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[冠状动脉内支架研发的临床策略]

[Clinical strategies for development of intracoronary stents].

作者信息

Dong W, Li J, Li F

机构信息

Cell Biol. Lab., First Military Medical University, Guangzhou.

出版信息

Sheng Wu Yi Xue Gong Cheng Xue Za Zhi. 1997 Jun;14(2):156-63.

PMID:9817646
Abstract

Intracoronary stenting is an effective measure to prevent PTCA-associated complications in clinical practice, appearing to be superior to all other interventional techniques. However, the intrinsic thrombogenicity and permanent stimulation to injured vessel wall tissue of all the current available metallic stents may result in inhospital events such as thrombosis, (sub)acute coronary closure, emergency bypass surgery, hemorrhagic complications, pseudoaneurysm, or even vessel perforation), and restenosis. In order to settle the above-mentioned problems, the authors point out that intravascular stenting in combination with target drug delivery, or ionic radiation, or gene therapy (direct gene transfer, antisense oligodeoxynucleotides, etc); seeding of genetically reformed endothelial cells on metallic stents; study and development of new materials for biodegradable stents, controlled drug release system; temporary metallic stents; and locally site-specific drug delivery system take facilitated new clinical strategies for the development of intracoronary stents.

摘要

冠状动脉内支架置入术是临床实践中预防经皮冠状动脉腔内血管成形术(PTCA)相关并发症的有效措施,似乎优于所有其他介入技术。然而,目前所有可用金属支架固有的血栓形成性以及对受损血管壁组织的持续刺激可能导致住院期间出现诸如血栓形成、(亚)急性冠状动脉闭塞、急诊搭桥手术、出血并发症、假性动脉瘤,甚至血管穿孔等事件,以及再狭窄。为了解决上述问题,作者指出血管内支架置入术与靶向药物递送、离子辐射或基因治疗(直接基因转移、反义寡脱氧核苷酸等)相结合;在金属支架上植入基因改造的内皮细胞;研究和开发可生物降解支架、控释药物系统的新材料;临时性金属支架;以及局部位点特异性药物递送系统为冠状动脉内支架的发展带来了便利的新临床策略。

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