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作 者:刘俊超[1] 王兵[1] LIU Junchao WANG Bing(Department of Vascular Surgery, the Fifth Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, Chin)
机构地区:[1]郑州大学第五附属医院血管外科,河南郑州450052
出 处:《中国普通外科杂志》2016年第12期1796-1800,共5页China Journal of General Surgery
基 金:河南省高等学校重点科研基金资助项目(16B320023);河南省医学科技攻关计划重点基金资助项目(201202015)
摘 要:支架内再狭窄(ISR)是治疗周围血管疾病中比较常见的临床问题,然而,目前通过介入技术治疗ISR尚没有统一、有效的方法。药物涂层球囊(DCB)为股腘动脉ISR的治疗提供了一种新思路,近年来已得到初步尝试,与普通球囊相比,DCB治疗股腘动脉ISR术后6个月甚至1年血管通畅率更高,靶血管干预率更低,但其中远期效果尚需进一步研究验证。且研究发现支架内长段狭窄或闭塞性病变管腔内更容易再次发生狭窄。DCB与"减容"技术联合治疗股腘动脉ISR被寄予很大希望,但目前尚缺少充分的研究报道。而且在治疗股腘ISR时,目前尚缺少DCB与新一代金属裸支架、药物释放支架、覆膜支架等的疗效对比,且DCB与这些方式的联合作用效果是否会更加理想还不清楚。尚需要高证据级别的临床随机对照试验来回答这些问题。In-stent restenosis (ISR) is the common clinical problem in treatment of peripheral vascular diseases. However, there is no uniform and effective interventional method for ISR at present. Drug-coated balloon (DCB) provides a new strategy in treatment of femoropopliteal ISR and some preliminary attempts have been done in recent years. For ISR, DCB has higher patency rate and lower target lesion revascularization rate at postoperative 6 months and even 1 year compared with common balloon, but its long-term effcacy still needs further veriifcation. Studies demonstrated that long segment stenosis in the stent or in the lumen of occlusive disease have higher rate of recurrent stenosis. The combination of DCB and debulking technique has been given great expectation, but it currently lacks enough study results. Besides, for femoropopliteal ISR, no study comparing the effects between DCB and new metal stent, drug-eluting stent or covered stent and so on has been performed as yet, and whether the combination of DCB with those techniques will bring better results is not clear. Thus, more high-quality randomized controlled trials are urgently needed to answer these questions.
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