Research of Prevention and Treatment of Restenosis after Stent Implantation_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

XU Qiang , DAI Yuanbin , GUO Facai.

Department of Vascular Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China;

Corresponding author：

Keywords：

Postoperative restenosis; Drugeluting stent; Mesenchymal stem cell; Prevention and treatment

Video：

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ObjectiveTo study the prevention and treatment of restenosis after the stent placement in the latest progress. MethodsThere were four methods including drug-eluting stents, intracavitary illuminate, drug therapy, and mesenchymal stem cells, which prevented or treatment restenosis after stent placement. ResultsAll the four methods could reduce the postoperative restenosis rate after interventional treatment. Many experimental study of prevention and treatment of restenosis had obvious effect, but clinical curative effect was not very satisfactory, because of a series of problems such as safety, animal models, experiment method, and so on. ConclusionThe multiple factors and links caused restenosis should be considered fully, and interrupting the links or factors as far as possible could control the occurrence or development effectively.

Citation： XU Qiang,DAI Yuanbin,GUO Facai.. Research of Prevention and Treatment of Restenosis after Stent Implantation. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2011, 18(5): 564-567. doi: Copy

1.	马震寰, 杨镛, 杨国凯, 等. 下肢动脉硬化闭塞症继发血栓形成治疗分析 [J]. 中国普外基础与临床杂志, 2010, 17(3): 275277.
2.	王玉琦，史振宇. 我国血管外科的现状与展望 [J]. 中国普外基础与临床杂志， 2008, 15（6）： 387389.
3.	Takasawa Y, Iijima R, Shiba M, et al. Predictor of subsequent target lesion revascularization in patients with drugeluting stent restenosis undergoing percutaneous coronary intervention [J]. J Cardiol, 2010, 55(3): 391396.
4.	Rabbat MG, Bavry AA, Bhatt DL, et al. Understanding and minimizing late thrombosis of drugeluting stents [J]. Cleve Clin J Med, 2007, 74(2): 129136．.
5.	Mahmud E, Ormiston JA, Turco MA, et al. TAXUS Liberté attenuates the risk of restenosis in patients with medically treated diabetes mellitus: results from the TAXUS ATLAS program [J]. JACC Cardiovasc Interv, 2009, 2(3): 240252.
6.	Erne P, Schier M, Resink TJ. The road to bioabsorbable stents: reaching clinical reality? [J]. Cardiovasc Intervent Radiol, 2006, 29(1): 1116.
7.	Machan L. Clinical experience and applications of drugeluting stents in the noncoronary vasculature, bile duct and esophagus [J]. Adv Drug Deliv Rev, 2006, 58(3): 447462.
8.	Kolachalama VB, Tzafriri AR, Arifin DY, et al. Luminal flow patterns dictate arterial drug deposition in stentbased delivery [J]. J Control Release, 2009, 133(1): 2430.
9.	Guo Q, Knight PT, Mather PT. Tailored drug release from biodegradable stent coatings based on hybrid polyurethanes [J]. J Control Release, 2009, 137(3): 224233.
10.	De Labriolle A, Bonello L, Lemesle G, et al. Clinical presentation and outcome of patients hospitalized for symptomatic instent restenosis treated by percutaneous coronary intervention: comparison between drugeluting stents and baremetal stents [J]. Arch Cardiovasc Dis, 2009, 102(3): 209217.
11.	郜俊清，赵德强，刘宗军. 新型药物支架 [J]. 心血管病学进展， 2009， 30（4）： 662666.
12.	Liistro F, Fineschi M, Grotti S, et al. Longterm effectiveness and safety of sirolimus stent implantation for coronary instent restenosis results of the TRUE (Tuscany Registry of sirolimus for unselected instent restenosis) registry at 4 years [J]. J Am Coll Cardiol, 2010, 55(7): 613666.
