药物涂层球囊:冠状动脉支架的最佳替代品

C. Singha
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引用次数: 0

摘要

介入心脏病学的发展见证了冠状动脉疾病(CAD)治疗模式的转变。在各种介入治疗中,冠状动脉支架一直是提供机械支持和降低再狭窄率的基石。然而,与支架相关的并发症,如支架内再狭窄、晚期支架血栓形成以及因长期使用双联抗血小板疗法(DAPT)而导致的出血危险等问题仍令人担忧。近年来,药物涂层球囊(DCB)的出现为治疗 CAD 带来了一种前景广阔的替代方法。DCB 具有独特的作用机制,可将抗增生药物直接输送到血管壁,而不会留下永久性植入物。这一特性消除了与支架血栓形成有关的担忧,也无需长期服用 DAPT。此外,DCB 还能保留血管解剖结构和血管运动,为未来的血管再造提供了可能。临床试验和实际数据已经证明了 DCB 在各种冠状动脉病变(包括小血管和支架内再狭窄)中的疗效。本摘要概述了 DCB 相对于传统冠状动脉支架的优势,并重点介绍了支持其使用的关键临床证据,此外还讨论了与 DCB 治疗相关的经济影响和以患者为中心的疗效。尽管具有这些优势,但设备输送和最佳药物配方等挑战仍是持续研发的领域。总之,DCB 是冠状动脉粥样硬化患者冠状动脉支架的绝佳替代品,在提供同等疗效的同时,还能减轻支架和抗血小板相关并发症。随着技术的不断进步,DCB 设计和给药系统的进一步完善有可能彻底改变冠状动脉介入治疗的格局,为冠状动脉粥样硬化患者提供更安全、更有效的治疗选择:151
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Drug-coated Balloon : A Superb Alternative To Coronary Stents
The evolution of interventional cardiology has witnessed a paradigm shift in the management of coronary arterydisease (CAD). Among the arsenal of interventions, coronary stents have been a cornerstone, providing mechanicalsupport and reducing restenosis rates. However, concerns persist regarding stent-related complications such asin-stent restenosis, late stent thrombosis & hazards of bleeding due to use of long dual antiplatelet (DAPT). Inrecent years, the emergence of drug-coated balloon (DCB) has introduced a promising alternative approach forthe treatment of CAD. DCB offer a unique mechanism of action, delivering antiproliferative drugs directly to thevessel wall without leaving a permanent implant. This characteristic eliminates concerns related to stent thrombosisand the need for long-term DAPT. Furthermore, DCB preserve vessel anatomy and vasomotion, potentially enablingfuture revascu- larization options. Clinical trials and real-world data have demonstrated the efficacy of DCB invarious coronary lesions, including small vessels and in-stent restenosis. This abstract provides an overview ofthe advantages of DCB over traditional coronary stents and highlights key clinical evidence supporting their use.Additionally, it discusses the economic implications and patient-centered outcomes associated with DCB therapy.Despite these advantages, challenges such as device delivery and optimal drug formulations remain areas ofongoing research and development. In conclusion, DCB represent a superb alternative to coronary stents inselected patients with CAD, offering comparable efficacy while mitigating stent & antiplatelet related complications.As technology continues to advance, further refinements in DCB design and drug delivery systems hold thepotential to revolutionize the landscape of coronary intervention, providing safer and more effective treatmentoptions for patients with CAD. Bangladesh J Medicine 2024; Vol. 35, No. 2, Supplementation: 151
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