Vojácek J
II. interní klinika 1. LF UK, Praha.
Vnitr Lek. 1995 May;41(5):325-31.
Percutaneous transluminal coronary angioplasty became well established mode of treatment of coronary artery disease. Restenosis remains, however, so far unresolved problem. Studies based on quantitative coronary angiography showed that restenosis is a time related phenomenon which may lead to a new significant coronary lesion after coronary angioplasty in 20 through 60% of patients. As the process of plaque growth is linear, the vessels with smaller luminal diameter or with suboptimal results after dilatation are more prone to the development of a new significant stenosis. The magnitude of restenotic plaque growth depends on the extent of initial vessel injury during the angioplasty. Fibrointimal proliferation is the basic process leading to the plaque growth after coronary angioplasty. Elastic recoil, coronary artery thrombosis and vessel remodelation are another mechanisms, which may cause recurrence of significant lesion after coronary artery dilatation. Although several experimental animal studies showed promising results in inhibiting smooth muscle cell proliferation, the data from clinical studies were mostly not able to confirm beneficial effects in preventing restenosis.
经皮腔内冠状动脉成形术已成为治疗冠状动脉疾病的成熟方法。然而，再狭窄至今仍是一个尚未解决的问题。基于定量冠状动脉造影的研究表明，再狭窄是一种与时间相关的现象，在20%至60%的患者中，冠状动脉成形术后可能会导致新的严重冠状动脉病变。由于斑块生长过程是线性的，管腔直径较小或扩张后效果欠佳的血管更容易出现新的严重狭窄。再狭窄斑块生长的程度取决于血管成形术中初始血管损伤的程度。纤维内膜增生是冠状动脉成形术后导致斑块生长的基本过程。弹性回缩、冠状动脉血栓形成和血管重塑是另外一些机制，它们可能导致冠状动脉扩张后严重病变的复发。尽管一些实验动物研究在抑制平滑肌细胞增殖方面显示出了有前景的结果，但临床研究数据大多未能证实其在预防再狭窄方面的有益作用。
