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紫杉醇涂层球囊的最新研究进展

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Pre-reading

支架内再狭窄仍是个临床难题，紫杉醇涂层球囊（Paclitaxel-coated balloons，PCBs）不失为一种替代方案。以下为PCBs的最新研究证据：


2019年1月新鲜出炉的“Clinical and angiographic outcomes of coronary dissection after paclitaxel-coated balloon angioplasty for small vessel coronary artery disease”纳入了单中心≤ 2.8mm的小冠脉血管病变，试图解释PCB即可经造影明确的冠脉夹层的发生机制及分型，并开展了术后长于6个月的临床随访，以进一步观察冠脉夹层的进展。


“Optical Coherence Tomography Predictors for Recurrent Restenosis After Paclitaxel-Coated Balloon Angioplasty for Drug-Eluting Stent Restenosis”介绍了经PCB-Angioplasty治疗DES-ISR后复发再狭窄的OCT影像学发现，6个月后发生复发再狭窄病变处的组织异质性更高，再狭窄病变处的最小官腔、支架面积、支架膨胀程度等指标显著不足。


“Long-term outcomes after treatment of bare-metal stent restenosis with paclitaxel-coated balloon catheters or everolimus-eluting stents: 3-year follow-up of the TIS clinical study”比较了3年PEB和DES在治疗BMS-ISR的长期疗效。


德国亚琛Schröder等回顾性完成了两种PCB术后一年MACE的比较分析“Long-term clinical outcomes after treatment of stent restenosis with two drug-coated balloons”采用单中心、非随机设计回顾性获取了单中心两种PCBs一年的MACE事概率（15.0 and 15.8% (P=0.879) for the BTHC-PCB and iopromide-based PCB groups）和1年TLR、心梗、心源性死亡事件概率（分别为9.6 versus 11.8%, P=0.622; 5.3 versus 3.9%, P=0.640; and 5.3 versus 3.9%, P=0.640）。


“Comparative efficacy of two paclitaxel-coated balloons with different excipient coatings in patients with coronary in-stent restenosis: A pooled analysis of the Intracoronary Stenting and Angiographic Results: Optimizing Treatment of Drug Eluting Stent In-Stent Restenosis 3 and 4 trial”比较了PCB两种药用辅料BTHC-PCB (n=127)和 iopromide-PCB（n=137）置入6-8个月随访造影终点和1年临床终点。


“Therapeutic efficacy of paclitaxel-coated balloon for de novo coronary lesions with diameters larger than 2.8 mm”前瞻性地对以2.8mm为血管直径为分组阈值，在238例原发病变中评价紫杉醇涂层球囊的安全性和有效性。


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