生物可降解血管支架在下肢动脉硬化闭塞症中的临床应用进展

Clinical application progress of bioresorbable vascular scaffolds in lower extremities arteriosclerotic obliterans

腔内技术已成为下肢动脉硬化闭塞症的首选治疗方式,生物可降解血管支架作为腔内技术的一种选择受到关注。近10年,有或无药物涂层的聚左旋乳酸可降解支架在下肢动脉硬化闭塞症中表现出良好的中远期安全性和有效性,但受试者病变相对简单。镁合金可降解支架在下肢动脉硬化闭塞症的治疗中具有良好的安全性但有效性欠佳。铁合金和锌合金可降解支架在动物实验中表现出可观的结果;具有药物涂层的铁合金支架在膝下狭窄动脉的成功植入,标志着铁合金可降解支架正式进入临床试验阶段。既往生物可降解血管支架的试验数据和下肢动脉硬化闭塞症的病变特点显示,有药物涂层的聚左旋乳酸可降解支架和铁合金可降解支架在下肢动脉硬化闭塞症的治疗中将具有更大的发展潜力。

Endovascular technology has become the first choice for the treatment of lower extremities arteriosclerotic obliterans.Bioresorbable vascular scaffolds have attracted more and more attention as a choice of endovascular technology.In the last decade,poly(L-lactic acid)bioresorbable scaffolds with or without drug coating have shown acceptable medium and long-term safety and efficacy in lower extremities arteriosclerotic obliterans,but the lesions of the subjects were relatively simple.Magnesium alloy bioresorbable scaffolds are safe but less effective in the treatment of lower extremities arteriosclerotic obliterans.Both iron and zinc alloy bioresorbable scaffolds have shown considerable results in animal experiments.In particular,the success of implantation of drug-coated iron alloy bioresorbable scaffolds in below-the-knee artery indicated that the iron alloy bioresorbable scaffolds have officially entered the clinical trial stage.Through the comprehensive summation of the previous clinical and experimental data of bioresorbable vascular scaffolds and the pathological characteristics of lower extremities arteriosclerotic obliterans,it is shown that the drug-coated poly(L-lactic acid)bioresorbable scaffolds and iron alloy bioresorbable scaffolds will have greater development potential in the treatment of lower extremities arteriosclerotic obliterans.