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生物可吸收支架载药用于再狭窄。

Bioresorbable Scaffold-Based Controlled Drug Delivery for Restenosis.

机构信息

Division of Cardiovascular and Renal Products, Center for Drug Evaluation and Research, FDA, 10903 New Hampshire Ave., Bldg 22, Rm 4176, Silver Spring, MD, 20993, USA.

出版信息

J Cardiovasc Transl Res. 2019 Jun;12(3):193-203. doi: 10.1007/s12265-018-9841-x. Epub 2018 Oct 26.

Abstract

Bioresorbable scaffolds have emerged as a potential alternative to non-erodible metal implants to alleviate the long-term risk of permanent device vascular implant-related adverse events. Bioresorbable scaffolds provide a temporary mechanical support function until the vessel reaches complete healing, and the implant progressively disappears and vasomotion resumes. A polymer matrix with embedded drugs coated onto the scaffold surface degrades slowly, reducing the size from the exterior toward the interior, and this allows controlled drug release to a local vascular segment. Drug elution from a bioresorbable scaffold system is characterized by a rapid initial release that achieves high concentration along the intimal surface, which is designed to prevail vascular dilation-induced injury and formation of neointimal hyperplasia. This review highlights diverse types of bioresorbable biomaterials as vascular scaffolds, drug release kinetics, adaptive arterial wall remodeling, and complexities in the advancement of vascular scaffolds to treat restenosis.

摘要

生物可吸收支架作为不可降解金属植入物的一种潜在替代品出现,以降低永久性器械相关血管植入不良事件的长期风险。生物可吸收支架在血管完全愈合之前提供暂时的机械支撑功能,在此期间支架逐渐降解,血管恢复正常舒缩功能。聚合物基质与嵌入的药物涂层在支架表面缓慢降解,从外部向内部逐渐缩小,从而实现药物的持续释放,以达到局部血管节段的效果。生物可吸收支架系统的药物洗脱具有快速初始释放的特点,可在血管内膜表面达到高浓度,以防止血管扩张引起的损伤和新生内膜过度增生。本综述重点介绍了多种类型的生物可吸收生物材料作为血管支架、药物释放动力学、动脉壁适应性重塑以及推进血管支架治疗再狭窄的复杂性。

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