13.	Pelliccia F, Cianfrocca C, Rosano G, et al. Role of endothelial progenitor cells in restenosis and progression of coronary atherosclerosis after percutaneous coronary intervention: a prospective study [J]. JACC Cardiovasc Interv, 2010, 3(1): 7886.
14.	黄宜杰，傅强，吴强. 药物洗脱支架治疗多支血管病变的疗效及安全性 [J]. 江苏医药， 2007， 33(12)： 12591260.
15.	郑启东，唐礼江，江建军，等．国产雷帕霉素洗脱支架远期预后的临床研究 [J]. 浙江临床医学， 2008， 10(6)： 746747．.
16.	朱中玉，高传玉，牛振民，等．药物洗脱支架置入术的长期随访 [J]. 临床心血管病杂志， 2008， 24(6)： 433435．.
17.	王小庆，彭长农，胡春华，等． Zotarolimus洗脱支架与雷帕霉素洗脱支架临床应用比较 [J]. 广东医学， 2009， 30(2)： 227229.
18.	Sun Z, Davidson R, Lin CH. Multidetector row CT angiography in the assessment of coronary instent restenosis: a systematic review [J]. Eur J Radiol, 2009, 69(3): 489495.
19.	张奇，张瑞岩，张建盛，等. 国产与进口西罗莫司药物洗脱支架治疗冠心病临床疗效对比 [J]．中国介入心脏病学杂志， 2006， 14(4)： 198201．.
20.	李锐洁，李静，陈玉成, 等. 药物洗脱支架治疗冠状动脉疾病的Meta分析 [J]．中国循证医学杂志， 2005， 5(7)： 519535．.
21.	Bonati LH, Ederle J, McCabe DJ, et al. Longterm risk of carotid restenosis in patients randomly assigned to endovascular treatment or endarterectomy in the Carotid and Vertebral Artery Transluminal Angioplasty Study (CAVATAS): longterm followup of a randomised trial [J]. Lancet Neurol, 2009, 8(10): 908917.
22.	Nordmann AJ, Briel M, Bucher HC. Mortality in randomized controlled trials comparing drugeluting vs. bare metal stents in coronary artery disease: a metaanalysis [J]. Eur Heart J, 2006, 27(23): 27842814.
23.	Pfisterer M, BrunnerLa Rocca HP, Buser PT, et al. Late clinical events after clopidogrel discontinuation may limit the benefit of drugeluting stents: an observational study of drugeluting versus baremetal stents [J]. J Am Coll Cardiol, 2006, 48(12): 25842591．.
24.	陈纪林，高润霖，杨跃进，等. 雷帕霉素和紫杉醇药物洗脱支架治疗冠心病复杂病变的临床近远期疗效比较 [J]．中华医学杂志， 2005， 85(31)： 21832186．.
25.	Shedden L, Kennedy S, Wadsworth R, et al. Towards a selfreporting coronary artery stent－measuring neointimal growth associated with instent restenosis using electrical impedance techniques [J]. Biosens Bioelectron, 2010, 26(2): 661666.
26.	EpsteinBarash H, Gutman D, Markovsky E, et al. Physicochemical parameters affecting liposomal bisphosphonates bioactivity for restenosis therapy: internalization, cell inhibition, activation of cytokines and complement, and mechanism of cell death [J]. J Control Release, 2010, 146(2): 182195.
27.	Takano M, Yamamoto M, Murakami D, et al. Optical coherence tomography after new scoring balloon angioplasty for instent restenosis and de novo coronary lesions [J]. Int J Cardiol, 2010, 141(3): e51e53.
28.	Kalińczuk , Demkow M, Mintz GS, et al. Impact of different restenting strategies on expansion of a drugeluting stent implanted to treat baremetal stent restenosis [J]. Am J Cardiol, 2009, 104(4): 531537.
29.	Shah QA, Georgiadis AL, Suri MF, et al. Cutting balloon angioplasty for carotid instent restenosis: case reports and review of the literature [J]. J Neuroimaging, 2008, 18(4): 428432．.
30.	Li J, De Leon H, Ebato B, et al. Endovascular irradiation impairs vascular functional responses in noninjured pig coronary arteries [J]. Cardiovasc Radiat Med, 2002, 3(4): 152162．.
31.	Therasse E, Donath D, Lespérance J, et al. External beam radiation to prevent restenosis after superficial femoral artery balloon angioplasty [J]. Circulation, 2005, 111(24): 33103315.
32.	Tagawa T, Urabe Y, Kimura Y, et al. Longterm treatment with probucol improves endothelial function in patients with coronary artery disease [J]. Hypertens Res, 2004, 27(5): 311318．.
