球囊可膨胀冠状动脉支架材料:一项针对临床成功的系统综述。

IF 2.4
In vitro models Pub Date : 2022-01-31 eCollection Date: 2022-04-01 DOI:10.1007/s44164-022-00009-w
Jithin Vishnu, Geetha Manivasagam, Diego Mantovani, Anjaneyulu Udduttula, Melanie J Coathup, Ketul C Popat, Pei-Gen Ren, K G Prashanth
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引用次数: 0

摘要

球囊可扩张冠状动脉支架植入术作为一种潜在的微创治疗冠状动脉疾病的方法,已经彻底改变了介入心脏病学领域。尽管与血管成形术(不留下支架)相比,支架置入术是成功的,但仍有许多相关的临床并发症。裸金属支架与支架内再狭窄相关,主要由内膜增生引起,而药物洗脱支架的成功是以支架后期血栓形成和新动脉粥样硬化为代价的。尽管具有创新性和前景,但生物可吸收支架的临床试验报告称,在一些情况下,在不执行支架作用的情况下,血栓形成和降解速度很快。值得注意的是,这些支架绝大多数是基于金属平台的,随着支架技术和抗血小板机制的不断改进,金属平台仍然具有减轻主要心血管事件和减轻患者经济负担的潜力。因此,我们按照PRISMA指南进行了系统评价,以评估金属支架材料的临床相关材料特性。从材料的角度来看,支架临床失败的主要原因是机械性能差和支架表面血液-材料相互作用相关的并发症。除此之外,支架材料应具有提高可视性的不透光性和降低伪影减少的磁化率值。此外,本文综述了未来经皮冠状动脉介入治疗策略的范围。最重要的是,这篇综述强调了临床医生、生物材料科学家和介入心脏病专家需要跨学科的方法来合作减轻与心血管支架相关的障碍,以减轻全世界数百万人的痛苦。图形化的简介:
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Balloon expandable coronary stent materials: a systematic review focused on clinical success.

Balloon expandable coronary stenting has revolutionized the field of interventional cardiology as a potential, minimally invasive modality for treating coronary artery disease. Even though stenting is successful compared to angioplasty (that leaves no stent in place), still there are many associated clinical complications. Bare metal stents are associated with in-stent restenosis caused mostly by neointimal hyperplasia, whereas success of drug-eluting stents comes at the expense of late-stent thrombosis and neoatherosclerosis. Even though innovative and promising, clinical trials with bioabsorbable stents reported thrombosis and a rapid pace of degradation without performing scaffolding action in several instances. It should be noted that a vast majority of these stents are based on a metallic platform which still holds the potential to mitigate major cardiovascular events and reduced economic burden to patients, alongside continuous improvement in stent technology and antiplatelet regimes. Hence, a systematic review was conducted following PRISMA guidelines to assess the clinically relevant material properties for a metallic stent material. From a materials perspective, the major causes identified for clinical failure of stents are inferior mechanical properties and blood-material interaction-related complications at the stent surface. In addition to these, the stent material should possess increased radiopacity for improved visibility and lower magnetic susceptibility values for artefact reduction. Moreover, the review provides an overview of future scope of percutaneous coronary interventional strategy. Most importantly, this review highlights the need for an interdisciplinary approach by clinicians, biomaterial scientists, and interventional cardiologists to collaborate in mitigating the impediments associated with cardiovascular stents for alleviating sufferings of millions of people worldwide.

Graphical abstract:

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