生物可降解血管支架的研究进展

*毛琳,章晓波,袁广银,丁文江(,200240)血管内支架是治疗心血管疾病最有效的方法之一,普通金属支架易导致支架内再狭窄,生物可降解血管支架的暂时存留性明显降低了支架内再狭窄的发生简述了支架的加工工艺,同时对生物可降解血管支架的研究现状进行了分类论述,包括生物可降解膜被覆金属支架载药生物可降解膜被覆金属支架(药物涂层支架)完全生物可降解性冠状动脉支架和载药生物可降解性冠状动脉支架最后展望了生物可降解血管支架的发展趋势ProgressinResearchesofBiodegradableIntravascularStentsMAOLin,ZHANGXiaobo,YUANGuangyin,DINGWenjiang(NationalEngineeringResearchCenterofLightAlloyNetForming,ShanghaiJiaoTongUniversity,Shanghai200240)AbstractIntravascularstentshavebecomeoneofthemosteffectivewaystothetreatmentofcardiovasculardiseases,ordinarymetalstentsmayleadtoinstentrestenosiseasily,biodegradablestentswhichexisttemporarilycouldreducetheincidenceofinstentrestenosissignificantly.Theprocessingtechnologyofintravascularstentsissketched.Atthesametime,theprogressinresearchesofbiodegradablestentsisdiscussed,includingmetalstentscoveredbybiodegradablemembrane,metalstentscoveredbybiodegradabledrugmembrane(drugelutingstents),fullybiodegradablecoronarystentsanddrugloadedbiodegradablecoronarystents.Andintheend,thetrendofbiodegradableintravascularstentsispredicted.Keywordsbiodegradableintravascularstents,processingtechnology,implantmaterials*上海市基础研究重点项目(08JC1412200);教育部新世纪优秀人才支持计划(NCET070554)毛琳:女,1983年生,博士研究生,主要从事生物可降解镁合金血管内支架的制备及其性能研究Email:[e-mail]0,,,1964Dotter,1977GruntZig[1],1987Sigwart[2],1988Stack[3],300,2080,,,,/,,,,,,,20%~30%,3~6,61,,,,,,X[4],(),,,,66材料导报:综述篇2010年10月(上)第24卷第10期,,,3,,,,,,,,,4,()1,(a)CordisCypher,(b)Biotronik,1Fig.1Partofthetopographyofbiodegradablestents2,,,,,:,,;!,,;∀,,,;#,,[5],Hoffmann[6],,[7,8]3,/,,/,,,,,,,32/,,,,[9-12],,,2/(a)(b)Fig.2Thetopographyofweaving/windingstent(a)and3Dlaserengravingstent(b)33.1316L316L,,[13];,,50.8%,49.2%[14];,XMRI,,,[15],,X,[16]/,,,25%~40%[17],,Tijima[18]67生物可降解血管支架的研究进展/毛琳等,,,,,[19,20],,,,,,3.2(),,,,[21]3,316L(PLA)(PGA)(PCL)(PAGA),,,,;,,,,,;;D[22],,,[23],,,[24],,,,,,,[25],10%,,,,,,3.3,[26],(PLA)(PGA)(PCL)FDA,,,[27,28],,,,[29](PDS),24PDS,,,PDS,,,,;,;;X,;;;,,,,1907,,,,2005Zartner[30]6,4,,,,68材料导报:综述篇2010年10月(上)第24卷第10期,,,,,;3.4,,,,,,,;;,;,Vogt[31]LPLLA,316L,3,,,,[32]AZ31B,,,,,1,Uurto[33]HMGASIMPLLA,,PLLA4,()4,,,,,;,,,1GrntzigAR,SenningA,etal.Nonopeartivedilatationofcoronaryarterystenosis:Percutaneoustransluminalcoronaryangioplasty[J].NEnglJMed,1979,301(2):612SigwartU,PuelJ,MirkovitchV,etal.Intravascularstentstopreventocclusionandrestenosisaftertransluminalgrafting[J].Radiology,1986,160:7233StackTE,CaliffRM,PhillipsHP,etal.InterventionalcardiaccatheterizationatDukemedicalcenter[J].AmJCardiol,1998,62(SupplF):34,,,.PLGA[J].,2006,27(3):4115,,,.