33.	Shudo J, Pongpeerapat A, Wanawongthai C, et al. In vivo assessment of oral administration of probucol nanoparticles in rats [J].Biol Pharm Bull, 2008, 31(2): 321325.
34.	Kaminnyi AI, Lankin VZ, Perepelitsa EI, et al. Relationship between freeradical lipid oxidation and efficiency of coronary angioplasty in coronary patients [J]. Bull Exp Biol Med, 2007, 144(5): 664666.
35.	Eckart RE, Uyehara CF, Shry EA, et al. Matrix metalloproteinases in patients with myocardial infarction and percutaneous revascularization [J]. J Interv Cardiol, 2004, 17(1): 2731．.
36.	胡春梅，李淑梅，张基昌, 等. 罗格列酮对大鼠血管再狭窄的影响及其发生机制 [J]. 山西医药杂志, 2009, 38（8）： 719720.
37.	Armstrong EJ, Morrow DA, Sabatine MS. Inflammatory biomarkers in acute coronary syndromes: part Ⅳ: matrix metalloproteinases and biomarkers of platelet activation [J]. Circulation, 2006, 113(9): e382e385．.
38.	陈斌，邓玉莲，吴志勇, 等. 阿伐他丁对兔动脉粥样硬化模型血管壁平滑肌细胞凋亡的影响 [J]. 中国老年学杂志， 2004, 24（6）: 542544.
39.	BlancoColio LM, Villa A, Ortego M, et al. 3Hydroxy3methylglutaryl coenzyme A reductase inhibitors, atorvastatin and simvastatin, induce apoptosis of vascular smooth muscle cells by downregulation of Bcl2 expression and Rho A prenylation [J]. Atherosclerosis, 2002, 161(1): 1726.
40.	Xu YG, Zhou SH, Li YG, et al. The mechanism underlying vascular smooth muscle cell apoptosis induced by atorvastatin may be mainly associated with downregulation of survivin expression [J]. Cardiovasc Drugs Ther, 2007, 21(3): 145153.
41.	Wang GJ, Sui XX, Simosa HF, et al. Regulation of vein graft hyperplasia by survivin, an inhibitor of apoptosis protein [J]. Arterioscler Thromb Vasc Biol, 2005, 25(10): 20812087.
42.	Naruko T, Ueda M, Ehara S, et al. Persistent high levels of plasma oxidized lowdensity lipoprotein after acute myocardial infarction predict stent restenosis [J]. Arterioscler Thromb Vasc Biol, 2006, 26(4): 877883．.
43.	Jandt E, Mutschke O, Mahboobi S, et al. Stentbased release of a selective PDGFreceptor blocker from the bisindolylmethanon class inhibits restenosis in the rabbit animal model [J]. Vascul Pharmacol, 2010, 52(2): 5562.
44.	Wang T, Tang W, Sun S, et al. Intravenous infusion of bone marrow mesenchymal stem cells improves myocardial function in a rat model of myocardial ischemia [J]. Crit Care Med, 2007, 35(11): 25872593.
45.	Johansson U, Rasmusson I, Niclou SP, et al. Formation of composite endothelial cellmesenchymal stem cell islets: a novel approach to promote islet revascularization [J]. Diabetes, 2008, 57(9): 23932401．.
46.	Silva GV, Litovsky S, Assad JA, et al. Mesenchymal stem cells differentiate into an endothelial phenotype, enhance vascular density, and improve heart function in a canine chronic ischemia model [J]. Circulation, 2005, 111(2): 150156．.
47.	Inoue T, Sata M, Hikichi Y, et al. Mobilization of CD34positive bone marrowderived cells after coronary stent implantation: impact on restenosis [J]. Circulation, 2007, 115(5): 553561．.
48.	Takamiya M, Okigaki M, Jin D, et al. Granulocyte colonystimulating factormobilized circulating cKit+/Flk1+ progenitor cells regenerate endothelium and inhibit neointimal hyperplasia after vascular injury [J]. Arterioscler Thromb Vasc Bio, 2006, 26(4): 751757．.
49.	Wang CH, Cherng WJ, Yang NI, et al. Lateoutgrowth endothelial cells attenuate intimal hyperplasia contributed by mesenchymal stem cells after vascular injury [J]. Arterioscler Thromb Vasc Biol, 2008, 28(1): 5460．.
50.	Chen L, Tredget EE, Wu PY, et al. Paracrine factors of mesenchymal stem cells recruit macrophages and endothelial lineage cells and enhance wound healing [J]. PLoS One, 2008, 3(4): e1886．.

