Lindholm Daniel, James Stefan
Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden.
Uppsala Clinical Research Center, Dag Hammarskjölds väg 14B, SE-752 37, Uppsala, Sweden.
Curr Cardiol Rep. 2016 Aug;18(8):74. doi: 10.1007/s11886-016-0750-9.
The evolution of percutaneous coronary intervention has been considerable. Coronary stents were introduced to avoid vessel recoil and reduce acute and late vessel complications. Later, drug-eluting stents were developed to decrease the neointimal hyperplasia associated with bare metal stents in order to reduce restenosis. However, very late stent thrombosis remains problematic, and the permanent presence of a metal stent could be associated with local inflammation and impaired vascular physiology. Thus, bioresorbable stents have been developed, to prevent recoil initially when this risk is the highest, with subsequent degradation over time, to avoid long-term complications of the presence of stents in the coronary vasculature. Here, we review the current status of bioresorbable stents in percutaneous coronary intervention (PCI), with focus on the platforms that have been studied the most: ABSORB, DESolve, and DREAMS. In terms of clinical outcomes, bioresorbable stents have not yet shown superiority compared with current generation drug-eluting stents, but rather a signal of increased stent thrombosis. Further development and longer-term studies are needed before the routine implementation of bioresorbable stents in clinical practice.
经皮冠状动脉介入治疗的发展历程意义重大。冠状动脉支架的引入旨在避免血管回缩，并减少急性和晚期血管并发症。后来，药物洗脱支架得以研发，以减少与裸金属支架相关的新生内膜增生，从而降低再狭窄的发生率。然而，极晚期支架血栓形成仍然是个问题，而且金属支架的长期存在可能会引发局部炎症并损害血管生理功能。因此，可生物吸收支架应运而生，它在风险最高的初期能够防止血管回缩，随后随着时间推移逐渐降解，以避免冠状动脉血管中长期存在支架所带来的并发症。在此，我们回顾了可生物吸收支架在经皮冠状动脉介入治疗（PCI）中的现状，重点关注研究最多的几个平台：ABSORB、DESolve和DREAMS。在临床疗效方面，与当代药物洗脱支架相比，可生物吸收支架尚未显示出优势，反而有支架血栓形成增加的迹象。在可生物吸收支架常规应用于临床实践之前，还需要进一步的研发和长期研究。
