准分子激光辅助治疗冠状动脉支架内再狭窄的研究进展Research progress in excimer laser-assisted treatment of coronary in-stent restenosis
何攀,汪奇
摘要(Abstract):
支架内再狭窄(ISR)通常导致不良心血管事件发生,药物洗脱支架(DES)已经使ISR的发生率显著下降,但现实世界中ISR的发生率仍有约10%。尽管药物涂层球囊(DCB)及DES作为一线治疗方法已经被广泛使用,但其疗效受限于斑块性质及病变特征等。准分子激光冠状动脉成形术(ELCA)基于中紫外波长(308 nm)的脉冲氯化氙激光,通过其独特的消融机制,实现对斑块安全、有效消融。随着技术迭代,ELCA成为越来越重要的辅助治疗ISR的消融方法。本文主要对ISR的发生机制、ELCA的作用及ELCA辅助治疗ISR的研究进行综述。
关键词(KeyWords): 支架内再狭窄;准分子激光冠状动脉成形术;药物涂层球囊
基金项目(Foundation):
作者(Author): 何攀,汪奇
参考文献(References):
- [1] Byrne RA,Joner M,Kastrati A. Stent thrombosis and restenosis:what have we learned and where are we going? The Andreas Gruntzig Lecture ESC 2014[J]. Eur Heart J,2015,36(47):3320-3331.
- [2] Moussa ID,Mohananey D,Saucedo J,et al. Trends and outcomes of restenosis after coronary stent implantation in the United States[J]. J Am Coll Cardiol,2020,76(13):1521-1531.
- [3] Spadaccio C,Antoniades C,Nenna A,et al. Preventing treatment failures in coronary artery disease:what can we learn from the biology of in-stent restenosis,vein graft failure,and internal thoracic arteries[J]? Cardiovasc Res,2020,116(3):505-519.
- [4] Andreou I,Stone PH,Ikonomidis I,et al. Recurrent atherosclerosis complications as a mechanism for stent failure[J].Hellenic J Cardiol,2020,61(1):9-14.
- [5] Joner M,Koppara T,Byrne RA,et al. Neoatherosclerosis in patients with coronary stent thrombosis:fi ndings from optical coherence tomography imaging(a report of the PRESTIGE consortium)[J]. JACC Cardiovasc Interv,2018,11(14):1340-1350.
- [6] Borovac JA,D’Amario D,Vergallo R,et al. Neoatherosclerosis after drug-eluting stent implantation:a novel clinical and therapeutic challenge[J]. Eur Heart J Cardiovasc Pharmacother,2019,5(2):105-116.
- [7] Mehran R,Dangas G,Abizaid AS,et al. Angiographic patterns of in-stent restenosis:classifi cation and implications for long-term outcome[J]. Circulation,1999,100(18):1872-1878.
- [8] Gonzalo N,Serruys PW,Okamura T,et al. Optical coherence tomography patterns of stent restenosis[J]. Am Heart J,2009,158(2):284-293.
- [9] Latib A,Mussardo M,Ielasi A,et al. Long-term outcomes after the percutaneous treatment of drug-eluting stent restenosis[J].JACC Cardiovasc Interv,2011,4(2):155-164.
- [10] Lawton JS,Tamis-Holland JE,Bangalore S,et al. 2021 ACC/AHA/SCAI guideline for coronary artery revascularization:a report of the American College of Cardiology/American Heart Association joint committee on clinical practice guidelines[J].J Am Coll Cardiol,2022,79(2):e21-e129.
- [11] Kokkinidis DG,Waldo SW,Armstrong EJ. Treatment of coronary artery in-stent restenosis[J]. Expert Rev Cardiovasc Ther,2017,15(3):191-202.
- [12] Neumann FJ,Sousa-Uva M,Ahlsson A,et al. 2018 ESC/EACTS guidelines on myocardial revascularization[J]. Eur Heart J,2019,40(2):87-165.
- [13] Baan J Jr,Claessen BE,Dijk KB,et al. A randomized comparison of paclitaxel-eluting balloon versus everolimus-eluting stent for the treatment of any in-stent restenosis:the DARE trial[J]. JACC Cardiovasc Interv,2018,11(3):275-283.
- [14] Giacoppo D,Alfonso F,Xu B,et al. Drug-coated balloon angioplasty versus drug-eluting stent implantation in patients with coronary stent restenosis[J]. J Am Coll Cardiol,2020,75(21):2664-2678.
- [15] Golino L,Caiazzo G,CalabròP,et al. Excimer laser technology in percutaneous coronary interventions:cardiovascular laser society’s position paper[J]. Int J Cardiol,2022,350:19-26.
- [16] Shishikura D,Otsuji S,Takiuchi S,et al. Vaporizing thrombus with excimer laser before coronary stenting improves myocardial reperfusion in acute coronary syndrome[J]. Circ J,2013,77(6):1445-1452.
