ELLIS 研究:通过扫描电子显微镜评估准分子激光冠状动脉血管成形术和血管内碎石术对药物洗脱支架的作用的比较分析。

IF 6.1 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Borja Rivero-Santana, Carlos Galán, Claudia Pérez-Martínez, Borja Ibañez, Armando Pérez de Prado, María Fernández-Velasco, Raúl Moreno, Alfonso Jurado-Roman
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引用次数: 0

摘要

背景:支架扩张不足是经皮冠状动脉介入治疗的一大难题,严重影响患者的预后。虽然准分子激光冠状动脉成形术(ELCA)和血管内碎石术(IVL)越来越多地被用于解决这一问题,但它们对药物洗脱支架完整性的全面影响仍不清楚,从而引发了对其安全性和有效性的担忧:这项体外研究使用扫描电子显微镜评估了 ELCA 和 IVL 对药物洗脱支架结构完整性的影响。按照标准化方案,在三维冠状动脉模拟器中植入了 9 个支架,其中 5 个为 Onyx Frontier(具有耐久的周缘聚合物涂层),4 个为 Cre8(不含聚合物)。植入后,使用生理盐水-ELCA、造影剂-ELCA、IVL 和高压球囊扩张治疗。结果:结果:扫描电子显微镜分析显示,不同技术对聚合物的损伤存在显著差异。与 IVL、生理盐水-ELCA 和传统扩张相比,高压球囊扩张和造影剂-ELCA 显示出大量聚合物碎裂和脱落。高压球囊扩张术的聚合物刮伤和过涂层发生率最高。无论采用哪种技术,无聚合物支架均未出现明显变化:结论:支架植入后立即使用静脉注射液和生理盐水-ELCA 对聚合物的损伤极小,而高压球囊扩张和造影剂-ELCA 则对聚合物涂层造成严重损伤。无论使用哪种技术,无聚合物药物洗脱支架的完整性似乎都很稳定。要验证这些发现并探索其临床意义,还需要进一步的研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
ELLIS Study: Comparative Analysis of Excimer Laser Coronary Angioplasty and Intravascular Lithotripsy on Drug-Eluting Stent as Assessed by Scanning Electron Microscopy.

Background: Stent underexpansion is a significant challenge in percutaneous coronary intervention, critically impacting patient outcomes. While excimer laser coronary angioplasty (ELCA) and intravascular lithotripsy (IVL) are increasingly used to address this issue, their full impact on the integrity of drug-eluting stents remains unclear, raising concerns about their safety and efficacy.

Methods: This in vitro study assessed the effects of ELCA and IVL on the structural integrity of drug-eluting stents using scanning electron microscopy. Nine stents, 5 Onyx Frontier (with durable circumferential polymer coating) and 4 Cre8 (polymer-free), were implanted in a 3-dimensional coronary artery simulator following standardized protocols. After implantation, treatments with saline-ELCA, contrast-ELCA, IVL, and high-pressure balloon dilatation were applied. A comprehensive evaluation of the stent surface was performed at 60-fold magnification.

Results: Scanning electron microscopy analysis revealed significant differences in polymer damage between the techniques. High-pressure balloon dilatation and contrast-ELCA exhibited substantial polymer fragmentation and detachment compared with IVL, saline-ELCA, and conventional dilatation. High-pressure balloon dilatation demonstrated the highest incidence of polymer shaving and overcoating. No significant alterations were observed in polymer-free stents, regardless of the technique used.

Conclusions: IVL and saline-ELCA applied immediately after stent implantation produce minimal polymer damage, whereas high-pressure balloon dilatation and contrast-ELCA cause significant damage to the polymer coating. The integrity of polymer-free drug-eluting stent appears stable regardless of the technique used. Further research is needed to validate these findings and explore their clinical implications.

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来源期刊
Circulation: Cardiovascular Interventions
Circulation: Cardiovascular Interventions CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
10.30
自引率
1.80%
发文量
221
审稿时长
6-12 weeks
期刊介绍: Circulation: Cardiovascular Interventions, an American Heart Association journal, focuses on interventional techniques pertaining to coronary artery disease, structural heart disease, and vascular disease, with priority placed on original research and on randomized trials and large registry studies. In addition, pharmacological, diagnostic, and pathophysiological aspects of interventional cardiology are given special attention in this online-only journal.
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