光学相干断层成像技术在冠状动脉支架失败中的研究进展

Research progress of optical coherence tomography in coronary stent failure

支架是经皮介入治疗冠状动脉疾病不可缺少的工具。然而,由于支架内再狭窄或支架内血栓形成而导致的支架失败可能会造成更高的病死率。与传统的无创影像学检查及其他有创影像学检查如血管内超声成像相比,光学相干断层成像技术(optical coherence tomography,OCT)具有超高的分辨率(10μm),更适合用来识别支架内再狭窄或血栓等精细结构,可以明确冠状动脉支架内再狭窄及支架内血栓形成的原因,从而早期识别支架失败的出现,给予相应的处理措施。本篇综述系统地总结了OCT在识别与评估支架失败及其相应机制方面的最新研究进展,并给出了相应的处理流程以指导临床处理支架失败。

Stent is an indispensable percutaneous measure for the treatment of coronary artery disease.However,stent failure caused by in-stent restenosis(ISR)and stent thrombosis(ST)may lead to a higher mortality rate.Compared with traditional noninvasive imaging examination and other invasive imaging examination such as intravascular ultrasound,optical coherence tomography(OCT)has a higher resolution(10μm),making it ideal for the identification of fine structures such as ISR and ST.Therefore,OCT can be used to determine the cause of ISR and ST,contributing to the early identification of stent failure and appropriate management.This review systematically summarized the latest advances in the evaluation and corresponding mechanisms of stent failure according to OCT and provided the corresponding treatment procedures to guide the clinical management of stent failure.