由于冠脉支架植入技术的日臻成熟,通过支架介入将药物或基因导入AS病灶局部已成为目前相关药剂的研制方向。支架为在局部较长时间导入高浓度的药剂提供了一个良好的支撑,尤其是生物可吸收性及微孔支架的应用更是带来了新的理想导入手段。最近RAVEL(Randomized study with the Sirolimus-eluting VELocity Balloon-Expandable Stent)试验对有单一、始发的、长度<18 mm冠脉病变的238例患者分别应用雷帕霉素(RPM,载药剂量140 μg/cm2)包被BX支架(120例)及无RPM包被的BX裸支架(118例)进行介入治疗。随访6个月发现,相比BX裸支架介入组中冠脉再狭窄率为26%,RPM包被BX支架介入组中无一例发生冠脉再狭窄;且后者介入1年后的主要心血管不良事件发生率(5.8%)亦显著低于BX裸支架介入组的28.8%(P<0.0001)[13]。
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