药物涂层球囊治疗冠状动脉原位病变后晚期管腔扩大现象的研究进展

Research progress of late lumen enlargement after drug-coated balloon angioplasty for de novo coronary artery disease

冠状动脉支架内再狭窄成为药物涂层球囊(DCB)的主要适应证后,DCB越来越多地作为其一线治疗方式。此外,更多的临床证据支持DCB在原位病变中的应用,尤其是小血管病变、高出血风险和心肌梗死等特殊患者群体。和药物洗脱支架相比,DCB的优势在于没有永久性金属支架的植入,同时,多项研究观察到DCB治疗冠状动脉原位病变后出现晚期管腔扩大现象,晚期管腔扩大的出现被认为有临床益处。本文就DCB治疗冠状动脉原位病变后的晚期管腔扩大现象的可能机制和影响因素作一综述。

Coronary in-stent restenosis(ISR)has become the main indication of the drug-coated balloon(DCB),DCB is increasingly used as a first-line treatment.In addition,more clinical evidence supports the application of DCB in de novo coronary lesions,especially in special patient groups such as small vessel disease,high bleeding risk,and myocardial infarction.Compared with drug-eluting stents,the advantage of DCB is that there is no permanent metal stent implantation.At the same time,many studies have observed the phenomenon of late lumen enlargement after DCB treatment of de novo coronary lesions.The emergence of late lumen enlargement is considered to be of clinical benefit.This article reviews the possible mechanisms and influencing factors of late lumen enlargement after DCB treatment of de novo coronary lesions.