1. 马震寰, 杨镛, 杨国凯, 等. 下肢动脉硬化闭塞症继发血栓形成治疗分析 [J]. 中国普外基础与临床杂志, 2010, 17(3): 275277.
2. 王玉琦，史振宇. 我国血管外科的现状与展望 [J]. 中国普外基础与临床杂志， 2008, 15（6）： 387389.
3. Takasawa Y, Iijima R, Shiba M, et al. Predictor of subsequent target lesion revascularization in patients with drugeluting stent restenosis undergoing percutaneous coronary intervention [J]. J Cardiol, 2010, 55(3): 391396.
4. Rabbat MG, Bavry AA, Bhatt DL, et al. Understanding and minimizing late thrombosis of drugeluting stents [J]. Cleve Clin J Med, 2007, 74(2): 129136．.
5. Mahmud E, Ormiston JA, Turco MA, et al. TAXUS Liberté attenuates the risk of restenosis in patients with medically treated diabetes mellitus: results from the TAXUS ATLAS program [J]. JACC Cardiovasc Interv, 2009, 2(3): 240252.
6. Erne P, Schier M, Resink TJ. The road to bioabsorbable stents: reaching clinical reality? [J]. Cardiovasc Intervent Radiol, 2006, 29(1): 1116.
7. Machan L. Clinical experience and applications of drugeluting stents in the noncoronary vasculature, bile duct and esophagus [J]. Adv Drug Deliv Rev, 2006, 58(3): 447462.
8. Kolachalama VB, Tzafriri AR, Arifin DY, et al. Luminal flow patterns dictate arterial drug deposition in stentbased delivery [J]. J Control Release, 2009, 133(1): 2430.
9. Guo Q, Knight PT, Mather PT. Tailored drug release from biodegradable stent coatings based on hybrid polyurethanes [J]. J Control Release, 2009, 137(3): 224233.
10. De Labriolle A, Bonello L, Lemesle G, et al. Clinical presentation and outcome of patients hospitalized for symptomatic instent restenosis treated by percutaneous coronary intervention: comparison between drugeluting stents and baremetal stents [J]. Arch Cardiovasc Dis, 2009, 102(3): 209217.
11. 郜俊清，赵德强，刘宗军. 新型药物支架 [J]. 心血管病学进展， 2009， 30（4）： 662666.
12. Liistro F, Fineschi M, Grotti S, et al. Longterm effectiveness and safety of sirolimus stent implantation for coronary instent restenosis results of the TRUE (Tuscany Registry of sirolimus for unselected instent restenosis) registry at 4 years [J]. J Am Coll Cardiol, 2010, 55(7): 613666.
13. Pelliccia F, Cianfrocca C, Rosano G, et al. Role of endothelial progenitor cells in restenosis and progression of coronary atherosclerosis after percutaneous coronary intervention: a prospective study [J]. JACC Cardiovasc Interv, 2010, 3(1): 7886.
14. 黄宜杰，傅强，吴强. 药物洗脱支架治疗多支血管病变的疗效及安全性 [J]. 江苏医药， 2007， 33(12)： 12591260.
15. 郑启东，唐礼江，江建军，等．国产雷帕霉素洗脱支架远期预后的临床研究 [J]. 浙江临床医学， 2008， 10(6)： 746747．.
16. 朱中玉，高传玉，牛振民，等．药物洗脱支架置入术的长期随访 [J]. 临床心血管病杂志， 2008， 24(6)： 433435．.
17. 王小庆，彭长农，胡春华，等． Zotarolimus洗脱支架与雷帕霉素洗脱支架临床应用比较 [J]. 广东医学， 2009， 30(2)： 227229.
18. Sun Z, Davidson R, Lin CH. Multidetector row CT angiography in the assessment of coronary instent restenosis: a systematic review [J]. Eur J Radiol, 2009, 69(3): 489495.
19. 张奇，张瑞岩，张建盛，等. 国产与进口西罗莫司药物洗脱支架治疗冠心病临床疗效对比 [J]．中国介入心脏病学杂志， 2006， 14(4)： 198201．.
20. 李锐洁，李静，陈玉成, 等. 药物洗脱支架治疗冠状动脉疾病的Meta分析 [J]．中国循证医学杂志， 2005， 5(7)： 519535．.
21. Bonati LH, Ederle J, McCabe DJ, et al. Longterm risk of carotid restenosis in patients randomly assigned to endovascular treatment or endarterectomy in the Carotid and Vertebral Artery Transluminal Angioplasty Study (CAVATAS): longterm followup of a randomised trial [J]. Lancet Neurol, 2009, 8(10): 908917.
