冠状动脉支架内再狭窄的研究进展

Current research progress of coronary in-stent restenosis

经皮冠状动脉介入是目前治疗冠状动脉粥样硬化性心脏病(以下简称冠心病)的有效方法之一.尽管支架置入给患者带来了较为显著的造影和临床效果,但是长期效果仍受限于支架置入术后发生的支架内再狭窄.支架内再狭窄的发生机制复杂且仍未明确,主要是由于新生内膜组织增生与新生动脉粥样硬化形成.目前的研究表明,再次置入第二代药物洗脱支架或药物洗脱球囊是最好的策略,生物可吸收支架也是较为安全的方法之一.

Percutaneous coronary intervention is one of the effective treatment methods for coronary heart disease.Although the use of coronary stent brought a dramatic improvement in patients'angiographic and clinical outcomes,but the long-term outcomes of stent implantation were still significantly constrianed by the risk of developing in-stent restenosis(ISR)over time.The mechanism of ISR is complex and not yet clear,mainly results from aggressive neointimal proliferation and neoatherosclerosis.Current study suggests that repeat transplanting second-generation stent or drug-elutingballoon is most likely to be the best strategy,and bioresorbable vascular stent also is one of the safe techniques.