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ABC OF INTERVENTIONAL CARDIOLOGY – PART 3

Thuốc tẩy rửa, ống đỡ động mạch tráng tráng ống đỡ động mạch có chứa các thuốc ức chế sự phát triển của mô mới trong intima phụ và là một lựa chọn mới đầy hứa hẹn để ngăn ngừa hoặc điều trị trong ống đỡ động mạch restenosis. | Percutaneous coronary intervention. II The procedure Drug eluting coated stents Coated stents contain drugs that inhibit new tissue growth within the sub-intima and are a promising new option for preventing or treating in-stent restenosis. Sirolimus an immunosuppressant used to prevent renal rejection which inhibits smooth muscle proliferation and reduces intimal thickening after vascular injury paclitaxel the active component of the anticancer drug taxol everolimus ABT-578 and tacrolimus are all being studied as are other agents. Although long term data and cost benefit analyses are not yet available it seems probable that coated stents will be commonly used in the near future. Occupation and driving Doctors may be asked to advise on whether a patient is fit for work or recovered from an event after percutaneous coronary intervention. Fitness depends on clinical factors level of symptoms extent and severity of coronary disease left ventricular function stress test result and the nature of the occupation as well as statutory and non-statutory fitness requirements. Advisory medical standards are in place for certain occupations such as in the armed forces and police railwaymen and professional divers. Statutory requirements cover the road marine and aviation industries and some recreational pursuits such as driving and flying. Patients often ask when they may resume driving after percutaneous coronary intervention. In Britain the Driver and Vehicle Licensing Agency recommends that group 1 private motor car licence holders should stop driving when anginal symptoms occur at rest or at the wheel. After percutaneous coronary intervention they should not drive for a week. Drivers holding a group 2 licence lorries or buses will be disqualified from driving once the diagnosis of angina has been made and for at least six weeks after percutaneous coronary intervention. Re-licensing may be permitted provided the exercise test requirement satisfactory completion of nine .