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Vol. 5. Núm. A.
Temas de actualidad en Cardiología 2004
Páginas 104A-117A (Junio 2005)
Temas de actualidad en cardiología 2004
Acceso a texto completo
Actualización en cardiología intervencionista 2004
Update in Interventional Cardiology (2004)
Visitas
...
Rosa A. Hernández Antolína,??, Felipe Fernández-Vázquezb, Ramón López Palopc, José Moreu Burgosd
a Unidad de Hemodinámica. Instituto Cardiovascular. Hospital Clínico San Carlos. Madrid. España
b Unidad de Hemodinámica. Servicio de Cardiología. Hospital de León. León. España
c Unidad de Hemodinámica. Servicio de Cardiología. Hospital Universitario Virgen de la Arrixaca. Murcia. España
d Unidad de Hemodinámica. Servicio de Cardiología. Hospital Virgen de la Salud. Toledo. España
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Bibliografía
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Los stents liberadores de drogas con su doble efecto mecánico y farmacológico son muy eficaces en prevenir la reestenosis, hecho ya conocido en lesiones favorables y que este año ha quedado confirmado también en lesions de alto riesgo. El número de angioplastias coronaries sigue aumentando (10% anual) como consecuencia del tratamiento invasivo de los síndromes coronarios agudos, la implantación de programas de angioplastia primaria y el tratamiento de pacientes más complejos. El diagnóstico y eventual tratamiento de las placas vulnerables es ahora un nuevo reto.

La medicina regenerativa ha levantado grandes expectativas, y la investigación clínica ha precedido a la experimentación animal. De hecho, aspectos tan básicos como el tipo celular, su preparación, la vía de administración, el momento de aplicación o la medicación coadyuvante no están todavía aclarados; todavía están en discusión si las células aplicadas anidan o no en el tejido miocárdico. Con todo, la terapia celular se está aplicando ya y empiezan a aparecer los resultados de los primeros estudios.

Las prótesis aórticas percutáneas están en fase avanzada de investigación clínica. En cuanto a los dispositivos de reducción de la regurgitación mitral, acaban de iniciar su fase de aplicación en humanos por lo que tardarán más en incorporarse a la clínica. Los dispositivos de cierre están ya bien desarrollados técnicamente, pero falta perfilar su indicación en determinadas entidades y su efectividad en otras.

En el presente artículo se revisan estos y otros aspectos relevantes que durante este año han supuesto aportaciones de interés en el campo de la cardiología intervencionista.

Palabras clave:
Intervencionismo coronario
Stents
Stent con fármacos
Terapia regenerativa
Intervenciones valvulares
Abreviaturas:
AAS
ACTP
ACV
CIA
CIV
FOP
HBPM
HNF
IVUS
IAM
SCA
SCASEST
TCI

Drug-eluting stents have both mechanical and pharmacological properties and are very effective in the prevention of restenosis. This feature, already known for favorable lesions, has been confirmed this year for high-risk lesions. The number of percutaneous coronary procedures steadily continues to increase as invasive strategy for acute coronary syndromes and primary angioplasty for acute myocardial infarction are being implemented in more centers, and more complex patients are now considered suitable for angioplasty. Diagnosis and treatment of vulnerable plaques is now a new challenge.

Regenerative medicine has raised great expectations, with clinical investigation running well before animal work in this field. Such basic features as cellular type, way of preparation and administration, best timing for application or adjuvant medication, are not still clear while evidence of seeding of implanted cells in myocardial tissue is still lacking. Nevertheless, cellular therapy is being applied in many centers around the world while initial clinical results have not been released yet.

Aortic valves for percutaneous implantation are in a well-advanced phase of clinical investigation. The role of devices to treat mitral regurgitation is under preclinical investigation; first human experiences have just started and more time will be required for these new devices to enter the clinical setting. Closure devices are technically well developed but its usefullness and indications in several clinical circunstances are still to be determined.

This article is a review of these and other relevant issues that during this year have represented significant advances in the field of interventional cardiology.

Key words:
Coronary intervention
Stents
Drug-eluting stents
Regenerative therapy
Valvular interventions
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