Genous™ endothelial progenitor cell-capturing stent system: a novel stent technology
Genous™ endothelial progenitor cell-capturing stent system: a novel stent technology
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DOI：
10.1586/erd.09.16
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发表时间：
2009-07-01
影响因子：
3.1
通讯作者：
de Winter, Robbert J.
中科院分区：
文献类型：
--
作者：
Klomp, Margo;Beijk, Marcel A. M.;de Winter, Robbert J.
与裸金属支架相比，药物洗脱支架已被证明可显著减少冠状动脉疾病患者的临床和血管造影再狭窄。然而，通过促进加速再内皮化预防支架内再狭窄的促愈合方法优于药物洗脱支架的积极药理学细胞毒性和细胞抑制方法。内皮祖细胞捕获支架吸引循环中的CD43（+）祖细胞，这些祖细胞与支架表面结合并分化为功能性内皮层。理论上，覆盖支架支柱的内皮层的加速建立将降低新生内膜增生和平滑肌细胞增殖的风险。在非随机健康内皮加速衬里抑制新生内膜生长（HEALING）研究中证实了其安全性和有效性，该器械于2005年获得CE认证。本文综述了内皮祖细胞捕获支架的实现，与其他支架类型相比的相关性，临床性能的当前证据以及未来前景。目前，正在进行的更大规模的随机三支架裁定研究（TRIAS）将直接比较这种新型内皮祖细胞捕获支架与裸金属支架和药物洗脱支架的临床有效性。
Drug-eluting stents have been demonstrated to significantly reduce clinical and angiographic restenosis in patients with coronary artery disease compared with bare-metal stents. Intuitively, however, a prohealing approach for the prevention of in-stent restenosis by promoting accelerated re-endothelialization is favored over the aggressive pharmacologic cytotoxic and cytostatic approach of the drug-eluting stents. The endothelial progenitor cell-capturing stent attracts circulating CD43(+) progenitor cells that bind to the stent surface and differentiate into a functional endothelial layer. It is theorized that the accelerated establishment of the endothelial layer covering the stent struts will reduce the risk of neointimal hyperplasia and smooth muscle cell proliferation. The safety and efficacy have been demonstrated in the nonrandomized Healthy Endothelial Accelerated Lining Inhibits Neointimal Growth (HEALING) studies, and the device received a CE mark in 2005. This article reviews the realization of the endothelial progenitor cell-capturing stent, its relevance compared with other stent types, current evidence on clinical performance, and future perspectives. At present, the larger randomized Tri-stent Adjudication Study (TRIAS) that is ongoing will directly compare the clinical usefulness of this new endothelial progenitor cell-capturing stent with bare-metal stents and drug-eluting stents.