改善血管内假体功能特性的最新趋势

P. A. Avgustovsky, V. M. Komarovskaya
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摘要

心血管疾病,特别是冠心病是全世界最常见的死亡原因。找到最有效的治疗方法似乎是一项超前的任务。支架置入术是解决这一问题的一种微创有效方法。随着内假体(支架)的出现,由于内膜增生(血管内壳过度积聚)而出现了血管反复收缩(再狭窄)的问题,其原因是金属离子从支架材料中释放出来,植入过程中对动脉壁的损伤,过敏反应。最初,他们试图通过寻找支架的最佳设计和材料来找到解决方案,这可以从500多个不同设计、材料、几何形状、轮廓、整体尺寸和其他参数的血管内假体模型中得到证明。目前,解决支架材料生物相容性问题最有效的方法是在支架表面形成涂层。有可能区分许多不同的血管内假体具有可修饰的涂层:分泌药用物质,生物可降解涂层,生物活性涂层。本文介绍了在血管内假体表面改性领域的最新研究成果的文献来源分析结果,从而证明了氧氮化钛涂层具有较高的耐腐蚀性,与人体细胞、组织和液体的生物相容性,良好的粘附性,因此推荐选择氧氮化钛涂层进行进一步优化和应用。同时,在保持所有结构和技术要求的同时,获得这种涂层有许多限制因素。
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Current Trends in Improving Functional Properties of Intravascular Endoprostheses
Cardiovascular diseases, and in particular, coronary heart disease are the most common cause of death worldwide. Finding the most effective method of treatment seems to be an advanced task. Stenting is a minimally invasive effective way to solve this problem. Immediately with the advent of endoprostheses (stents), there was a problem of repeated vasoconstriction (restenosis) due to neointimal hyperplasia (excessive build-up of the inner shell of the vessel), the causes of which are the release of metal ions from the stent material, damage to the artery wall during implantation, allergic reactions. Initially, they tried to find a solution by searching for the optimal design and material of the stent, as evidenced by the release of more than five hundred models of intravascular endoprostheses differing in design, material, geometric shape, profile, overall dimensions and other parameters. Currently, the most effective way to solve the problems of biocompatibility of stent materials is the formation of coatings on the surface of stents. It is possible to distinguish a number of different intravascular endoprostheses with modifiable coatings: secreting medicinal substances, with biodegradable coatings, with bioactive coatings. The paper presents the results of the analysis of the literature sources of the most advanced research in the field of surface modification of intravascular endoprostheses, which allowed to justify the choice of titanium oxynitride coating as recommended for further optimization and application due to high corrosion resistance, biocompatibility with cells, tissues and fluids of the human body, a good level of adhesion. At the same time there are a number of limiting factors associated with obtaining such coatings while maintaining all structural and technological requirements. 
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