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冠状动脉介入治疗中的生物可吸收支架:未满足的需求与发展

Bioresorbable Scaffolds in Coronary Intervention: Unmet Needs and Evolution.

作者信息

Capodanno Davide

机构信息

Division of Cardiology, Cardio-Thoracic-Vascular Department, Azienda Ospedaliero Universitaria "Policlinico-Vittorio Emanuele" and Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy.

出版信息

Korean Circ J. 2018 Jan;48(1):24-35. doi: 10.4070/kcj.2017.0194.

Abstract

Bioresorbable scaffolds (BRS) represent a novel paradigm in the 40-year history of interventional cardiology. Restoration of cyclic pulsatility and physiologic vasomotion, adaptive vascular remodeling, plaque regression, and removal of the trigger for late adverse events are expected BRS benefits over current metallic drug-eluting stents. However, first-generation BRS devices have significant manufacturing limitations and rely on optimal implantation technique to avoid experiencing an excess of clinical events. There are currently at least 22 BRS devices in different stages of development, including many trials of device iterations with thinner (<150 μm) struts than first-generation BRS. This article reviews the outcomes of commercially available and potentially upcoming BRS, focusing on the most recent stages of clinical development and future directions for each scaffold type.

摘要

生物可吸收支架(BRS)在介入心脏病学40年的历史中代表了一种新的范例。与目前的金属药物洗脱支架相比,生物可吸收支架有望带来恢复周期性搏动和生理性血管运动、适应性血管重塑、斑块消退以及消除晚期不良事件触发因素等益处。然而,第一代生物可吸收支架装置存在显著的制造限制,并且依赖于最佳植入技术来避免出现过多的临床事件。目前至少有22种处于不同开发阶段的生物可吸收支架装置,包括许多对支架进行迭代试验的产品,这些产品的支架小梁比第一代生物可吸收支架更薄(<150μm)。本文回顾了市售和可能即将上市的生物可吸收支架的研究结果,重点关注每种支架类型的临床开发最新阶段和未来方向。

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