- [17] Yamanaka Y,Shimada Y,Tonomura D,et al. Laser vaporization of intracoronary thrombus and identifying plaque morphology in ST-segment elevation myocardial infarction as assessed by optical coherence tomography[J]. J Interv Cardiol,2021,2021:5590109.
- [18] Larosa C,Ricco A,Cosentino N,et al. A case of very late thrombosis of bare metal stent successfully treated with excimer laser coronary angioplasty[J]. Int J Cardiol,2010,145(2):e60-e63.
- [19] Topaz O,Minisi AJ,Bernardo NL,et al. Alterations of platelet aggregation kinetics with ultraviolet laser emission:the “stunned platelet” phenomenon[J]. Thromb Haemost,2001,86(4):1087-1093.
- [20] Sasaki S,Nakajima K,Watanabe K,et al. Integrated backscatter-intravascular ultrasound and modification of plaque during excimer laser coronary angioplasty[J]. Cardiovasc Interv Ther,2022,37(2):354-362.
- [21] Nishino M,Lee Y,Nakamura D,et al. Dif ferences in optical coherence tomographic findings and clinical outcomes between excimer laser and cutting balloon angioplasty for focal in-stent restenosis lesions[J]. J Invasive Cardiol,2012,24(10):478-483.
- [22] Basavarajaiah S,Loku Waduge BH,Watkin R,et al. Is a high calcific burden an indication,or a contraindication for drug coated balloon[J]? Rev Cardiovasc Med,2021,22(4):1087-1093.
- [23] Viceconte N,Biscione C,Tarsia G,et al. Laser “explosion”technique for treatment of unexpanded coronary stent[J]. Int J Cardiol,2011,149(3):395-397.
- [24] Latib A,Takagi K,Chizzola G,et al. Excimer laser lesion modification to expand non-dilatable stents:the ELLEMENT registry[J]. Cardiovasc Revasc Med,2014,15(1):8-12.
- [25] Lee T,Shlofmitz RA,Song L,et al. The ef fectiveness of excimer laser angioplasty to treat coronary in-stent restenosis with peristent calcium as assessed by optical coherence tomography[J].Euro Intervention,2019,15(3):e279-e288.
- [26] K?ster R,Hamm CW,Seabra-Gomes R,et al. Laser angioplasty of restenosed coronary stents:results of a multicenter surveillance trial. The laser angioplasty of restenosed stents(LARS)investigators[J]. J Am Coll Cardiol,1999,34(1):25-32.
- [27] Mehran R,Mintz GS,Satler LF,et al. Treatment of in-stent restenosis with excimer laser coronary angioplasty:mechanisms and results compared with PTCA alone[J]. Circulation,1997,96(7):2183-2189.
- [28] Ichimoto E,Kadohira T,Nakayama T,et al. Long-term clinical outcomes after treatment with excimer laser coronary atherectomy for in-stent restenosis of drug-eluting stent[J].Int Heart J,2018,59(1):14-20.
- [29] Pereira GTR,Dallan LAP,Vergara-Martel A,et al. Treatment of in-stent restenosis using excimer laser coronary atherectomy and bioresorbable vascular scaf fold guided by optical coherence tomography[J]. Cardiovasc Revasc Med,2021,22:44-49.
- [30] Ambrosini V,Golino L,Niccoli G,et al. The combined use of drug-eluting balloon and excimer laser for coronary artery restenosis in-stent treatment:the DERIST study[J].Cardiovasc Revasc Med,2017,18(3):165-168.
- [31]李辉,夏博,米秀青.准分子激光消蚀术在支架内再狭窄病变中的应用[J].中国介入心脏病学杂志,2020,28(8):425-429.
- [32]杨丽霞,周玉杰,王志坚.联合应用准分子激光冠状动脉斑块消融术和药物涂层球囊治疗冠状动脉支架内再狭窄的观察性研究[J].中国医药,2020,15(8):1174-1177.
- [33] Sato T,Tsuchida K,Yuasa S,et al. The ef fect of the debulking by excimer laser coronary angioplasty on long-term outcome compared with drug-coating balloon:insights from optical frequency domain imaging analysis[J]. Lasers Med Sci,2020,35(2):403-412.
- [34] Hashimoto S,Takahashi A,Mizuguchi Y,et al. The impact of tissue characterization for in-stent restenosis with optical coherence tomography during excimer laser coronary angioplasty[J].Cardiovasc Interv Ther,2019,34(2):171-177.
- [35] Ishihara T,Dohi T,Nakamura D,et al. Impact of in-stent tissue characteristics on excimer laser coronary angioplasty prior to drugcoated balloon treatment[J]. Int J Cardiol,2021,339:28-32.