[J].,2006,8(1):456HoffmannR,MintzGS,HaagerPK,etal.UnexpectedsensitizationroutesandgeneralfrequencyofcontactallergiesinanelderlystentedSewdishpopulation[J].ContactDermatitis,2007,56(6):3387QiuJJ,HeZX,LiuCM,etal.Crosslinkingpropertyofanoligomericunsaturatedphosphoesterusedasapotentialinjectablebiomaterial[J].BiomedMater,2008,3(4):441078ZhuY,LiuT,SongK,etal.Collagenchitosanpolymerasascaffoldfortheproliferationofhumanadiposetissuederivedstemcells[J].JMaterSciMaterMed,2009,20(3):7999,.[J].:,2007,35(S1):14310,,,.[J].,2007,42(2):22911,,,.[J].,2003,26(3):37412,,,.[J].,2007,34(5):73313,,,.[J].,2006,13(4):54214TepeG,SchmehlJ,WendelHP,etal.Thebiocompatibilityofnitinolstentsinvitroevaluationofdifferentsurfacemodificationsandcoatings[J].Biomaterials,2006,27(4):64315LengYX,ChenJY,HuangN,etal.Thebiocompatibilityofthetantalumandtantalumoxidefilmssynthesizedbypulsemetalvacuumarcsourcedeposition[J].NuclInstrumMethodsPhysRes,2006,242:3016HagspielKD,LeungDA,NandalurKR,etal.ContrastenhancedMRangiographyat1.5Tafterimplantationofplatinumstents:Invitroandinvivocomparisonwithcon69生物可降解血管支架的研究进展/毛琳等ventionalstentdesigns[J].AJRAmJRoentgenol,2005,184(1):28817,,,.NiTi[J].,2006,30(1):318TijimaR,IkariY,AmiyaEetal.TheimpactofmetallicallergyonstentImplantation:metalalleryandrecurrenceofinstentrostenosis[J].IntJCardiol,2005,104(3):31919,,,.[J].,2003,19(2):12920,,,.[J].,2007,24(1):2921.[M].:,200322,,.[J].,2004,7(9):80223,,,.[J].,2007,16(10):65724,,.[J].:,2006,25(6):42325,.[J].,2004,39(4):626AgrawalCM,HaasKF,LeopoldDA,etal.Evaluationofpoly(Llacticacid)asmaterialforintravascularpolymericstents[J].Biomaterials,1992,13:17627,,,.[J].,2003,31(7):52828,,,.CD34[J].,2007,11(3):36929,,.PDS[J].,2009,29(6):4030ZartnerP,CesnjevarR,SingerH,etal.Firstsuccessfulimplantationofabiodegradablemetalstentintotheleftpulmonaryarteryofpretermbaby[J].CatheterCardiovascInterv,2005,66(4):59031VogtF,SteinA,RettemeierG,etal.Longtermassessmentofanovelbiodegradablepaclitaxelelutingcoronarypolylactidestent[J].EurHeartJ,2004,25(15):133032,,,.[J].,2009,23(3):30033UurtoI,MikkonenJ,ParkkinenJ,etal.DrugelutingbiodegradablepolyD/Llacticacidvascularstents:Anexperimentalpilotstudy[J].JEndovascTher,2005,12(3):371(责任编辑王炎)(上接第56页)14,,,.[J].,2005,24(5):4515,,.[J].,2001,10(6):5316NilsonRH,etal.Analyticalmodelsforhightemperaturecorrosionofsilicarefracatoiesinglassmeltingfurnace[J].GlassSciTechn,2003,76(3)17.[J].,1995(6):3118.[J].,2007,59(1):1319DuvierreG,ZanoliY,BoussantRoux,etal.Selectionofoptimumrefractoriesforthesuperstructureofo