Departments of Neurosurgery and of Biomedical Engineering, Yale University, New Haven, CT, USA.
Adv Exp Med Biol. 2018;1097:181-189. doi: 10.1007/978-3-319-96445-4_9.
Coronary artery disease (CAD) is the leading cause of mortality and morbidity worldwide. Clinically, CAD can be potentially managed through surgical artery bypass. However, due to the highly invasive nature, surgical intervention has been gradually replaced by percutaneous transluminal coronary angioplasty and recently by percutaneous coronary revascularization using metallic stents. However, the permanent presence of metallic scaffolds inevitably impairs arterial physiology and may induce a variety of adverse effects, such as inflammation, restenosis, thrombosis, and neoatherosclerosis. To address these limitations, revascularization using bioresorbable vascular scaffolds (BVSs) has emerged as the most promising approach. After angioplasty, BVSs provide temporarily mechanical support and are completely resorbed over defined time. This transient nature allows favorable arterial remodeling and avoids thrombosis and in-stent restenosis. However, the theoretical advantages of BVSs have yet to be demonstrated. In this chapter, we first review the evolution of nonsurgical vascular intervention approaches over the past few decades. Next, we discuss the current status of BVS development and propose potential approaches to addressing the limitations associated with the current BVSs.
冠心病（CAD）是全球范围内导致死亡和发病的主要原因。临床上，CAD 可以通过手术动脉旁路进行潜在治疗。然而，由于手术具有高度的侵入性，手术干预已逐渐被经皮腔内冠状动脉成形术和最近的金属支架经皮冠状动脉血运重建术所取代。然而，金属支架的永久性存在不可避免地损害了动脉生理学，并可能引发多种不良反应，如炎症、再狭窄、血栓形成和新动脉粥样硬化。为了解决这些局限性，使用生物可吸收血管支架（BVS）进行血运重建已成为最有前途的方法。血管成形术后，BVS 提供暂时的机械支持，并在规定的时间内完全吸收。这种短暂的性质允许有利的动脉重塑，并避免血栓形成和支架内再狭窄。然而，BVS 的理论优势尚未得到证实。在本章中，我们首先回顾过去几十年非手术血管介入治疗方法的演变。接下来，我们讨论了 BVS 开发的现状，并提出了一些潜在的方法来解决当前 BVS 相关的局限性。
