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冠状动脉生物可吸收血管支架在冠状动脉疾病治疗中的应用。

Coronary Bioresorbable Vascular Scaffold Use in the Treatment of Coronary Artery Disease.

作者信息

Testa Luca, Latib Azeem, Montone Rocco A, Colombo Antonio, Bedogni Francesco

机构信息

From the Department of Cardiology, IRCCS Pol. S. Donato, S.Donato Milanese, Milan, Italy (L.T., R.A.M., F.B.); and Interventional Cardiology Unit, San Raffaele Scientific Institute and EMO-GVM Centro Cuore Columbus, Milan, Italy (A.L., A.C.).

出版信息

Circ Cardiovasc Interv. 2016 Jul;9(7). doi: 10.1161/CIRCINTERVENTIONS.116.003978.

Abstract

Bioresorbable vascular scaffolds (BVS) represent a promising novel approach for the treatment of coronary artery disease. BVS promise to address some of the well-known limitations of current drug-eluting stents, while providing a transient scaffolding of the vessel to prevent acute vessel closure/recoil. Drug elution by BVS prevents neointimal proliferation in a similar fashion to drug-eluting stents, and complete bioresorption is associated with late vessel lumen enlargement, plaque regression, and restoration of vasomotion. Based on the pathophysiological reasons and on the results derived from clinical studies, BVS are increasingly being used in clinical practice. The aim of this review is to provide an overview of the current evidence supporting the use of BVS in clinical practice. In particular, we will discuss the randomized controlled trials and registries evaluating the clinical outcome of these devices, with a special focus on their application in patients with acute coronary syndrome and in specific lesion subsets (bifurcations, chronic total occlusions, and in-stent restenosis).

摘要

生物可吸收血管支架(BVS)是治疗冠状动脉疾病的一种有前景的新方法。BVS有望解决当前药物洗脱支架的一些众所周知的局限性,同时为血管提供临时支架以防止急性血管闭塞/回缩。BVS的药物洗脱以与药物洗脱支架类似的方式防止内膜增生,完全生物吸收与晚期血管腔扩大、斑块消退和血管运动恢复有关。基于病理生理原因和临床研究结果,BVS在临床实践中的应用越来越多。本综述的目的是概述支持BVS在临床实践中应用的现有证据。特别是,我们将讨论评估这些装置临床结果的随机对照试验和注册研究,特别关注它们在急性冠状动脉综合征患者和特定病变亚组(分叉病变、慢性完全闭塞和支架内再狭窄)中的应用。

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