Клиническая практика (Aug 2019)
Long-term results of stenting of long coronary artery stenosis with consecutive implantation of stents of different types with overlapping edges in patients with acute coronary syndrome without ST-segment elevation and multivessel coronary artery disease
Abstract
Introduction. In urgent interventional cardiology practice, combinations of drug-eluting stents and bare-metal stents are sometimes forced to treat extended stenosis in a clinic-dependent artery. Objective. A comparison of long-term results of treatment of patients with coronary heart disease and multivessel coronary lesions, which performed stenting of the clinic-dependent artery by two successive partially overlapping stents using stents of the 3rd generation with drug coating or a combination of the 3rd generation stent with drug coating and a bare-metal stent for acute coronary syndrome without St segment elevation and later complete functional myocardial revascularization by endovascular method. Methods. The minimum overall length sentiremos section was made 55 mm. In main group included 32 patients for whom revascularization clinic-dependent artery performed endovascular intervention with the use of 2 stents 3-generation drug-coated sirolimus and biodegradable polymer implanted overlap. In 30 patients (control group), clinic-dependent artery revascularization was also performed by a combination of implanted overlap stents, one of which was a 3rd generation stent with sirolimus drug coating and biodegradable polymer, and the other was a bare-metal stent. There were no statistically significant differences between the groups in clinical, demographic and operational characteristics. Results. The analysis of the results revealed a significant difference between the groups in the frequency of repeated revascularization of the target artery, which were observed more often in the control group. Conclusion. When performing an extended stenting of the clinic-dependent artery in patients with acute coronary syndrome without ST segment elevation, overlapping of the drug-coated stent and the bare-metal stent should be avoided, since the antirestenotic effect of the drug-coated stent is leveled when overlapping with the bare-metal stent, but this strategy can be used in case of full coverage of the stenotic lesion or closure of the dissection.
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