"Leaving nothing behind": is the bioresorbable vascular scaffold a new hope for patients with coronary artery disease?
"Leaving nothing behind": is the bioresorbable vascular scaffold a new hope for patients with coronary artery disease?
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DOI：
10.5114/pwki.2014.46940
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发表时间：
2014
期刊：
影响因子：
--
通讯作者：
Araszkiewicz A
中科院分区：
文献类型：
--
作者：
Lesiak M;Araszkiewicz A
尽管药物洗脱支架(DES)的设计和技术有了很大的进步，改善了接受经皮冠状动脉介入治疗的患者的长期结果，但金属支架的植入仍存在一些局限性。覆盖冠状动脉长节段的多个支架显著影响血管运动，将血管变成坚硬的管状。生物可吸收血管支架(BVS)承诺在2-3年后完全生物吸收，血管管腔扩大，斑块/中膜比降低，血管运动恢复。因此，BVS似乎是一种新的、有希望的、甚至是一种突破性的冠心病患者的侵入性治疗方法。随机试验和登记的结果证实了BVS的有效性和安全性，前提是符合植入的技术方面。一个关键的作用也是选择可能从BVS植入中获得最大好处的患者。在现代介入心脏病学中，“不留下任何东西”的理念在现代介入心脏病学中是一个非常激动人心的概念。如果目前的技术满足挑战，重大限制将被克服，支架被证明至少与目前的DES一样安全和有效，那么从长远来看，我们将面临真正的突破，不仅是在心脏病学，而且在一般的医学上。
Despite significant advances in design and technology of drug eluting stents (DES) and improved long-term outcome of patients treated with percutaneous coronary intervention, the implantation of metallic stents is associated with some limitations. Multiple stents, covering long coronary segments substantially affect vasomotion, changing the vessel into a rigid tube. Bioresorbable vascular scaffolds (BVS) promise complete bioresorption after 2 to 3 years, vessel lumen enlargement, reduction of the plaque to media ratio, and restoration of vasomotion. Thus BVS seems to be a new, promising, and perhaps even a breakthrough invasive treatment for patients with coronary artery disease. The results of randomised trials and registries confirm the efficacy and safety of the BVS, provided the compliance with the technical aspects of implantation. A key role plays also the selection of patients who could potentially benefit most from the implantation of the BVS. The idea of “leaving nothing behind” after percutaneous coronary interventions is a very exiting concept in modern interventional cardiology. If current technology meets the challenge, major limitations will be overcome, and scaffolds prove to be at least as safe and effective as current DES, than in a long run we will be facing a real breakthrough not only in cardiology, but generally in medicine.
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