Abstract:
Percutaneous coronary intervention is a critical treatment for coronary artery disease, particularly myocardial infarction, and is highly recommended in clinical guidelines. Traditional metallic stents, although initially effective, remain permanently in the artery and can lead to complications such as in-stent restenosis, late thrombosis, and chronic inflammation. Given the temporary need for stenting and the potential for late complications, bioresorbable stents have emerged as a promising alternative. However, bioresorbable polymeric stents have encountered significant clinical challenges due to their low mechanical strength and ductility, which increase the risks of thrombosis and local inflammation. Consequently, bioresorbable metals are being considered as a superior option for coronary stents. This review examines the progress of bioresorbable metallic stents from both preclinical and clinical perspectives, aiming to provide a theoretical foundation for future research. Iron, zinc, and magnesium are the primary materials used for these stents. Zinc-based bioresorbable stents have shown promise in preclinical studies due to their biocompatibility and vascular protective properties, although human clinical studies are still limited. Magnesium-based stents have demonstrated positive clinical outcomes, being fully absorbed within 12 months and showing low rates of late lumen loss and target lesion failure at 6- and 12-months post-implantation. Initial trials of iron-based stents have indicated favorable mid-term safety and efficacy, with complete absorption by the body within three years and consistent luminal expansion beyond six months post-implantation. Despite these advancements, further trials are needed for comprehensive validation. In conclusion, while current materials do not fully meet the ideal requirements, ongoing research should focus on developing bioresorbable stents with enhanced performance characteristics to better meet clinical needs.
摘要:
经皮冠状动脉介入治疗是冠状动脉疾病的关键治疗方法,特别是心肌梗塞,并在临床指南中强烈推荐。传统金属支架,虽然最初是有效的,永久保留在动脉中,并可能导致并发症,如支架内再狭窄,晚期血栓形成,慢性炎症。考虑到临时需要支架置入和晚期并发症的可能性,生物可吸收支架已经成为一种有希望的替代品。然而,生物可吸收聚合物支架由于其低机械强度和延展性而遇到了重大的临床挑战,增加血栓形成和局部炎症的风险。因此,生物可吸收金属被认为是冠状动脉支架的首选.这篇综述从临床前和临床角度探讨了生物可吸收金属支架的研究进展。旨在为今后的研究提供理论基础。熨斗,锌,镁是这些支架的主要材料。基于锌的生物可吸收支架由于其生物相容性和血管保护特性而在临床前研究中显示出希望。尽管人体临床研究仍然有限。镁基支架已显示出积极的临床结果,在12个月内完全吸收,并在植入后6个月和12个月显示晚期管腔丢失和靶病变失败的发生率较低。铁基支架的初步试验表明,中期安全性和有效性良好,在三年内被身体完全吸收,并在植入后六个月内持续扩张。尽管取得了这些进步,需要进一步的试验进行全面验证.总之,虽然目前的材料不能完全满足理想的要求,正在进行的研究应专注于开发具有增强性能特征的生物可吸收支架,以更好地满足临床需求。