冠状动脉药物洗脱支架内再狭窄治疗的研究进展

Research progress on the treatment of in-stent restenosis in coronary drug-eluting stents

摘要:

随着药物洗脱支架(DES)技术的广泛应用和支架生物工程的迅速发展,经皮冠状动脉介入治疗(PCI)术的有效性和安全性显著提高。然而,支架内再狭窄(ISR)的发生率仍然是一个重要问题,每年约有1%~2%的患者需再次接受血运重建手术。鉴于全球每年植入的DES数量高达数百万例,ISR已成为临床领域亟待解决的重大挑战。DES-ISR的病理机制复杂多样,且随着冠状动脉内成像技术的不断进步,其机制和类型得到了进一步揭示。与此同时,针对ISR的治疗工具和策略也在持续发展和优化。该文综述了近年来关于DES-ISR的定义、分型、病理机制、成像特征以及治疗领域的最新研究进展和成果。

Abstract:

With the widespread application of drug-eluting stent (DES) technology and rapid advancement in stent bioengineering, the efficacy and safety of percutaneous coronary intervention (PCI) have significantly improved. However, the incidence of in-stent restenosis (ISR) remains a critical issue, with approximately 1% to 2% of patients requiring repeat revascularization annually. Given the global implantation of millions of DES each year, ISR has emerged as a major clinical challenge demanding urgent resolution. The pathological mechanisms underlying DES-ISR are complex and heterogeneous, and with continuous progress in intracoronary imaging techniques, these mechanisms and classifications have been further elucidated. Concurrently, therapeutic tools and strategies for ISR are undergoing ongoing development and optimization. This review summarizes recent research progress and achievements in the definition, classification, pathological mechanisms, imaging characteristics, and treatment approaches related to DES-ISR.