Alraies M Chadi, Darmoch Fahed, Tummala Ramyashree, Waksman Ron
Heart and Vascular Institute, Department of Interventional Cardiology, Georgetown University/MedStar Washington Hospital Center, Washington, DC 20010, United States.
Internal Medicine Department, St Vincent Charity Medical Center/Case Western Reserve University, Cleveland, OH 44115, United States.
World J Cardiol. 2017 Aug 26;9(8):640-651. doi: 10.4330/wjc.v9.i8.640.
Over the course of the 3 decades, percutaneous coronary intervention (PCI) with stent implantation transformed the practice of cardiology. PCI with stenting is currently the most widely performed procedure for the treatment of symptomatic coronary disease. In large trials, drug-eluting stents (DES) have led to a significant reduction in in-stent restenosis (ISR) rates, one of the major limitations of bare-metal stents. Due to these favorable findings, DES was rapidly and widely adopted enabling more complex coronary interventions. Nevertheless, ISR remains a serious concern as late stent complications. ISR mainly results from aggressive neointimal proliferation and neoatherosclerosis. DES-ISR treatment continues to be challenging complications for interventional cardiologists.
在这30年里，经皮冠状动脉介入治疗（PCI）并植入支架改变了心脏病学的实践。带支架的PCI目前是治疗有症状冠状动脉疾病最广泛实施的手术。在大型试验中，药物洗脱支架（DES）已使支架内再狭窄（ISR）率显著降低，而ISR是裸金属支架的主要局限性之一。由于这些有利的结果，DES被迅速广泛采用，从而能够进行更复杂的冠状动脉介入治疗。然而，ISR作为晚期支架并发症仍然是一个严重问题。ISR主要由侵袭性内膜增生和新生动脉粥样硬化引起。DES-ISR的治疗仍然是介入心脏病学家面临的具有挑战性的并发症。
