[Indications to balloon angioplasty and intracoronary stenting in patients with ischemic heart disease].
Four hundred and ten patients with ischemic heart disease (IHD) were treated. The study group consisted of 197 patients with IHD who have undergone intracoronary stenting (IS). The control group consisted of 213 patients treated with traditional balloon coronary angioplasty (BCA). All the patients in both groups were divided in four subgroups depending on a type of stenosis by classification ACC/AHA. A positive angiographic and clinical result straight away after IS was seen in all 197 patients. Any links with a stenosis type or with construction of the stent were not revealed. In 5 (2.5%) patients on day 5-7 after IS acute coronary occlusion in the place of stenting was seen. In 2 (1%) patients attempt of recanalization was unsuccessful, in both cases transmural myocardial infarction has developed. Thus, in further study 195 (98.98%) patients were included. Out of 213 patients after traditional BCA immediate good angiographic and clinical results were achieved in 191 (89.7%). There were no differences in rate of good immediate results of IS and BCA of types A and B1 stenoses. In types B2 and C stenosis immediate good results were achieved more often in group with IS. Good immediate results after BCA were better in patients with type A stenosis than with B2 and C stenoses. Rate of the "stent-like" result after BCA of types A and B1 stenosis was higher than after dilatation of types B2 and C stenosis. There was no difference in rate of restenosis after traditional BCA and IS of types A and B1 stenosis. In BCA of types B2 and C stenosis restenosis was seen more often than in IS. It is concluded that in patients with types A and B1 stenoses "stent-like" result is achieved more often after traditional BCA than in patients with types B2 and C stenosis. In patients with type A stenosis and "stent-like" result stenting does not improve significantly long-term results. In patients with types B2 and C stenosis and "stent-like" result IS is tustified. Good immediate results of angioplasty in these patients don't reduce the rate of restenosis, white IS does reduce its rate.
Puretskiĭ
M V
MV
Abugov
S A
SA
Saakian
Iu M
IuM
D015906:Angioplasty, Balloon, Coronary / Q000706:statistics & numerical data*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D017202:Myocardial Ischemia / Q000601:surgery*; D015607:Stents; D016896:Treatment Outcome