22. Nordmann AJ, Briel M, Bucher HC. Mortality in randomized controlled trials comparing drugeluting vs. bare metal stents in coronary artery disease: a metaanalysis [J]. Eur Heart J, 2006, 27(23): 27842814.
23. Pfisterer M, BrunnerLa Rocca HP, Buser PT, et al. Late clinical events after clopidogrel discontinuation may limit the benefit of drugeluting stents: an observational study of drugeluting versus baremetal stents [J]. J Am Coll Cardiol, 2006, 48(12): 25842591．.
24. 陈纪林，高润霖，杨跃进，等. 雷帕霉素和紫杉醇药物洗脱支架治疗冠心病复杂病变的临床近远期疗效比较 [J]．中华医学杂志， 2005， 85(31)： 21832186．.
25. Shedden L, Kennedy S, Wadsworth R, et al. Towards a selfreporting coronary artery stent－measuring neointimal growth associated with instent restenosis using electrical impedance techniques [J]. Biosens Bioelectron, 2010, 26(2): 661666.
26. EpsteinBarash H, Gutman D, Markovsky E, et al. Physicochemical parameters affecting liposomal bisphosphonates bioactivity for restenosis therapy: internalization, cell inhibition, activation of cytokines and complement, and mechanism of cell death [J]. J Control Release, 2010, 146(2): 182195.
27. Takano M, Yamamoto M, Murakami D, et al. Optical coherence tomography after new scoring balloon angioplasty for instent restenosis and de novo coronary lesions [J]. Int J Cardiol, 2010, 141(3): e51e53.
28. Kalińczuk , Demkow M, Mintz GS, et al. Impact of different restenting strategies on expansion of a drugeluting stent implanted to treat baremetal stent restenosis [J]. Am J Cardiol, 2009, 104(4): 531537.
29. Shah QA, Georgiadis AL, Suri MF, et al. Cutting balloon angioplasty for carotid instent restenosis: case reports and review of the literature [J]. J Neuroimaging, 2008, 18(4): 428432．.
30. Li J, De Leon H, Ebato B, et al. Endovascular irradiation impairs vascular functional responses in noninjured pig coronary arteries [J]. Cardiovasc Radiat Med, 2002, 3(4): 152162．.
31. Therasse E, Donath D, Lespérance J, et al. External beam radiation to prevent restenosis after superficial femoral artery balloon angioplasty [J]. Circulation, 2005, 111(24): 33103315.
32. Tagawa T, Urabe Y, Kimura Y, et al. Longterm treatment with probucol improves endothelial function in patients with coronary artery disease [J]. Hypertens Res, 2004, 27(5): 311318．.
33. Shudo J, Pongpeerapat A, Wanawongthai C, et al. In vivo assessment of oral administration of probucol nanoparticles in rats [J].Biol Pharm Bull, 2008, 31(2): 321325.
34. Kaminnyi AI, Lankin VZ, Perepelitsa EI, et al. Relationship between freeradical lipid oxidation and efficiency of coronary angioplasty in coronary patients [J]. Bull Exp Biol Med, 2007, 144(5): 664666.
35. Eckart RE, Uyehara CF, Shry EA, et al. Matrix metalloproteinases in patients with myocardial infarction and percutaneous revascularization [J]. J Interv Cardiol, 2004, 17(1): 2731．.
36. 胡春梅，李淑梅，张基昌, 等. 罗格列酮对大鼠血管再狭窄的影响及其发生机制 [J]. 山西医药杂志, 2009, 38（8）： 719720.
