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[SICI - GISI关于镁生物可吸收支架Magmaris在临床实践中应用的立场文件]

[SICI-GISE Position paper on the use of the magnesium bioresorbable scaffold Magmaris in clinical practice].

作者信息

Galli Stefano, Testa Luca, Montorsi Piero, Bedogni Francesco, Pisano Francesco, Palloshi Altin, Mauro Ciro, Contarini Marco, Varbella Ferdinando, Esposito Giovanni, Caramanno Giovanni, Secco Gioel Gabrio, D'Amico Gianpiero, Musumeci Giuseppe, Tarantini Giuseppe

机构信息

Centro Cardiologico Monzino IRCCS, Università degli Studi, Milano.

IRCCS Policlinico San Donato, San Donato Milanese (MI).

出版信息

G Ital Cardiol (Rome). 2020 Feb;21(2 Suppl 1):52S-59S. doi: 10.1714/3311.32822.

Abstract

Bioresorbable scaffolds have emerged as a potential breakthrough for the treatment of coronary artery lesions. The need for drug release and plaque scaffolding is temporary, and leaving a permanent stent once the process of plaque recoil and vessel healing has ended might be superfluous or even deleterious exposing the patient to the risk of very late thrombosis, eliminating vessel reactivity, impairing non-invasive imaging and precluding possible future surgical revascularization. This long-term potential limitation of permanent bare metal stents might be overcome by using a resorbable scaffold. The metallic and antithrombotic properties makes the resorbable magnesium scaffold an appealing technology for the treatment of coronary artery lesions. Notwithstanding this, its mechanical properties substantially differ from those of conventional bare metal stents, and previous experience using polymer-based scaffolds has shown that a standardized implantation technique and optimal patient and lesion selection are key factors for a successful implantation. A panel of expert cardiologists gathered to find a consensus on the best practices for Magmaris implantation in a selected patient population and to discuss the rationale for new potential future indications.

摘要

生物可吸收支架已成为治疗冠状动脉病变的一项潜在突破。药物释放和斑块支撑的需求是暂时的,一旦斑块回缩和血管愈合过程结束后仍留置永久支架可能是多余的,甚至是有害的,会使患者面临极晚期血栓形成的风险,消除血管反应性,损害无创成像,并排除未来可能的外科血管重建。使用可吸收支架可能克服永久裸金属支架的这一长期潜在局限性。金属和抗血栓特性使可吸收镁支架成为治疗冠状动脉病变的一项有吸引力的技术。尽管如此,其机械性能与传统裸金属支架有很大不同,并且先前使用基于聚合物的支架的经验表明,标准化的植入技术以及最佳的患者和病变选择是成功植入的关键因素。一组专家心脏病学家齐聚一堂,就选定患者群体中Magmaris植入的最佳实践达成共识,并讨论新的潜在未来适应症的基本原理。

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