美发现含药支架可以减少再狭窄的发生率

 
 
新一代能够缓慢释放药物的支架，在防止瘢痕组织扩大方面比传统支架更加有效，从而减少了再狭窄、心脏病发作和死亡的发生率。

一项在Cedars-Sinai医疗中心( Los Angeles, CA, USA)进行的心血管干预研究，是少数侧重于研究药物释放支架对来自下肢静脉移植物影响的研究之一，这是对心血管医生而言是很特别的挑战。含药支架能够在局部产生益处，防止在支架部位发生再狭窄，但是在搭桥的其它部位并无益处，而那种情况常常发生。

Michael S. Lee医生是该研究的第一作者，是Cedars-Sinai的介入心血管医生，他说旧的静脉移植物表面“肮脏”。“它们在长轴断层上更加容易堆积动脉粥样硬化斑块，充满胆固醇碎片和血凝块。”

随着时间推移，采自下肢移植到心脏治疗阻塞冠状动脉的静脉之中，有半数发生病变，需要在该位置上进行再次介入治疗，再次开心手术或者气囊血管扩张植入支架。

这项研究发表在2005年11月的《心血管血管扩张和介入学会期刊》上，该研究发现与传统支架相比较，含药支架再狭窄发生率，下降了4倍。

Medicated Stents Reduce Restenosis
 
Newer-generation stents that slowly release medication are far more effective than conventional stents in preventing the overgrowth of scar tissue, thereby reducing the incidence of restenosis, heart attack, and death.

A new study conducted at the cardiovascular intervention center of Cedars-Sinai Medical Center ( Los Angeles, CA, USA) is one of very few to focus on drug-eluting stents for use in vein grafts from the legs, which pose unique challenges for cardiologists. The medicated stents appear to provide localized benefits, preventing restenosis at the site of the stent but not in other parts of the bypass graft, which often occurs.

Michael S. Lee, M.D., the study’s first author and an interventional cardiologist at Cedars-Sinai, said old vein grafts have a “mucky” appearance. “They are more likely to build up atherosclerotic plaque over long sections and to be filled with cholesterol debris and blood clots.”

Over time, half of all veins removed from the legs and attached to the heart to replace clogged coronary artery grafts become diseased to the point of requiring re-intervention, either repeat open-heart surgery or balloon angioplasty with the insertion of a stent.

The study, published in the November 2005 issue of the Journal of the Society for Cardiovascular Angiography and Interventions, found that there was a fourfold reduction in the incidence of restenosis with the medicated stents in comparison to conventional stents.