新型生物可降解单面刻槽载药靶向支架对冠状动脉内膜增生的影响

发布时间：2018-07-31 14:07

【摘要】：背景:理论上,新型生物可降解单面刻槽载药靶向支架可避免长期存在药物涂层对局部血管壁的致炎作用,减少药物剂量,减少血栓形成的可能性,减轻管腔狭窄。目的:评价生物可降解新型单面刻槽载药支架对健康小型猪冠状动脉内膜增生的影响。方法:将18只健康小型猪随机分为裸支架组、Firebird 2支架组和Firehawk支架组,分别植入L605钴铬合金裸金属支架、L605钴铬合金不可降解涂层雷帕霉素支架和L605钴铬合金可降解单面刻槽涂层雷帕霉素靶向洗脱支架,于左前降支和右冠状动脉各植入相同支架1枚。支架植入后1,3个月时复查冠状动脉造影并处死取材,观察内膜增生情况。结果与结论:(1)冠状动脉造影结果:植入1,3个月时,3组支架段冠状动脉均无狭窄发生,支架段血管均通畅,见血栓及动脉瘤等影像学表现;植入后1,3个月时,Firebird 2支架组、Firehawk支架组管腔丢失均低于裸支架组(P0.05),Firebird 2支架组与Firehawk支架组管腔丢失比较差异无显著性意义;(2)组织病理学结果:3组均未见支架段冠状动脉管壁组织坏死或管腔内血栓形成;支架植入后1,3个月时,Firebird2支架组、Firehawk支架组新生内膜面积及面积狭窄百分比低于裸支架组(P0.05),残余管腔面积、内弹力板面积高于裸支架组(P0.05)。Firebird 2支架组与Firehawk支架组上述各指标比较差异无显著性意义;(3)结果表明:生物可降解新型单面刻槽载药支架可有效抑制冠状动脉内膜增生,预防冠状动脉支架内狭窄,效果与不可降解涂层雷帕霉素支架相当,长期效果仍有待进一步观察。
[Abstract]:Background: in theory, a novel biodegradable single-side grooved targeted stent can avoid the long-term effect of drug coating on the inflammation of local vascular wall, reduce the dosage of drugs, reduce the possibility of thrombosis and reduce the stenosis of the lumen. Aim: to evaluate the effect of biodegradable stents on intimal hyperplasia of coronary artery in healthy miniature pigs. Methods: eighteen healthy miniature pigs were randomly divided into bare stents group and Firehawk stent group. L605 cobalt-chromium alloy bare metal stent L605 cobalt-chromium alloy non-degradable coating rapamycin stent and L605 cobalt-chromium alloy biodegradable single-side groove coating rapamycin eluting stent were implanted respectively. One stent was implanted in the left anterior descending branch and the right coronary artery respectively. Coronary angiography was performed 1 and 3 months after stent implantation and the intimal hyperplasia was observed. Results and conclusion: (1) Coronary angiography: coronary artery stenosis was not found in the 3 groups at 1 and 3 months after implantation. The loss of lumen in Firebird 2 stent group was lower than that in bare stent group at 1 and 3 months after implantation (P0.05) there was no significant difference in lumen loss between Firebird 2 stent group and Firehawk stent group. Necrosis of vessel wall or thrombosis in lumen; At 1 and 3 months after stent implantation, the area of neointima and the percentage of stenosis of neointima in firebird2 stent group were lower than those in bare stent group (P0.05), and the area of residual lumen in firebird2 stent group was lower than that in bare stent group (P0.05). The area of inner elastic plate was higher than that of bare stent group (P0.05). There was no significant difference between Firebird 2 stent group and Firehawk stent group. (3) the results showed that biodegradable stents with single-sided grooves could effectively inhibit the intimal hyperplasia of coronary artery. The effect of preventing coronary stent stenosis is comparable to that of non-degradable rapamycin stent, and the long-term effect remains to be further observed.
【作者单位】：包头市中心医院心内科;
【分类号】：R318.08;R54

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