤其是关于极晚期(超过1年)支架血栓形成的问题。新一代DES已被开发出来,通过使用新型支架平台、新药、生物相容性更好的耐用聚合物以及可生物吸收的聚合物或骨架来克服这一局限性。迄今为止,新一代DES在全球范围内几乎已取代了第一代DES的使用。在这篇综述文章中,我们详细讨论了新一代永久性和可生物吸收的依维莫司洗脱平台支架的设计、药理学及作用机制。此外,我们展示并评估了与其他现有支架平台相比,这些装置在性能和安全性方面的现有证据。