Jackson Damon, Tong David, Layland Jamie
Peninsula Health, Melbourne, Victoria, Australia; Monash Heart, Monash Health, Melbourne, Victoria, Australia.
Peninsula Health, Melbourne, Victoria, Australia; St Vincent's Hospital, Melbourne, Victoria, Australia.
Int J Cardiol. 2017 Jan 1;226:77-86. doi: 10.1016/j.ijcard.2016.09.045. Epub 2016 Sep 16.
The drug coated balloon (DCB) platform offers several theoretical benefits over stent-based technologies. It allows the homogenous transfer of an anti-proliferative drug to reduce neo-intimal hyperplasia whilst potentially maintaining normal vessel anatomy and function. They also avoid the introduction of an additional stent layer in the context of in-stent restenosis. The data pertaining to the treatment of de-novo coronary disease still favors the new generation of drug eluting stents. DCB may, however, have a role in the context of challenging coronary anatomy and small vessel disease where results with stent insertion are poor. The body of evidence supporting the role of DCB in the treatment of in-stent restenosis is more substantial and appears to yield similar results to DES without the introduction of an additional stent layer. Further trials are required to clarify the ideal duration of dual anti-platelet treatment following DCB use and to further elucidate the ideal clinical context for their use.
与基于支架的技术相比，药物涂层球囊（DCB）平台具有若干理论优势。它能使抗增殖药物均匀传递，以减少新生内膜增生，同时有可能维持血管的正常解剖结构和功能。在支架内再狭窄的情况下，DCB还可避免引入额外的支架层。关于初发冠心病治疗的数据仍支持新一代药物洗脱支架。然而，在冠状动脉解剖结构复杂和小血管病变中，支架置入效果不佳，DCB可能发挥作用。支持DCB在支架内再狭窄治疗中作用的证据更为充分，且在不引入额外支架层的情况下，似乎能产生与药物洗脱支架相似的效果。需要进一步试验来明确DCB使用后双联抗血小板治疗的理想持续时间，并进一步阐明其理想的临床应用场景。
