Rapetto Claudio, Leoncini Massimo
S.S.D. Cardiologia Invasiva Endovascolare Sanremo, Sanremo, Italy.
J Thorac Dis. 2017 Aug;9(Suppl 9):S903-S913. doi: 10.21037/jtd.2017.06.34.
Drug-eluting stents (DES) have reached a high safety and efficacy profile, becoming the best option for percutaneous coronary interventions (PCI) based revascularization. However, despite their optimal performance, a few concerns remain regarding their use, mainly due to permanent caging of the vessels and its consequences, first of all late stent thrombosis (ST). Bioresorbable scaffolds (BRS) aim to overcome these issues. The results achieved in randomized controlled trials (RCT) by the first generation of poly-L-lactic acid (PLLA) based scaffolds were promising at 1 year, but the first long term reports (albeit flawed by non-optimal implantation technique) have been disappointing, showing, for instance, an increased risk of ST and target vessel myocardial infarction (TV-MI). In such a scenario the advent of a newer generation magnesium (Mg) based BRS is welcome, mainly because of its innovative mechanical and chemical features coupled with well proven biocompatibility. Despite being in its infancy, this technology seems to promise a great potential. In our article, we review the Magmaris (Biotronik AG, Bülach, Switzerland) Mg BRS development from animal models to human use, underscore its best qualities and weaknesses, and provide hints of its possible future perspectives.
药物洗脱支架(DES)已达到较高的安全性和有效性,成为经皮冠状动脉介入治疗(PCI)为基础的血运重建的最佳选择。然而,尽管其性能最佳,但在其使用方面仍存在一些问题,主要是由于血管的永久性支架植入及其后果,首先是晚期支架血栓形成(ST)。生物可吸收支架(BRS)旨在克服这些问题。第一代基于聚-L-乳酸(PLLA)的支架在随机对照试验(RCT)中1年时取得的结果很有前景,但首批长期报告(尽管因植入技术不理想而存在缺陷)却令人失望,例如显示出ST和靶血管心肌梗死(TV-MI)风险增加。在这种情况下,新一代基于镁(Mg)的BRS的出现是受欢迎的,主要是因为其创新的机械和化学特性以及已得到充分证实的生物相容性。尽管这项技术尚处于起步阶段,但似乎有很大的潜力。在我们的文章中,我们回顾了Magmaris(百多力公司,瑞士比拉赫)镁基BRS从动物模型到人体应用的发展历程,强调其优点和缺点,并对其可能的未来前景提供一些提示。