Патология кровообращения и кардиохирургия (Nov 2018)

Results of stenting the left main lesions in patients with stable coronary artery disease using biodegradable polymer and permanent polymer stents

  • R. U. Ibragimov,
  • A. G. Badoyan,
  • D. A. Khelimskiy,
  • O. V. Krestyaninov,
  • E. A. Pokushalov,
  • A. B. Romanov

DOI
https://doi.org/10.21688/1681-3472-2018-3-49-55
Journal volume & issue
Vol. 22, no. 3
pp. 49 – 55

Abstract

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Background. Routine coronary angiography reveals about 4–10% cases of the left main lesions in patients with different forms of coronary artery disease. With the advance of stenting technologies, percutaneous coronary intervention in this type of lesions might be an alternative to coronary artery bypass grafting in some patients. Despite a significant technical progress and current generations of drug-eluting stents, the issue of optimal dual antiplatelet therapy (DAAT) duration to minimize hemorrhagic complications in the long-term period is still an open question. The problem is especially acute in the case of left main lesions. Aim. To evaluate clinical outcomes of unprotected left main stenting using Synergy stents (Boston Scientific) followed by 4-month DAAT and Xience Prime stents (Abbott Vascular) followed by 12-month DAAT. Methods. Fifty patients with stable coronary artery disease were randomized into two groups depending on the stent type (Synergy and Xience). The subjects were evaluated in 12 months after the stenting procedure. Results. 100 % success was achieved in the study. At 3-month check-up, the indicators of endothelialization, strut overlapping and late lumen bore did not statistically differ in the groups under study. During 12-month follow-up 2 cases of restenosis were recorded, one in each group, which required revascularization. The remaining cases of repeated revascularization were associated with de novo lesions. The overall major cardiac events rate was 4% in the Xience group and 8% in the Synergy group. In one case, myocardial infarction in the Synergy group was associated with the right coronary artery. Conclusion. While treating patients with left main lesions, the use of Synergy stents followed by 4-month DAAT has no lesser clinical efficacy and safety than the Xience stents followed by 12-month DAAT.

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