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用于冠状动脉疾病的药物涂层球囊:当前概念与争议

Drug-coated balloons for coronary artery disease: current concepts and controversies.

作者信息

Buccheri Dario, Lombardo Renzo M, Cortese Bernardo

机构信息

Department of Cardiology, S. Antonio Abate Hospital, Interventional Cardiology Unit, Via Cosenza 80, 91016, Erice, TP, Italy.

Interventional Cardiology Unit, San Carlo Clinic, Via Ospedale, 21, 20037, Paderno Dugnano, MI, Italy.

出版信息

Future Cardiol. 2019 Nov;15(6):437-454. doi: 10.2217/fca-2019-0009. Epub 2019 Nov 5.

Abstract

Drug-coated balloons (DCBs) are a novel development for percutaneous coronary intervention. The first successful application was in-stent restenosis but in recent years, strong evidence has been released for its use in native small-vessels disease. Additional applications such as acute myocardial infarction, chronic total occlusion and bifurcation lesions are still under investigation. This article reviews the key studies evaluating the role of DCBs in several settings and reports on interesting cases where DCBs showed positive results for high-risk patients with neoplasm, as well as with high bleeding risk, planned surgery or renal injury. We also highlight a new biodegradable therapy for coronary bifurcation treatment, in which a bioresorbable vascular scaffold is implanted in the main branch, completed with a DCB angioplasty in the side branch when a treatment is deemed necessary.

摘要

药物涂层球囊(DCBs)是经皮冠状动脉介入治疗的一项新进展。首次成功应用是在支架内再狭窄治疗中,但近年来,有强有力的证据表明其可用于原发性小血管疾病。诸如急性心肌梗死、慢性完全闭塞和分叉病变等其他应用仍在研究中。本文回顾了评估DCBs在多种情况下作用的关键研究,并报告了一些有趣的病例,其中DCBs对患有肿瘤、高出血风险、计划进行手术或有肾损伤的高危患者显示出阳性结果。我们还重点介绍了一种用于冠状动脉分叉治疗的新型可生物降解疗法,即在主支植入生物可吸收血管支架,必要时在侧支完成DCB血管成形术。

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