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  • 1 Semmelweis Egyetem, Általános Orvostudományi Kar Kardiológiai Központ Budapest Gaál József u. 9. 1122
  • | 2 Semmelweis Egyetem, Általános Orvostudományi Kar Ér- és Szívsebészeti Klinika Budapest
  • | 3 Ruprecht Karl Egyetem Szívsebészeti Klinika Heidelberg
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A vascularis intervenciókat követő restenosis fontos limitációja ezen beavatkozások hosszú távú sikerének. A restenosis gyakorisága az atheroscleroticus szűkület kezelési módjától (stentelés, endarterectomia) és érterülettől függően igen változó, de a rizikófaktorok és patomechanizmus tekintetében sok a hasonlóság. Jelen közlemény a szerzők ez irányban végzett tanulmányainak összefoglalója. Klinikai munkákban a carotisendarterectomia és carotisstentelés utáni restenosisarányok összehasonlítását végezték el, valamint a két beavatkozás utáni komplementaktiváció jellemzőit elemezték. Az ösztrogénreceptor-alfa polimorfizmusainak szerepét vizsgálták a carotisintervenciók után fellépő restenosisban. A carotisendarterectomia állatmodelljén a nitrogén-monoxid-ciklikus guanozin-monofoszfát-jelátvitel szerepét vizsgálták a neointimalis hyperplasia alakulására foszfodiészteráz-5-gátló terápia mellett. Eredményeik szerint a carotisendarterectomia után megfigyelhető nagyobb restenosisarány ezen beavatkozás után kifejezettebb komplementaktivációval lehet összefüggésben. A restenosishoz vezető neointimalis hyperplasia kialakulásában az ösztrogénreceptor mutációi is szerepet játszhatnak, elsősorban nőkben carotisendarterectomia után. A ciklikus guanozin-monofoszfát-jelátvitel serkentésével a neointimalis hyperplasia gátolható.

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