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纽约（路透社健康专栏）12月21日――据研究者报道，对已经接受药物洗脱支架（DES）的病人再次出现支架内再狭窄（ISR）的问题，血管内放射治疗是一种有效的治疗进展，其治疗效果优于再次进行DES。

高级研究者Ron Waksman博士对路透社健康专栏说：“DES置入后，随时间的推移有大约10％的病人发生DES后的支架内再狭窄，虽然其病变范围不如金属裸支架广泛，但DES的ISR仍然和晚期事件发生相关。”研究者在11月15日的《美国心脏病学杂志》上报道：为了进一步研究，他们将60例发生ISR的病人进行血管内放射治疗的结果和50例行再次DES的病例进行了对比。8个月后，进行DES的病例组有18％需要行靶血管再通治疗，8％需行靶病变血管再通治疗；而在血管内放射治疗组，这二项指标均为10％。除此以外，行DES治疗的病例有24％发生主要不良心脏事件，而行血管内放射治疗的病例为9.8％。

因而Waksman博士总结：“对DES后发生的支架内再狭窄，血管内放射治疗是一种安全有效的治疗方法，与再次进行DES比较其似乎有更好的效果。”

Radiation Useful in Drug-Eluting Stent Restenosis

By David Douglas

NEW YORK (Reuters Health) Dec 21 - Intravascular radiation therapy appears to be a helpful approach in treatment of in-stent restenosis (ISR) in patients, who, despite having received drug-eluting stents (DES) still experience this problem, according to researchers. The outcome is superior to that with repeat DES.

"In-stent restenosis of DES occurs in nearly 10% of all DES implanted over time," senior investigator Dr. Ron Waksman told Reuters Health. "Although not diffuse as with bare metal stents, DES ISR still associated with late events."

To investigate further, the researchers note in the November 15th issue of the American Journal of Cardiology, that they compared outcomes in 61 patients who had intravascular brachytherapy for the condition, with those of 50 patients who were assigned to repeat DES treatment.

At 8 months, in the repeat DES group, 18% required target vessel revascularization and 8% required target lesion revascularization. Corresponding proportions in the radiation group were 10% for both. [tab3]

In addition, 24% of DES patients experienced major cardiovascular events compared to 9.8% of radiation patients.

Thus, concluded, Dr. Waksman, "vascular brachytherapy is a safe and effective therapy for ISR of DES and seems to have better results when compared to treatment using DES" for such restenosis.

Am J Cardiol 2006;98:1340-1344.

http://www.medscape.com/viewarticle/549783

编辑：蓝色幻想