Noad Rebecca L, Hanratty Colm G, Walsh Simon J
Specialist Registrar in Cardiology.
Consultant Cardiologist, Belfast City Hospital, Belfast Health and Social Care Trust, Belfast, Northern Ireland, UK.
Interv Cardiol. 2014 Apr;9(2):89-93. doi: 10.15420/icr.2011.9.2.89.
The introduction and widespread adoption of drug-eluting stents into routine clinical practice has seen tremendous changes in the practice of interventional cardiology. For a prolonged period, manufacturers have focused research on drugs and polymers that are the key to the prevention of in-stent restenosis. However, stent platform design and its clinical implications have now come back to the fore. This has occurred for numerous reasons, but has primarily been driven by the need for modern stents to perform well in increasingly demanding clinical scenarios. This paper reviews the historical evolution of stent platform design. Current manufacturing processes and materials are also explored. Geometric stent construction and its implications for longitudinal stability and the longer term risks of stent fracture are reviewed. Finally, the implications of the specific stent chosen for different clinical applications including the treatment of bifurcations and left main disease are also summarised. This article will familiarise cardiologists with the crucial impact of each of these factors on modern day practice, as well as acute and long-term outcomes for patients.
药物洗脱支架引入并广泛应用于常规临床实践后，介入心脏病学的实践发生了巨大变化。长期以来，制造商一直将研究重点放在预防支架内再狭窄的关键药物和聚合物上。然而，支架平台设计及其临床意义如今再度成为焦点。出现这种情况有诸多原因，但主要是由于现代支架需要在日益复杂的临床场景中表现良好。本文回顾了支架平台设计的历史演变。还探讨了当前的制造工艺和材料。对支架的几何结构及其对纵向稳定性和支架断裂长期风险的影响进行了综述。最后，还总结了不同临床应用（包括分叉病变和左主干病变的治疗）中所选特定支架的意义。本文将使心脏病学家熟悉这些因素对现代实践的关键影响，以及对患者的急性和长期预后的影响。
