Tom 17, Nr 2 (2022)
Inne materiały uzgodnione z Redakcją
Opublikowany online: 2022-09-02
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Czy powinniśmy stosować balony uwalniające leki w przezskórnym leczeniu tętnic obwodowych?
Kardiol Inwazyjna 2022;17(2):70-76.
Streszczenie
Balony pokrywane lekami antyproliferacyjnymi (DEB, drug-eluting balloon; DCB, drug-coated balloon) mają wiele zastosowań w leczeniu zwężeń naczyń. Obecnie stosuje się je w leczeniu długich zmian, restenoz, przewlekłych okluzji, a po odpowiednim przygotowaniu (litotrypsja, aterektomia) także do leczenia zmian
uwapnionych. Od niedawna wykorzystywane są także w leczeniu zwężeń przetok dializacyjnych. Balony uwalniające paklitaksel mają ugruntowaną pozycję przede wszystkim w leczeniu zwężeń odcinka udowo-podkolanowego. Pomimo sygnałów o szkodliwości urządzeń uwalniających paklitaksel, nie wykazano
w stosunku do balonów i stentów uwalniających tę substancję jednoznacznego związku ze zwiększoną śmiertelnością w porównaniu z balonami niepokrywanymi lekiem. Dzięki zastosowaniu
technologii fosfolipidowych nanonośników udało się zwiększyć dostarczalność sirolimusu do ściany naczynia, co spowodowało wprowadzenie balonów pokrywanych sirolimusem do leczenia zwężeń tętnic, w tym miażdżycy tętnic obwodowych. Jeśli wstępne, obiecujące wyniki leczenia balonami uwalniającymi sirolimus w piętrze naczyniowym poniżej kolana potwierdzą się w dłuższej obserwacji, być może dojdzie do znaczącej zmiany w zakresie interwencji „bezstentowych” w tętnicach goleni, gdzie DCB (DEB) będą urządzeniami pierwszego wyboru.
Słowa kluczowe: restenozabalony pokrywane lekamipaklitakselsirolimusmiażdżyca tętnic obwodowych
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