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Updated: Sep 11, 2025

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对长扩散冠状动脉疾病的第二代单一长期支架和重叠支架之间的长期结果的比较 - 系统性审查和元分析

Masaaki Ikehara^1,2, Kaoru Hattori^2,3,4, Hiroshi Niinami^2,3

¹Cooperative Major in Advanced Biomedical Sciences, Joint Graduate School of Tokyo Women's Medical University and Waseda University Tokyo Japan.

Circulation reports

|August 11, 2025

概括

对于长期扩散冠状动脉疾病 (ldCAD),单一长支架 (SLS) 与重叠支架 (OLS) 与较新的药物排泄支架 (DES) 具有相似的结果,SLS可能会降低心肌梗塞风险.

科学领域:

干预心脏病学干预心脏病学
心血管研究研究心血管研究
医疗器械技术医疗器械技术

背景情况:

在老年人群中冠状动脉疾病 (CAD) 的患病率增加.
长时间扩散性CAD (ldCAD),定义的病变≥30毫米,提出了重要的治疗挑战.
评估使用第二代和后期药物排泄支架 (DES) 的 ldCAD 治疗策略.

研究的目的:

在ldCAD患者中,比较单个长支架 (SLS) 和重叠支架 (OLS) 之间的长期预后结果.
评估支架策略对主要不良心血管事件 (MACE) 和其他心脏事件的影响.
为了研究SLS和OLS策略之间心肌梗塞 (MI) 发病率的差异.

主要方法:

2000年至2024年10月期间发表的研究的系统审查和元分析.
包括来自PubMed,Embase,Web of Science和Cochrane图书馆的研究.
分析了5项涉及2,756名患者的研究,重点关注MACE,心脏死亡,TVR和MI.

主要成果:

在MACE和目标血管再血管化 (TVR) 中,SLS和OLS之间没有发现显著差异.
与OLS相比,SLS的心肌梗塞 (MI) 的发生率明显较低.
SLS策略与对比度减少以及病变和支架长度缩短的趋势有关.

结论:

支架重叠对现代药物排泄支架 (DES) 的预后影响最小.
需要进一步的研究来优化ldCAD的治疗策略.
临床实践指南可能需要更新关于ldCAD的支架选择.

关键词:

扩散性冠状动脉疾病是冠状动脉疾病.药物释放的支架可以释放药物.叠加式支架 (stent) 是一种叠加式支架.单个长长的支架.

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