The outcomes of bioabsorbable vascular stents implantation in patients with coronary artery disease and concomitant diabetes mellitus type II

Aim. Toevaluate an efficacy of bioabsorbable everolimus-coated vascular stents implantation in patients with diabetes mellitus type I. Material and methods. 143 patients were initially selected. S ubsequently 125 patients were included who were randomized into 2 groups. In group I (n=57) bioabsorbable vascular grafts were implanted and in the second group (n=68) everolimus-coated coronary stents were used. Inclusion criteria were primary coronary lesion, stable angina class I-II (CCS), myocardial ischemia (>10%), confirmed by stress test data, compensated or subcompensated diabetes type I, middle or distal coronary stenosis =70% according to digital angiography. Exclusion criteria were the diameter of target artery less than 4mm, acute coronary syndrome, excessive tortuosity of the vessel, severe calcification of coronary artery, bifurcation lesion, left main coronary artery lesion, previous myocardial revascularization. Immediate results were assessed based on incidence of major cardiovascular events (death, MI, urgent reoperation). Long-term results were estimated using incidence of major cardiovascular events (death, myocardial infarction, reoperation), the incidence of bioabsorbable prosthesis/stent restenosis, thrombosis of bioabsorbable prosthesis/stent. Bioabsorbable stents implantation were controlled by optical coherence tomography that was performed at the end of intervention and in long-term period. Long-term results were observed within 12 months after surgery. Results. 63 bioabsorbable and 102 everolimus-coated vascular stents were implanted in groups 1 and 2 respectively. T he average diameter of grafts was 2.88±0.06 mm in group 1 and 2.68±0.12 mm in group 2 (p>0.05). T echnically successful deployment was achieved in 100%. O verall incidence of major in-hospital cardiovascular complications was 3.5 and 2.94% in both groups respectively (p>0.05). Long-term results were followed in 41 patients from group I and in 52 patients from group I. 1-year survival was 100% in both groups. T he incidence of non-fatal myocardial infarction was 4.9 and 3.8% in groups 1 and 2 respectively (p>0.05). T he reason was progression of atherosclerosis in other arteries. T he frequency of restenosis that required reoperation was 2.4 and 1.9%, respectively (p>0.05). Remote thrombosis was absent in both groups. According to optical coherence tomography long-term loss of internal lumen was 0, 14±0, 19 and 0, 12±0, 23 mm respectively (p>0.05). Conclusion. Bioabsorbable vascular grafts and everolimus-coated stents showed similar efficacy and safety in 12 months after surgery in patients with coronary artery disease, concomitant diabetes mellitus and primary lesion of middle and distal coronary segments. © 2016, Media Sphera Publishing Group. All rights reserved.