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光学相干断层成像术(OCT)在 1、2、3 个月时对生物可降解聚合物药物洗脱支架的冠状动脉愈合情况进行的连续评估-REPAIR 试验。

Serial Assessment of Coronary Artery Healing of a Biodegradable Polymer Drug-Eluting Stent at 1, 2, and 3 Months by Optical Coherence Tomography (OCT)-The REPAIR Trial.

机构信息

Av. Dante Pazzanese, n. 500, 04012- 909, Sao Paulo, Brazil.

出版信息

J Invasive Cardiol. 2023 May;35(5):E225-E233. doi: 10.25270/jic/22.00349. Epub 2023 Mar 13.

Abstract

BACKGROUND

Although first-generation drug-eluting stent (DES) devices have effectively achieved their main goal of reducing restenosis, their safety has been limited by suboptimal polymer biocompatibility, delayed stent endothelialization, and local drug toxicity, which ultimately prompted the development of new-generation DES options carrying biocompatible or even biodegradable polymers.

AIMS

We sought to assess the vessel-healing pattern of the novel sirolimus-eluting Inspiron DES (Scitech Medical) using serial optical coherence tomography (OCT) and assuming the hypothesis that this thin-strut (75-μm), biodegradable-polymer DES promotes a faster healing, with very early strut coverage.

METHODS

This is a prospective, multicenter, open-label, single-arm study enrolling 68 patients who underwent percutaneous coronary intervention guided by OCT. These patients were consecutively assigned into 3 groups. The first group had its OCT imaging follow-up performed at 3 months, the second group at 2 months, and the third group at 1 month.

RESULTS

Mean age was 59.5 years, 70.6% were male, 41.2% had type 2 diabetes, and 29.4% presented with acute coronary syndrome. A total of 72 lesions were treated and 1.06 stents were implanted per patient. OCT assessment of the stents at 1, 2, and 3 months showed a strut coverage of 90.41%, 93.96%, and 97.21%, respectively (P=.04).

CONCLUSION

The Inspiron DES showed an early strut healing pattern, with >90% of the struts covered by neointima within the first month and with almost all struts covered by the third month.

摘要

背景

尽管第一代药物洗脱支架(DES)设备有效地实现了减少再狭窄的主要目标,但由于聚合物生物相容性不理想、支架内皮化延迟和局部药物毒性,其安全性受到限制,最终促使开发了具有生物相容性甚至可生物降解聚合物的新一代 DES 选择。

目的

我们旨在使用连续光学相干断层扫描(OCT)评估新型西罗莫司洗脱 Inspiron DES(Scitech Medical)的血管愈合模式,并假设这个薄壁(75μm)、可生物降解聚合物的 DES 可以促进更快的愈合,具有非常早期的支架覆盖率。

方法

这是一项前瞻性、多中心、开放标签、单臂研究,共纳入 68 例接受 OCT 指导的经皮冠状动脉介入治疗的患者。这些患者连续分为 3 组。第一组在 3 个月时进行 OCT 成像随访,第二组在 2 个月时进行,第三组在 1 个月时进行。

结果

平均年龄为 59.5 岁,70.6%为男性,41.2%患有 2 型糖尿病,29.4%患有急性冠状动脉综合征。共治疗 72 处病变,每位患者植入 1.06 个支架。支架在 1、2 和 3 个月的 OCT 评估显示,支架覆盖率分别为 90.41%、93.96%和 97.21%(P=.04)。

结论

Inspiron DES 表现出早期的支架愈合模式,在第一个月内超过 90%的支架被新生内膜覆盖,并且几乎所有的支架在第三个月内都被覆盖。

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