[Endovascular treatments in coronary heart disease patients with restenosis after primary ballon angioplasty].
The study was undertaken to comparatively assess the results of stenting and transluminal balloon angioplasty (TBAP) of coronary arteries in patients with chronic forms of coronary heart disease concurrent with restenosis of primary TBAP. The data on 77 patients undergone endovascular procedures for restenosis of prior primary TBAP of coronary arteries at the Moscow Research and Practical Center of Interventional Cardioangiology in March 1997 to May 2003 were analyzed. Group 1 comprised 35 patients with a stent implanted at the site of coronary restenosis; Group 2 included 42 patients undergone repeated TBAP. These groups did not significantly differ in main clinical and functional characteristics, the extent coronary bed lesion, the number of diseased arteries and the morphological type of a coronary lesion (p < 0.05). The angiographic success of secondary TBAP, as well as coronary stenting was 100%. Survival was 100% in the late period. A control examination revealed the clinical picture of angina on exertion in 57.1% and 76.2% of the patients in Groups 1 and 2, respectively (p = 0.039). In the late period, a satisfactory angiographic result of coronary stenting was revealed in most cases (74.3 and 35.7% in Groups 1 and 2, respectively); restenosis was detected in 20 and 59.5% of cases, respectively (p < 0.01); occlusion in 5.7 and 4.8% (p > 0.05). Need for repeated interventional and surgical (aortocoronary bypass surgery) procedures was significantly less after coronary stenting than that after repeated TBAP (20 and 40.5%, respectively). In the late period, the factors significantly increasing a risk for in-stent restenosis were hypercholesterolemia (cholesterol > or = 5.5 mmol/l); the length of restenosis of an operated segment was > or = 18 mm and that of a stent > or = 20 mm. It is expedient to use coronary endroprosthesis to reduce the incidence of repeated restenosis and needs for repeated procedures for myocardial revascularization in the late period.
Zakharova
O V
OV
Arablinskiĭ
A V
AV
Ioseliani
D G
DG
D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000601:surgery / Q000628:therapy*; D023903:Coronary Restenosis / Q000601:surgery / Q000628:therapy*; D003627:Data Interpretation, Statistical; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012307:Risk Factors; D015607:Stents; D013997:Time Factors