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A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
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Estrategias de intervención coronaria percutánea para el tratamiento de la restenosis de estentos: un metanálisis de
George C M Siontis1, Giulio G Stefanini2, Dimitris Mavridis3
1Department of Cardiology, Bern University Hospital, Bern, Switzerland; Department of Medicine, Mayo Clinic, Rochester, MN, USA.
Lancet (London, England)
|September 4, 2015
Resumen
Los stents que emiten everolimus ofrecen los mejores resultados para el tratamiento de la restenosis en el stent (ISR). Los globos revestidos de fármacos son una segunda opción viable, que proporciona buenos resultados sin un stent nuevo.
Área de la Ciencia:
- Cardiología intervencionista
- Ingeniería biomédica
- Ensayos clínicos
Sus antecedentes:
- Los stents de liberación de fármacos (DES) son estándar para las estenosis de las arterias coronarias.
- El tratamiento óptimo para la restenosis de stent (ISR) después de la implantación de stent de metal desnudo (BMS) o DES sigue sin estar claro.
Objetivo del estudio:
- Comparar y clasificar varias estrategias de intervención coronaria percutánea (ICP) para el tratamiento de la ISR coronaria.
Principales métodos:
- Un metanálisis de red sintetizó evidencia directa e indirecta de ensayos controlados aleatorios.
- Buscado en PubMed, Cochrane Library y Embase hasta el 31 de octubre de 2014.
- Resultado primario: estenosis porcentual de diámetro en el seguimiento angiográfico.
Principales resultados:
- Los stents con elusión de everolimus demostraron la reducción más efectiva de la estenosis de diámetro en comparación con todas las otras estrategias probadas.
- Los globos revestidos de fármaco (DCB) fueron el segundo tratamiento más eficaz.
- No se observaron diferencias significativas entre DCB y los stents que liberan sirolimus o paclitaxel.
Conclusiones:
- Se recomienda la ICP con stents que emiten everolimus para obtener resultados angiográficos y clínicos superiores en la RSI coronaria.
- DCB es una alternativa recomendada, que ofrece resultados favorables sin requerir una capa de stent adicional.
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