vestimИзвестия Национальной академии наук Беларуси. Серия медицинских наукProceedings of the National Academy of Sciences of Belarus, Medical series1814-60232524-2350The Republican Unitary Enterprise Publishing House "Belaruskaya Navuka"10.29235/1814-6023-2019-16-1-65-76vestim-477Research ArticleКЛИНИЧЕСКАЯ И ЭКСПЕРИМЕНТАЛЬНАЯ МЕДИЦИНАCLINICAL AND EXPERIMENTAL MEDICINEВнутристентовое рестенозирование в среднесрочном периоде после успешно выполненной реканализации хронических окклюзий коронарных артерий антеградным доступомIn-stent restenosis in the mid-term period after successful coronary arteries chronic total occlusion recanalization by antegrade approachСтельмашокВ. И.StelmashokV. I.

Стельмашок Валерий Иванович – кандидат медицинских наук, доцент, заведующий лабораторией

ул. Р. Люксембург, 110В, 220036, г. Минск

Valeriy I. Stelmashok – Ph. D. (Med.), Assistant Professor, Head of the Laboratory

110B, R. Luxemburg Str., 220036, Minsk

stelval@yandex.ruРеспубликанский научно-практический центр «Кардиология»Republican Scientifc and Practical Centre “Cardiology”2019120320191616576Copyright © Стельмашок В.И., 20192019Стельмашок В.И.Stelmashok V.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vestimed.belnauka.by/jour/article/view/477

Оценены результаты внутристентового рестенозирования в среднесрочном периоде после успешно выполненной реканализации хронических окклюзионных поражений коронарных артерий антеградным доступом. В исследование было включено 117 пациентов, которым выполнена реканализация хронических тотальных окклюзий (ХТО) за период с 2009 по 2012 г. Через 6,1 ± 0,9 мес. (этап К1) и 12,7 ± 1,6 мес. (этап К2) все пациенты были приглашены на плановое обследование, включавшее проведение коронарографии, внутрисосудистого ультразвукового исследования и оптической когерентной томографии. В течение первого полугодия после реканализации ХТО коронарных артерий наблюдалось более частое (на 25,6 %) развитие внутристентового рестенозирования в бассейне правой коронарной артерии, а также преобладание (59,1 % от общего количества) фокальных типов внутристентовых поражений. Частота развития рестенозов, в зависимости от типа имплантированного стента с медикаментозным покрытием, варьировалась в широком диапазоне значений (от 0 до 52,4 % в первом полугодии и от 0 до 41,2 % во втором полугодии). Достоверное увеличение частоты рестенозирования наблюдалось в группах пациентов, которым были имплантированы трапидил-элютирующие стенты (52,4 % в первом полугодии, 26,3 % во втором полугодии) и сиролимус-элютирующие стенты (38,9 % в первом полугодии, 41,2 % во втором полугодии). Полученные данные свидетельствуют о том, что различные типы коронарных стентов с лекарственным покрытием по-разному определяют характер изменений сосудистого просвета в среднесрочном периоде после успешно выполненной реканализации ХТО коронарных артерий.

The results on the in-stent restenosis in the mid-term period after successful coronary arteries chronic total occlusion (CTO) recanalization by the antegrade approach are assessed. The study included 117 patients who underwent coronary artery CTO recanalization for the period from 2009 to 2012. After 6.1 ± 0.9 months (stage К1) and 12.7 ± 1.6 months (stage К2), all patients were examined by coronary angiography, intravascular ultrasound and optical coherence tomography. During the frst half of the year after the CTO recanalization, there was a more frequent in-stent restenosis rate in the right coronary artery (in 25.6 %) as well as a predominance of focal types of restenosis (59.1 % of the total). The incidence of restenosis depending on the DES type varied over a wide range of values (from 0 to 52.4 % in the frst half of the year and from 0 to 41.2 % in the second half of the year). A signifcant increase in the incidence of restenosis was observed after the trapidil eluting stents implantation (52.4 % in the frst half of the year, 26.3 % in the second half of the year) and sirolimus eluting stents (38.9 % in the frst half, 41.2 % in the second half of the year). Our data show that different types of DES differently determine the changes in the vascular lumen during the medium term period after the successful CTO recanalization.

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The authors declare that there are no conflicts of interest present.