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糖尿病和小血管疾病患者使用生物可吸收支架进行冠状动脉血运重建的当前概念。

Current concepts on coronary revascularization using BRS in patients with diabetes and small vessels disease.

作者信息

Masiero Giulia, Mojoli Marco, Ueshima Daisuke, Tarantini Giuseppe

机构信息

Department of Cardiac, Thoracic and Vascular Sciences, University of Padua Medical School, Padua, Italy.

出版信息

J Thorac Dis. 2017 Aug;9(Suppl 9):S940-S949. doi: 10.21037/jtd.2017.06.36.

Abstract

Diabetes mellitus (DM) and small vessel (SV) disease are two major predictors of adverse outcome in patients treated by percutaneous coronary intervention (PCI), even when last generation metallic drug-eluting stents (DES) are used. Bioresorbable scaffold (BRS) technology has been recently developed to overcome the disadvantages of metallic DES due to their permanent struts. Through the resorption process, BRS may provide a vascular restoration that appears very attractive especially when distal or diffusely diseased coronary segments are involved, as in diabetic patients and SV disease. However, robust evidence on the use of BRS in diabetics is lacking, and recent data have raised concerns on the use of BRS in SVs, particularly when reference vessel diameter (RVD) is <2.25 mm. This review aims at summarizing current evidence related to the use of BRS in diabetics and SV disease.

摘要

糖尿病(DM)和小血管(SV)疾病是接受经皮冠状动脉介入治疗(PCI)患者不良预后的两大主要预测因素,即便使用的是新一代金属药物洗脱支架(DES)。生物可吸收支架(BRS)技术最近已得到开发,以克服金属DES因永久性支架带来的缺点。通过吸收过程,BRS可能提供血管修复,这显得非常有吸引力,尤其是当累及远端或弥漫性病变的冠状动脉节段时,如糖尿病患者和SV疾病。然而,缺乏关于在糖尿病患者中使用BRS的有力证据,并且最近的数据引发了对在SV中使用BRS的担忧,特别是当参考血管直径(RVD)<2.25毫米时。本综述旨在总结与在糖尿病患者和SV疾病中使用BRS相关的当前证据。

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