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【2007ESC年会】生物可吸收支架：下一个前沿领域？

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蓝色幻想

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这个帖子发布于13年零178天前，其中的信息可能已发生改变或有所发展。

Bioabsorbable stents: 'the next frontier'?

Author: Lisa Hitchen

Biodegradable polymer-coated stents. The coating degrades shortly after completion of drug elution

ALTHOUGH DRUG-ELUTING stents (DES) have a much lower restenosis rate, their long-term use has been linked to a higher rate of instent thrombosis than bare metal stents (BMS). This is why bioabsorbable stents appear to make sense and could have enormous potential. Once initial healing has taken place, the stent disappears – removing the problem of late stent thrombosis and the need for long-term anti-platelet therapy.

Another advantage is that they don’t show up on MRI or CT scans and nor do they cause problems for surgeons trying to find a metalfree segment to work on if patients require traditional re-interventional techniques.

However, Ron Waksman, associate director at Washington Hospital Center, USA, says: “I don’t think we have to convince doctors to use them. The issue would be to show that overall results in terms of performance are as good, or not inferior to, BMS or DES.”

Two types of bioabsorbable stents exist – polymer and metal-based. Both must be capable of being safely absorbed by the body, without causing harm to the surrounding tissues.

A group from Poland presented nine- (angiographic) and 12-month (clinical) follow-up findings from fitting LUCChopin2, paclitaxel-eluting biodegradable polymer-coated stents into 115 patients.

One of the group, Dr Krzysztof Milewski, director of Animal Cath Lab, Upper-Silesian Heart Centre, Poland, told ESC Congress News: “Safety profile appeared excellent and we did not observe incidents of late stent thrombosis between 30 and 365 days of follow-up. The results were comparable to other commercially available stents.” The coating degrades shortly after completion of drug elution, leaving a metal stent covered with endothelium that does not irritate tissues.

The plan of Waksman and colleagues is to eliminate the entire metallic stent. In the Progress study, 61 patients were fitted with an AMS (Absorbable Metallic Stent), using magnesium in the alloy. All were tracked for 12 months, with nine patients followed for up to 28 months. The team found complete degradation of the stents and durability of the results at longer time points. This included restoration of the vaso-reactivity function of the vessel of the stented segment once the stent was absorbed.

“The artery had regained its capability to restrict and dilate,” says Waksman. “One of the promises of these stents is that once their job is done, they disappear and the artery regains its capabilities and, in these nine patients, this was the case.” He sees bioabsorbable stents as “the next frontier of stenting”, but emphasises the need to wait for better data before cardiologists can fully embrace this latest technological development.

http://www.escardio.org/congresses/esc_congress/esc2007/news/bioabsorable-stents.htm

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2007-09-06 09:12 浏览 : 1831 回复 : 11

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蓝色幻想

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1.ALTHOUGH DRUG-ELUTING stents (DES) have a much lower restenosis rate, their long-term use has been linked to a higher rate of instent thrombosis than bare metal stents (BMS).
即使药物涂层支架再狭窄率很低，相比于裸金属支架，它们的长期应用已经与高血管血栓形成率联系在一起。

尽管药物洗脱支架（DES）与金属裸支架（BMS）相比，再狭窄的发生率显著降低，但远期支架血栓形成的发生率却较高。

2. This is why bioabsorbable stents appear to make sense and could have enormous potential.
这就是生物可吸收支架看起来有意思可能蕴涵巨大潜力的原因。

这就是为什么生物可吸收支架看起来很有意义且蕴涵巨大潜力的原因。

3. Once initial healing has taken place, the stent disappears – removing the problem of late stent thrombosis and the need for long-term anti-platelet therapy.
一旦疾病治愈，支架就消失——解决了迟发性血管血栓形成和需要长期抗血小板凝聚治疗的问题。

late stent thrombosis 晚期支架血栓形成

4. One of the group, Dr Krzysztof Milewski, director of Animal Cath Lab, Upper-Silesian Heart Centre, Poland, told ESC Congress News: .
其中之一，Krzysztof Milewski博士, 波兰Upper-Silesian心脏中心动物导管实验室主任在欧洲心脏病学会会议中说：“

波兰Upper-Silesian心脏中心动物导管实验室主任Krzysztof Milewski博士, 是研究小组成员，他在欧洲心脏病学会会议中说：

5. leaving a metal stent covered with endothelium that does not irritate tissues.
留下一个盖着内皮的不使组织发炎的金属支架。

留下一个对组织无刺激的金属支架覆盖内皮。

编译：

生物可吸收支架：下一个前沿领域？

作者：Lisa Hitchen 来源：2007ESC年会

尽管药物洗脱支架（DES）与金属裸支架（BMS）相比，再狭窄的发生率显著降低，但远期支架血栓形成的发生率却较高。这就是为什么生物可吸收支架看起来很有意义且蕴涵巨大潜力的原因。一旦疾病治愈，支架就消失——解决了晚期血栓形成和需要长期抗血小板治疗的问题。生物可吸收支架的另一个优点是不在核磁共振和CT扫描上显示，如果病人要求传统的重新介入治疗时，不需要外科医师努力去发现非金属片断。目前有两种生物可吸收支架——聚合物和金属基质。两者都能被机体安全吸收，对周围组织无害。

波兰一个研究小组对115位植入LUCChopin2－紫杉醇可吸收生物降解聚合物涂层支架病人随访9个月（血管造影的）和12个月（临床的）。波兰Upper-Silesian心脏中心动物导管实验室主任Krzysztof Milewski博士,是研究小组成员，他在欧洲心脏病学会会议中说：“该支架安全性显示极好，在30～365天的随访中，我们没有观察到发生晚期支架血栓形成。此结果可与其他商业支架相比较。”药物完全释放后涂层很快降解，留下一个对组织无刺激的金属支架覆盖内皮。

然而，美国华盛顿医院中心副主管Ron Waksman说：“我认为我们不必说服医生去使用生物可吸收支架，关键是所有结果都与BMS或DES一样好，或不劣于他们。”Waksman和同事计划消除全金属支架。在进一步的研究中，61例病人植入镁合金可吸收金属支架。所有病例随访12个月，其中9名患者随访了28个月。研究人员发现支架完全降解，而且结果持续时间较长。这包括一旦支架被吸收，支架植入片段的血管反应性再生。

“动脉恢复了收缩和舒张功能，”Waksman说，“这些支架的一个前景是，一旦工作完成，它们就消失，动脉恢复功能，在这9名患者身上，就是如此。”他把生物可吸收支架看作是“支架的下一个前沿，”但强调，在心脏病学家完全接受这个最新技术之前，需要等待更多的资料。

2007-09-09 21:15

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蓝色幻想编辑于 2007-09-10 12:30

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