Wurdeman R L, Hilleman D E, Mooss A N
Creighton University and Creighton Cardiac Center, Omaha, Nebraska 68131, USA.
Pharmacotherapy. 1998 Sep-Oct;18(5):1024-40.
Coronary angioplasty is widely performed for the management of symptomatic coronary artery disease. With improvements in technique, operator experience, and tools, more complex lesions are being treated. Unfortunately, luminal renarrowing continues to limit the long-term success of the procedure, resulting in the need for repeat revascularization in approximately 30% of patients within 6 months. As the pathophysiologic process of restenosis is better defined, various pharmacologic and mechanical interventions have been tried to attenuate the process. Some agents are antithrombotics, antiplatelets, angiotensin-converting enzyme inhibitors, lipid-lowering drugs, and calcium channel blockers. Improvement has been noted with the newer glycoprotein IIb- and IIIa-blocking agents, mechanical stents, and radioactive materials. Whether these new compounds will withstand the test of time is unknown.
冠状动脉血管成形术被广泛用于治疗有症状的冠状动脉疾病。随着技术、术者经验和工具的改进，越来越复杂的病变得到治疗。不幸的是，管腔再狭窄仍然限制着该手术的长期成功率，导致约30%的患者在6个月内需要再次进行血管重建。随着再狭窄病理生理过程得到更明确的界定，人们尝试了各种药物和机械干预措施来减轻这一过程。一些药物包括抗凝血药、抗血小板药、血管紧张素转换酶抑制剂、降脂药和钙通道阻滞剂。新型糖蛋白IIb和IIIa阻滞剂、机械支架及放射性材料已显示出疗效改善。这些新化合物能否经受住时间的考验尚不得而知。
