Wayangankar Siddharth A, Ellis Stephen G
Cleveland Clinic, OH.
Cleveland Clinic, OH.
Prog Cardiovasc Dis. 2015 Nov-Dec;58(3):342-55. doi: 10.1016/j.pcad.2015.08.011. Epub 2015 Aug 28.
Current drug-eluting stents (DES) have shown excellent safety and efficacy in various clinical settings. However, the presence of a permanent metallic scaffold remains an Achilles heel, with concerns for late stent thrombosis and the need for prolonged dual anti-platelet therapy. The bioresorbable vascular scaffold (BRS) has been termed the fourth revolution in interventional cardiology, with an ability to not only treat the coronary lesion, but also restore endothelial function after complete absorption. The absence of a permanent scaffold after months of implantation has the potential to overcome the shortcomings of current metallic DES and markedly impact interventional cardiology practice around the world. This review article focuses on the history, development and clinical studies on various BRS and attempts to predict how this technology could impact future cardiology practice.
目前的药物洗脱支架(DES)在各种临床环境中已显示出卓越的安全性和有效性。然而,永久性金属支架的存在仍然是一个致命弱点,存在晚期支架血栓形成的担忧以及需要长期双重抗血小板治疗。生物可吸收血管支架(BRS)被称为介入心脏病学的第四次革命,它不仅能够治疗冠状动脉病变,还能在完全吸收后恢复内皮功能。植入数月后不存在永久性支架有可能克服当前金属DES的缺点,并显著影响全球介入心脏病学实践。这篇综述文章重点关注各种BRS的历史、发展和临床研究,并试图预测这项技术将如何影响未来的心脏病学实践。