赵烨婧,彭红玉,郑斌,柳景华

• 1:首都医科大学附属北京安贞医院心内科北京市心肺血管疾病研究所

摘要(Abstract)：

近年来随着介入技术和理念的发展,冠状动脉慢性完全闭塞病变(CTO)经皮冠状动脉介入治疗(PCI)的成功率得到明显提高。但研究表明,CTO病变成功开通后因操作复杂需要置入较长的药物洗脱支架(DES),而支架长度是PCI术后支架内血栓形成及再次血运重建等不良事件的强有力预测因素。因此接受CTO-PCI的患者术后可能面临较高的支架内血栓形成及再狭窄的潜在风险。在这种情况下,具有吸收特性的生物可吸收支架(BRS)能否成为CTO开通后的新选择呢?本文对BRS在CTO-PCI中的安全性和有效性的研究进展进行综述。

关键词(KeyWords)： 慢性完全闭塞病变;经皮冠状动脉介入治疗;生物可吸收支架

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 赵烨婧,彭红玉,郑斌,柳景华

参考文献(References)：

• [1] Vemmou E, Nikolakopoulos I, Xenogiannis I, et al. Recent advances in microcatheter technology for the treatment of chronic total occlusions. Expert Rev Med Devices, 2019, 16(4):267-273.
• [2] Schumacher SP, Stuijfzand WJ, Opolski MP, et al. Percutaneous coronary intervention of chronic total occlusions:when and how to treat. Cardiovasc Revasc Med,2019, 20(6):513-522.
• [3] Lee CW, Park SJ. Stent length and outcomes after drug-eluting stent placement:time to redefine long lesions. Coron Artery Dis, 2017,28(6):452-453.
• [4] Smits PC, Chang CC, Chevalier B, et al. Bioresorbable vascular scaffold versus metallic drug-eluting stent in patients at high risk of restenosis:the COMPARE-ABSORB randomized clinical trial.Euro Intervention, 2020,16(8):645-653.
• [5] Hong SJ, Kim BK, Kim YJ, et al. Incidence, predictors, and outcomes of distal vessel expansion on follow-up intravascular ultrasound after recanalization of chronic total occlusions using new-generation drug-eluting stents:data from the CTO-IVUS randomized trial. Catheter Cardiovasc Interv, 2020, 95(1):154-164.
• [6] Marchenko R, Nazir S, Malla S, et al. Clinical outcomes of successful revascularization of chronic total coronary occlusions with bioresorbable vascular scaff olds:a systematic review. Cureus, 2018,10(11):e3647.
• [7] Ellis SG, Kereiakes DJ, Metzger DC, et al. Everolimus-eluting bioresorbable scaff olds for coronary artery disease. N Engl J Med,2015, 373(20):1905-1915.
• [8] Gao R, Yang Y, Han Y, et al. Bioresorbable vascular scaff olds versus metallic stents in patients with coronary artery disease:ABSORB China trial. J Am Coll Cardiol,2015, 66(21):2298-2309.
• [9] Kimura T, Kozuma K, Tanabe K, et al. A randomized trial evaluating everolimus-eluting absorb bioresorbable scaffolds vs. everolimus-eluting metallic stents in patients with coronary artery disease:ABSORB Japan. Eur Heart J, 2015, 36(47):3332-3342.
• [10] Serruys PW, Chevalier B, Dudek D, et al. A bioresorbable everolimuseluting scaf fold versus a metallic everolimus-eluting stent for ischaemic heart disease caused by de-novo native coronary artery lesions(ABSORBⅡ)：an interim 1-year analysis of clinical and procedural secondary outcomes from a randomised controlled trial. Lancet, 2015,385(9962):43-54.
• [11] Wykrzykowska JJ, Kraak RP, Hofma SH, et al. Bioresorbable scaff olds versus metallic stents in routine PCI. N Engl J Med, 2017,376(24):2319-2328.
• [12] Mitomo S, Naganuma T, Fujino Y, et al. Bioresorbable vascular scaff olds f or the treatment of chronic total occlusions:an international multicenter registry. Circ Cardiovasc Interv, 2017, 10(1):e004265.
• [13] Ojeda S, Pan M, Romero M, et al. Outcomes and computed tomography scan follow-up of bioresorbable vascular scaff old for the percutaneous treatment of chronic total coronary artery occlusion.Am J Cardiol, 2015, 115(11):1487-1493.
• [14] Wiebe J, Liebetrau C, Dorr O, et al. Feasibility of everolimuseluting bioresorbable vascular scaff olds in patients with chronic total occlusion. Int J Cardiol, 2015, 179:90-94.
• [15]?zel E, Tastan A, Ozturk A, et al. Procedural and one-year clinical outcomes of bioresorbable vascular scaffolds for the treatment of chronic total occlusions:a single-centre experience. Cardiovasc J Afr, 2016, 27(6):345-349.
• [16] Vaquerizo B, Barros A, Pujadas S, et al. One-year results of bioresorbable vascular scaff olds for coronary chronic total occlusions.Am J Cardiol, 2016, 117(6):906-917.
• [17] Abellas-Sequeiros RA, Ocaranza-Sanchez R, Trillo-Nouche R, et al.Bioresorbable vascular scaff olds in coronary chronic total occlusions revascularization:safety assessment related to struts coverage and apposition in 6-month OCT follow-up. Heart Vessels, 2017, 32(9):1077-1084.
• [18] Polimeni A, Anadol R, Munzel T, et al. Bioresorbable vascular scaffolds for percutaneous treatment of chronic total coronary occlusions:a meta-analysis. BMC Cardiovasc Disord, 2019, 19(1):59.
• [19] La Manna A, Chisari A, Giacchi G, et al. Everolimuseluting bioresorbable vascular scaff olds versus second generation drug-eluting stents for percutaneous treatment of chronic total coronary occlusions:technical and procedural outcomes from the GHOST-CTO registry. Catheter Cardiovasc Interv, 2016, 88(6):E155-E163.
• [20] Azzalini L, Giustino G, Ojeda S, et al. Procedural and longterm outcomes of bioresorbable scaff olds versus drug-eluting stents in chronic total occlusions:the BONITO registry(Bioresorbable Scaff olds Versus Drug-Eluting Stents in Chronic Total Occlusions).Circ Cardiovasc Interv, 2016, 9(10):e004284.
• [21]中华医学会心血管病学分会.冠状动脉生物可吸收支架临床应用中国专家共识.中华心血管病杂志，2020, 48(5):350-358.