LONG-TERM RESULTS OF PERCUTANEOUS CORONARY INTERVENTIONS IN PATIENTS WITH DIFFUSE AND MULTIVESSEL CORONARY ARTERY DISEASES; [ОТДАЛЕННЫЕ РЕЗУЛЬТАТЫ ЧРЕСКОЖНЫХ КОРОНАРНЫХ ВМЕШАТЕЛЬСТВ У ПАЦИЕНТОВ С ДИФФУЗНЫМ И МНОГОСОСУДИСТЫМ ПОРАЖЕНИЕМ КОРОНАРНЫХ АРТЕРИЙ]

To evaluate the two-year results of percutaneous coronary interventions (PCI) in Aim patients with diffuse and multivessel coronary lesions. 128 patients were included in the study and divided into two groups. In group I (n = 62) PCI was performed using intravascular imaging methods, in group II (n = 66) no intravascular imaging methods (retrospectively) were used. The measurement of fractional flow reserve (FFR) in diffusely altered arteries was performed against the background of maximum hyperemia between stenoses by pulling the sensor Methods starting from the distal segment. Initially, the most distal hemodynamically significant stenosis underwent the stenting. Then, a repeated measurement of FFR was performed and it showed if the further stenting was needed. The results of stenting, as well as the determination of the stent implantation area were carried out by the method of optical coherence tomography. 12 months after PCI the results of treatment were checked in all patients and after 24 months – in 106 patients (56 and 50, respectively, in groups I and II). The achievement of complete (functionally adequate, according to FFR measurements) myocardial revascularization was achieved in 93.5% of patients from group I, while the result in the control group was only 56% of patients. The average number of stenoses in the target non-occluded artery according to angiography and after FFR measurement was the following: in patients with two-vessel lesions – 2.95±0.65 and 1.82±0.88, respectively, and in patients with three-vessel lesions – 2.96±0.6 Results and 2.24±0.76, respectively (p = 0.0024). After 12 months of follow-up, significant differences were observed between groups I and II in the frequency of myocardial infarction (1.8 and 4.0%, respectively; χ2 = 5.172) and repeated interventions (3.6 and 16.0%, respectively; χ2 = 8.114). By the 24th month of follow-up, among the observed patients, the total frequency of myocardial infarction, repeated interventions and cardiac death were significantly higher in patients of group II compared with group I and they were 45.5 and 9.6%, respectively (χ2 = 14.784; p<0,0001). Long-term results of PCI in patients with diffuse and multivessel coronary lesions using intravascular imaging methods (optical coherence tomography and FFR Conclusion measurements) are characterized by low cardiac complications, compared with patients operated without imaging methods. © 2022 Complex Issues of Cardiovascular Diseases. All rights reserved.

Авторы
Maximkin D.A. , Bolivogui J.M. , Shugushev Z.Kh. , Faybushevich A.G. , Chepurnoy A.G. , Gitelzon E.A.
Издательство
Федеральное государственное бюджетное научное учреждение "Научно-исследовательский институт комплексных проблем сердечно-сосудистых заболеваний"
Номер выпуска
2
Язык
Русский
Страницы
60-71
Статус
Опубликовано
Том
11
Год
2022
Организации
  • 1 Peoples' Friendship University of Russia, 6, Miklukho-Maklaya St., Moscow, 117198, Russian Federation
Ключевые слова
Diffuse lesion; Fractional flow reserve; Multivessel lesion; Optical coherence tomography
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