37. Armstrong EJ, Morrow DA, Sabatine MS. Inflammatory biomarkers in acute coronary syndromes: part Ⅳ: matrix metalloproteinases and biomarkers of platelet activation [J]. Circulation, 2006, 113(9): e382e385．.
38. 陈斌，邓玉莲，吴志勇, 等. 阿伐他丁对兔动脉粥样硬化模型血管壁平滑肌细胞凋亡的影响 [J]. 中国老年学杂志， 2004, 24（6）: 542544.
39. BlancoColio LM, Villa A, Ortego M, et al. 3Hydroxy3methylglutaryl coenzyme A reductase inhibitors, atorvastatin and simvastatin, induce apoptosis of vascular smooth muscle cells by downregulation of Bcl2 expression and Rho A prenylation [J]. Atherosclerosis, 2002, 161(1): 1726.
40. Xu YG, Zhou SH, Li YG, et al. The mechanism underlying vascular smooth muscle cell apoptosis induced by atorvastatin may be mainly associated with downregulation of survivin expression [J]. Cardiovasc Drugs Ther, 2007, 21(3): 145153.
41. Wang GJ, Sui XX, Simosa HF, et al. Regulation of vein graft hyperplasia by survivin, an inhibitor of apoptosis protein [J]. Arterioscler Thromb Vasc Biol, 2005, 25(10): 20812087.
42. Naruko T, Ueda M, Ehara S, et al. Persistent high levels of plasma oxidized lowdensity lipoprotein after acute myocardial infarction predict stent restenosis [J]. Arterioscler Thromb Vasc Biol, 2006, 26(4): 877883．.
43. Jandt E, Mutschke O, Mahboobi S, et al. Stentbased release of a selective PDGFreceptor blocker from the bisindolylmethanon class inhibits restenosis in the rabbit animal model [J]. Vascul Pharmacol, 2010, 52(2): 5562.
44. Wang T, Tang W, Sun S, et al. Intravenous infusion of bone marrow mesenchymal stem cells improves myocardial function in a rat model of myocardial ischemia [J]. Crit Care Med, 2007, 35(11): 25872593.
45. Johansson U, Rasmusson I, Niclou SP, et al. Formation of composite endothelial cellmesenchymal stem cell islets: a novel approach to promote islet revascularization [J]. Diabetes, 2008, 57(9): 23932401．.
46. Silva GV, Litovsky S, Assad JA, et al. Mesenchymal stem cells differentiate into an endothelial phenotype, enhance vascular density, and improve heart function in a canine chronic ischemia model [J]. Circulation, 2005, 111(2): 150156．.
47. Inoue T, Sata M, Hikichi Y, et al. Mobilization of CD34positive bone marrowderived cells after coronary stent implantation: impact on restenosis [J]. Circulation, 2007, 115(5): 553561．.
48. Takamiya M, Okigaki M, Jin D, et al. Granulocyte colonystimulating factormobilized circulating cKit+/Flk1+ progenitor cells regenerate endothelium and inhibit neointimal hyperplasia after vascular injury [J]. Arterioscler Thromb Vasc Bio, 2006, 26(4): 751757．.
49. Wang CH, Cherng WJ, Yang NI, et al. Lateoutgrowth endothelial cells attenuate intimal hyperplasia contributed by mesenchymal stem cells after vascular injury [J]. Arterioscler Thromb Vasc Biol, 2008, 28(1): 5460．.
50. Chen L, Tredget EE, Wu PY, et al. Paracrine factors of mesenchymal stem cells recruit macrophages and endothelial lineage cells and enhance wound healing [J]. PLoS One, 2008, 3(4): e1886．.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Research of Prevention and Treatment of Restenosis after Stent Implantation

Abstract Full text Figures/Tables Video References Cited by

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