下肢动脉支架内再狭窄的腔内治疗研究进展

Research progress in endovascular treatment of lower extremity artery in-stent restenosis

下肢动脉支架内再狭窄(ISR)是下肢血管腔内支架成形术后的常见并发症,会严重影响患者的治疗效果及预后。血管准备不良、支架选择错误或患者自身的原因都会导致ISR的发生。ISR主要的病理生理过程是内膜增生与胶原积累。目前针对ISR的治疗策略主要包括药物治疗、腔内治疗(如单纯球囊血管成形术、切割和棘突球囊、药物涂层球囊、准分子激光治疗、药物洗脱支架及生物可吸收支架等)、开放手术治疗及必要时的杂交手术治疗,本文针对ISR腔内治疗方式的治疗策略及新技术应用进行综述。

In-stent restenosis(ISR)of lower extremity arteries is a common complication after endovascular stent angioplasty,which will seriously affect the therapeutic effect and prognosis of patients.ISR can occur due to poor vascular preparation,wrong stent selection,or the personal conditions of patients.The main pathophysiological processes of ISR are intimal hyperplasia and collagen accumulation.At present,the ISR treatment strategies mainly include drug therapy,endovascular therapy(such as balloon angioplasty,cutting or lacrosse non-slip element balloon,drug-coated balloon,excimer laser angioplasty,drug-eluting stents,and biologically absorbable stents),open surgery and,necessary combined surgical treatment,this article mainly reviews the endovascular treatment strategies and new technology of ISR.