Brie Daniel, Penson Peter, Serban Maria-Corina, Toth Peter P, Simonton Charles, Serruys Patrick W, Banach Maciej
Institute for Cardiovascular Medicine Timisoara, Cardiology Department, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania.
School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, UK.
Int J Cardiol. 2016 Jul 15;215:47-59. doi: 10.1016/j.ijcard.2016.04.027. Epub 2016 Apr 12.
Today, drug-eluting metal stents are considered the gold standard for interventional treatment of coronary artery disease. While providing inhibition of neointimal hyperplasia, drug-eluting metal stents have many limitations such as the risk of late and very late stent thrombosis, restriction of vascular vasomotion and chronic local inflammatory reaction due to permanent implantation of a 'metallic cage', recognized as a foreign body. Bioresorbable scaffold stents (BRS) are a new solution, which is trying to overcome the limitation of the 'metallic cage'. This structure provides short-term scaffolding of the vessel and then disappears, leaving nothing behind. The purpose of this review is to present the theoretical rationale for the use of BRS and to outline the clinical outcomes associated with their use in terms of data obtained from RCTs, clinical trials, registries and real life use. We have also tried to answer all questions on this intervention based on available data, with a focus on ABSORB BVS (Abbott Vascular, Santa Clara, USA). We consider that this new technology can be the "magic bullet" to treat coronary artery disease.
如今，药物洗脱金属支架被视为冠状动脉疾病介入治疗的金标准。在抑制内膜增生的同时，药物洗脱金属支架存在诸多局限性，如晚期和极晚期支架血栓形成风险、由于“金属笼”永久植入（被视为异物）导致的血管舒缩受限以及慢性局部炎症反应。生物可吸收支架（BRS）是一种新的解决方案，旨在克服“金属笼”的局限性。这种结构为血管提供短期支撑，随后消失，不留任何痕迹。本综述的目的是阐述使用BRS的理论依据，并根据随机对照试验、临床试验、注册研究和实际应用中获得的数据，概述其使用相关的临床结果。我们还试图根据现有数据回答关于该干预措施的所有问题，重点关注ABSORB生物可吸收血管支架（美国圣克拉拉雅培血管公司）。我们认为这项新技术可能成为治疗冠状动脉疾病的“神奇子弹”。
