Stephan Windecker， MD，瑞士伯恩心血管中心介入心脏病学主任
　　International Circulation:  In your mind， which one will be right choice for the drug carrier vehicle in the next generation DES， bioresorbable polymers or no polymers?
　　Stephan Windecker:  Most platforms that are currently in development that will come to the market in the near future use biodegradable polymers.  The reason is that with this category of stent you can have a direct release for an certain period of time and with this there is an effect of a high degree of efficacy with very good safety profile.  For this reason for the near future the way that most DES are going to the market are polymer-based biodegradable drug-eluting stents.  In the more distant future it could very well be possible that there are polymer-free DES.  As you heard in this session of the meeting there are some very interesting concepts out there， but most use some kind of second drug or additional formulation of drugs， which is not polymer based in an effort to improve drug delivery to the vessel wall.  I don’t think that you will see this platform being used in the immediate future and believe it needs further development before coming to market.
　　《国际循环》：在您看来，什么是下一代DES理想的载药涂层，生物可吸收聚合物还是无聚合物涂层？
　　Stephan Windecker：大多数当前研发中并将在不远的将来上市的平台，都使用生物可降解聚合物。原因在于使用这种支架，可在一定时间内获得药物的直接释放，并且兼具高度的有效性和良好的安全性。由于这个原因，在不远的将来就要上市的多数DES均为基于聚合物的生物可降解药物洗脱支架。在稍远一些的未来，可能会出现无聚合物DES。在这个专题分会上有很多有趣的新概念，多数使用了某种类型的第二代药物或额外的药物配方，这些方案均不使用聚合物，旨在增加药物向血管壁的输送。我想这些不是近期可以临床应用的平台，在上市前还需要进一步研究和完善。
　　International Circulation:  How realistic to you think it is going to be to get these stents in wide-spread use?  You just mentioned that with the event rates we have already being so low， that we need huge studies to prove that one treatment or device platform has superiority over another.
　　Stephan Windecker:  Sure， but I don’t think it is always possible or necessary to prove superiority.  With technology there is this technological evolution where certain desired attributes just fall into place.  Overall， it is a good sign that the event rate has improved so much that we really do not need to worry so much about adverse events anymore and that the efficacy is so high.  For the future we need to think more about potential paradigm shifts or improvements.  Two such things that come to my mind are first， developing stents that require no anti-thrombotic therapy， as well as stents that may be able to address vulnerable plaques.
　　《国际循环》：您认为广泛使用这些支架的现实可能性如何？您刚刚提到我们目前的事件发生率已经很低，我们需要大型的研究证明一种治疗或装置优于另一种。
　　Stephan Windecker：当然，但我并不认为总是需要去证明优势性的存在。技术的革新使得许多我们所期待的事情变成现实。总而言之，事件率已经降低很多，以至于我们不再需要非常担心不良事件，同时疗效也达到很高的水平，这些都是好的迹象。在我看来有两件事非常重要，第一是研发不需要抗栓治疗的支架，第二是可能解决易损斑块问题的支架。
 

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