Natarajan Rajkumar, Corballis Natasha, Merinopoulos Ioannis, Vassiliou Vassilios S, Eccleshall Simon C
Department of Cardiology, Norfolk and Norwich University Hospital, Norwich, UK.
Department of Cardiology, Norwich Medical School, University of East Anglia, Norwich, UK.
Heart Int. 2024 Dec 18;18(2):14-23. doi: 10.17925/HI.2024.18.2.5. eCollection 2024.
It has been recognized for decades that dissections occur as a mechanism of balloon angioplasty. A successful angioplasty result contains some degree of intimal splitting and disruption, which usually heals well. Nonetheless, some dissections are extensive, leading to serious ischaemic complications. The concept of therapeutic coronary dissection started evolving in the 1970s and seems to be a favourable mechanism for drug delivery in the current era of drug-coated balloons. This article will primarily focus on studies undertaken to understand the mechanism of balloon angioplasty and the morphological changes in the plaque post-balloon angioplasty. In the early days of balloon angioplasty, there was an enormous interest in dissections, mainly to prevent acute vessel closure events and to address the importance of their occurrence in relation to vessel restenosis. We will review the historical background, studies defining the clinical, angiographic and morphological patterns of the dissection spectrum and various currently evolving management strategies.
几十年来，人们已经认识到夹层形成是球囊血管成形术的一种机制。成功的血管成形术结果包含一定程度的内膜撕裂和破坏，通常愈合良好。尽管如此，一些夹层范围广泛，会导致严重的缺血性并发症。治疗性冠状动脉夹层的概念在20世纪70年代开始演变，在当前药物涂层球囊时代，它似乎是一种有利于药物递送的机制。本文将主要关注为了解球囊血管成形术机制以及球囊血管成形术后斑块形态变化而进行的研究。在球囊血管成形术的早期，人们对夹层非常感兴趣，主要是为了预防急性血管闭塞事件，并探讨其发生与血管再狭窄的关系。我们将回顾历史背景、定义夹层谱系的临床、血管造影和形态学模式的研究以及各种当前正在发展的管理策略。
