Arh Rok, Balevski Igor, Granda Samo, Bevc Sebastjan
Clinical Department of Cardiology, Clinic for Internal Medicine, University Clinical Centre Maribor, 2000 Maribor, Slovenia.
Department of Nephrology, Clinic for Internal Medicine, University Clinical Centre Maribor, 2000 Maribor, Slovenia.
J Clin Med. 2025 Jul 1;14(13):4643. doi: 10.3390/jcm14134643.
Coronary artery disease is the most common cause of mortality worldwide. Percutaneous coronary intervention represents an important method of treatment. Over time, the methods have been refined to improve safety and efficacy. With the development of drug-eluting stents, in-stent restenosis has importantly decreased, but it remains a relevant concern in terms of the need for additional revascularization procedures or recurrent coronary events. Different platforms, polymers, and anti-proliferative agents have been tested, mostly demonstrating non-inferiority when compared. Additional devices, such as drug-coated balloons, bioresorbable scaffold systems, gene-eluting stents and bioadaptor implants have been developed. As none of the aforementioned methods demonstrated considerable superiority over the others, the search for the ideal treatment method continues. Based on currently available data, the ideal treatment method could be a personalized approach combining different revascularization methods. Additional research with subpopulation group studies, different associated diseases or vessels affected, and longer follow-up are required to determine better subgroups of patients that would benefit most from specific treatment methods.
冠状动脉疾病是全球最常见的死亡原因。经皮冠状动脉介入治疗是一种重要的治疗方法。随着时间的推移，这些方法不断完善以提高安全性和疗效。随着药物洗脱支架的发展，支架内再狭窄已显著减少，但就需要额外的血运重建程序或复发性冠状动脉事件而言，它仍然是一个相关问题。不同的平台、聚合物和抗增殖剂已经过测试，大多数在比较时显示出非劣效性。还开发了其他装置，如药物涂层球囊、生物可吸收支架系统、基因洗脱支架和生物适配器植入物。由于上述方法均未显示出比其他方法有相当大的优越性，因此对理想治疗方法的探索仍在继续。根据目前可得的数据，理想的治疗方法可能是一种结合不同血运重建方法的个性化方法。需要进行更多针对亚人群组研究、不同相关疾病或受累血管以及更长随访时间的研究，以确定能从特定治疗方法中获益最大的更好的患者亚组。
