Lim Elizabeth, Varcoe Ramon L
The Prince of Wales Hospital, Sydney, NSW 2031, Australia.
The Prince of Wales Hospital, University of New South Wales, Sydney, NSW 2031, Australia.
J Clin Med. 2024 Mar 19;13(6):1757. doi: 10.3390/jcm13061757.
Chronic limb-threatening ischaemia can be a debilitating disease and may result in limb amputation if untreated. Atherosclerotic disease of the infra-popliteal arteries is particularly challenging to treat due to the small caliber of the vessels and the heavy burden of atherosclerotic plaque. Percutaneous transluminal angioplasty is the conventional first-line approach and is advantageous due to its minimal invasiveness, repeatability, and cost-effectiveness but is limited by high rates of elastic recoil, dissection, and short- to mid-term re-stenosis. This review analyses the growing body of published and presented clinical data from multiple randomised controlled trials that have investigated the role of coronary drug-eluting stents in the treatment of infrapopliteal disease. Coronary drug-eluting stents demonstrate superior primary patency compared with angioplasty and/or bare metal stenting alone but are limited to application in short-segment disease and have not been widely adopted due to the nature of the permanent implant. Newer devices like drug-eluting resorbable scaffolds are promising as they allow the restoration of vessel wall vasomotion without a residual foreign body and can be used to treat longer, complex lesions.
慢性肢体威胁性缺血是一种使人衰弱的疾病，若不治疗可能导致肢体截肢。由于腘下动脉血管口径小且动脉粥样硬化斑块负担重，治疗腘下动脉粥样硬化疾病特别具有挑战性。经皮腔内血管成形术是传统的一线治疗方法，因其微创性、可重复性和成本效益而具有优势，但受弹性回缩、夹层形成以及短期至中期再狭窄发生率高的限制。本综述分析了来自多项随机对照试验的越来越多已发表和展示的临床数据，这些试验研究了冠状动脉药物洗脱支架在治疗腘下疾病中的作用。与单纯血管成形术和/或裸金属支架置入相比，冠状动脉药物洗脱支架显示出更好的初始通畅率，但仅限于应用于短节段疾病，并且由于永久性植入物的性质尚未得到广泛应用。像药物洗脱可吸收支架这样的新型装置很有前景，因为它们能够在没有残留异物的情况下恢复血管壁的血管运动，并且可用于治疗更长、更复杂的病变。
