药物涂层球囊治疗下肢动脉硬化闭塞病变的现状

Drug-coated balloon in treatment of lower limb atherosclerosis obliterans:current status

下肢动脉粥样硬化闭塞性疾病腔内治疗的模式在最近十年取得了很大的进展,从最初的单纯球囊扩张到支架成形,再发展到以药物涂层球囊、斑块切除和激光销蚀为代表的无移植物"leave nothing behind"手术。为应对单纯球囊扩张成形术和支架置入术后高再狭窄率的顽疾,近5年来在全球范围,尤其是国内自2016年6月开始了药物涂层球囊治疗下肢动脉硬化闭塞症的尝试,取得了理想的治疗效果。笔者概括介绍药物涂层球囊的原理和技术,并回顾现有的随机对照试验。

The mode of endovascular treatment for atherosclerosis obliterans of the lower limbs has evolved significantly over the last decade, from the initial percutaneous transluminal angioplasty （PTA） to stenting, and then to the implant-free surgery following the ＂leave nothing behind＂ concept that is represented by drug-coated balloon, plaque excision and laser erosion. In an attempt to overcome the stubborn problem of high restenosis rates after PTA and stenting, the attempts of using drug-coated balloon in treatment of atherosclerosis obliterans of the lower limbs have been started worldwide in the past five years and especially in China since June 2016, and favorable therapeutic results have been obtained. Here, the authors provide an overview of the rationale and the technology of DCB and review currently available data from randomized controlled trials.