インステント・レステノシスの治療のための皮膚経冠動脈介入戦略: ネットワークメタ解析
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
まとめ
エベロリマス放出ステントは,インステント回復症 (ISR) 治療において最良の結果をもたらします. 薬でコーティングされた気球は,新しいステントなしで良い結果をもたらす,実行可能な第二の選択肢です.
科学分野:
- 介入心臓科
- 生物医学工学
- 臨床試験
背景:
- 薬剤排出ステント (DES) は冠動脈狭窄症の標準です.
- 裸金属ステント (BMS) またはDESの植え付け後のインステント回復症 (ISR) の最適な治療法は不明である.
研究 の 目的:
- 冠動脈ISRの治療のための様々な皮膚経冠動脈介入 (PCI) 戦略を比較し,ランク付けする.
主な方法:
- ランダム化制御試験からの直接的・間接的な証拠を合成したネットワークメタ解析.
- 2014年10月31日までのPubMed,Cochrane Library,Embaseで検索しました
- 主要アウトカム:血管検査での直径狭窄率
主要な成果:
- Everolimusを放出するステントは,他のすべてのテストされた戦略と比較して,直径の狭窄を最も効果的に減少させました.
- 薬で覆われた風船 (DCB) は2番目に効果的な治療法でした.
- DCBとシロリムスまたはパクリタキセルを放出するステントの間で有意な差異は観察されなかった.
結論:
- 冠動脈ISRの優れた血管検査と臨床結果のために,エベロリマス放出ステントを使ったPCIが推奨されます.
- DCBは,追加のステント層を必要とせずに好ましい結果を提供する推奨される代替手段です.
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