生物可吸收血管内支架的现状

The current clinical application status of bioresorbable endovascular stents

心脑血管疾病是全球常见的死亡原因,经皮冠状动脉介入术是目前最有效手术方式之一,血管内支架作为其重要治疗手段,其临床疗效决定着患者远期预后。新一代生物可吸收支架在很大程度上解决了先前金属支架存在的血管急性闭塞与再狭窄等临床不良事件,有望成为未来血管支架主力军,但无论是可吸收金属支架,包括铁基、镁基和锌基亦或是可吸收聚合物支架,都或多或少存在降解速率、支架机械性能等方面的局限性,所以尚未能完全克服远期血栓事件等不良预后的发生。本文总结20年来已出现的各种生物可吸收血管内支架,同时从支架原理、特性、优缺点等角度出发对理想的生物可吸收支架进行展望,为更新一代血管内支架的开发提供客观有效数据及参考建议。

Cardiovascular and cerebrovascular diseases are the common causes of the human death worldwide.Percutaneous coronary intervention(PCI)has been one of the most effective surgical methods.The endovascular stent implantation is an important therapeutic means,and its clinical efficacy determines the long-term prognosis of patients.The new generation of bioresorbable stents(BRSs)have largely resolved the occurrence of clinical adverse events due to the presence of previous metal stents,such as acute vascular occlusion,restenosis,etc.The BRSs are expected to become the main force of vascular stents in the future.However,whether the absorbable metal stents,including iron-based stents,magnesium-based stents and zinc-based stents,or the absorbable polymer stents,all of them have more or less limitations in the degradation rate,stent mechanical properties and other aspects.Therefore,the occurrence of poor prognosis such as long-term thrombotic events has not yet been fully overcome.This paper summarizes the various bioabsorbable endovascular stents that have emerged over the past 20 years,at the same time,the ideal BRSs are expected from the aspects of its principle,characteristics,advantages and disadvantages,etc.so as to provide objective and effective data and reference suggestions for developing a newer generation of endovascular stents in the future.