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不断发展的冠状动脉支架技术——展望未来

Evolving Coronary Stent Technologies - A Glimpse Into the Future.

作者信息

Patel Smeet, Patel Kalpen B, Patel Zeel, Konat Ashwati, Patel Ami, Doshi Jinish S, Chokshi Priyank, Patel Divya, Sharma Kamal, Amdani MohmadSabir M, Shah Darshini B, Dholu Urva, Patel Merik

机构信息

Medicine, New York University School of Global Public Health, New York City, USA.

Internal Medicine, Pandit Deendayal Upadhyay Medical College, Rajkot, IND.

出版信息

Cureus. 2023 Mar 1;15(3):e35651. doi: 10.7759/cureus.35651. eCollection 2023 Mar.

Abstract

One of the most widely accepted forms of treatment for coronary artery disease (CAD) is the implementation of stents into the vessel. This area of research is constantly evolving, ranging from bare-metal stents through drug-eluting stents and, more recently, approaching bioresorbable stents and polymer-free stents. This article reviews the evolution of all these devices and emphasizes how they might be further evolved to provide an optimal coronary stent and overcome unsolved challenges in stent development. We thoroughly evaluated a number of published studies in order to advance coronary stent technologies. Additionally, we looked for various literature that highlighted the inadequacies of the coronary stents that are currently available and how they might be modified to create the optimum coronary stent. Coronary stents have significantly improved clinical outcomes in interventional cardiology, but there are still a number of drawbacks, including an persisted risk of thrombosis due to endothelial injury and in-stent restenosis. Gene eluting stents (GES) and customized coronary stents with self-reporting stent sensors are appealing alternatives to existing stent approaches. Considering the adequacy of these gene eluting stents (GES), customized coronary stents produced by novel 4D printing technologies and integrated self-reporting stent sensors should be assumed for anticipating future advancements to optimal coronary stent devices; however, more interventional evidence is required to determine the future prospects of these stent innovations.

摘要

冠状动脉疾病(CAD)最广泛接受的治疗形式之一是在血管中植入支架。该研究领域不断发展,从裸金属支架到药物洗脱支架,最近又朝着生物可吸收支架和无聚合物支架发展。本文回顾了所有这些装置的演变,并强调它们如何进一步发展以提供最佳冠状动脉支架并克服支架开发中尚未解决的挑战。为了推进冠状动脉支架技术,我们全面评估了大量已发表的研究。此外,我们查找了各种文献,这些文献突出了现有冠状动脉支架的不足之处以及如何对其进行改进以制造出最佳冠状动脉支架。冠状动脉支架在介入心脏病学中显著改善了临床结果,但仍存在一些缺点,包括由于内皮损伤和支架内再狭窄导致的持续血栓形成风险。基因洗脱支架(GES)和带有自我报告支架传感器的定制冠状动脉支架是现有支架方法的有吸引力的替代方案。考虑到这些基因洗脱支架(GES)的适用性,应设想通过新型4D打印技术生产的定制冠状动脉支架以及集成的自我报告支架传感器,以期待未来向最佳冠状动脉支架装置的发展;然而,需要更多的介入证据来确定这些支架创新的未来前景。

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本文引用的文献

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4D Printing Applications in the Development of Smart Cardiovascular Implants.4D打印在智能心血管植入物开发中的应用。
Front Bioeng Biotechnol. 2022 May 25;10:873453. doi: 10.3389/fbioe.2022.873453. eCollection 2022.
5
Deep Learning in Personalization of Cardiovascular Stents.深度学习在心血管支架个性化定制中的应用
J Cardiovasc Pharmacol Ther. 2020 Mar;25(2):110-120. doi: 10.1177/1074248419878405. Epub 2019 Sep 25.
8
Cardiovascular stents: overview, evolution, and next generation.心血管支架:概述、演进及下一代产品
Prog Biomater. 2018 Sep;7(3):175-205. doi: 10.1007/s40204-018-0097-y. Epub 2018 Sep 10.
10
Analysis of trends and prospects regarding stents for human blood vessels.人体血管支架的趋势与前景分析
Biomater Res. 2018 Mar 13;22:8. doi: 10.1186/s40824-018-0114-1. eCollection 2018.

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