Лечение коронарного атеросклероза: влияние массового применения стентов на ближайшие и отдаленные результаты коронарной ангиопластики

Abstract

We report a prospective analysis of immediate and long-term effects of two coronary angioplasty methods – balloon dilation and stenting – in different working periods of two endovascular laboratories. For the last 10 years the number of stents implanted has grown 30-fold, and stenting is used today in 95% to 97% of coronary angioplasty procedures. The strategy of massive use of stents has improved the immediate outcomes of angioplasty as seen by substantial decrease of the rate of acute myocardial infarction, emergency coronary artery bypass grafting and acute coronary occlusions (from 2.7% after balloon angioplasty to 0.6% after stenting, р = 0.001). Stenting improved the long-term prognosis by decreasing the frequency of cardiovascular events. The 5-year survival rate after stenting was 98.8%, after balloon angioplasty — 92.7% (р = 0.004). However, the rate to angiographically revealed restenosis and the need for repeated myocardium revascularization after stenting (27.1 and 30.4%) decrease less significantly compared to balloon angioplasty (30.1 vs. 34.5%, р = 0.0025).

Keywords

• coronary angioplasty
• coronary stenting
• in-stent restenosis
• restenosis risk factors