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Abstract:

Aim: was to study the efficacy and functionality of the Yukon Chrome PC stent in clinical practice.

Materials and methods: in 2021, a prospective, observational study of the safety, effectiveness of the Yukon Chrome PC stent, as well as its functionality during implantation in clinical practice, was launched on the basis of 25 domestic clinics. The study included 364 patients who underwent implantation of 495 Yukon Chrome PC stents. Mean age of patients was 62,8 years (from 33 to 89 years). Men were 263 (72,3%). The vast majority (82,4%) of patients were diagnosed with acute coronary syndrome (ACS): without ST segment elevation - 180 (49,45%) patients; with ST segment elevation - 120 (32,9%) patients. Unstable angina was verified in 22 (6%) patients. There were 42 (11,5%) patients with stable angina class 2-3.

Moderate tortuosity of vessels occurred in 27,7% of cases, while severe tortuosity of vessels occurred in 3,57% of cases. Moderate calcification was noted in 115 (31,5%) patients, severe/massive - in 23 (6,3%) cases. A complex lesion combining severe/moderate calcification and severe/moderate tortuosity of the target artery occurred in 79 (21,7%) patients.

Results: technical success of the procedure was achieved in 97,5% of cases. In one patient with severe calcification, the Yukon Chrome PC stent could not be inserted into the affected area. Attempts to implant another stent were also unsuccessful.

Depending on the number of implanted stents, the patients were distributed as follows: 3 stents were inplanted in 31 (8,5%) patients; 2 stents - 102 (28%) patients, 1 stent - 231 (63,5%) patients.

Bifurcation stenting using a two-stent technique was performed in 69 (19%) patients. Stenting of the left main was performed in 11 (3%) cases. Predilation was performed in 245 (67%) patients; postdilation - in 179 (49%) patients.

Conclusion: analysis of hospital results of implantation of Yukon Chrome PC stents indicates good flexibility and deliverability of stents even in patients with moderate and severe sheath calcification.

The overall assessment of the functional characteristics of the stent among endovascular surgeons who performed stenting is quite high.

 

 

Abstract:

Aim. To compare safety and efficiency of drug-eluting stents (DES) and bare metal stents (BMS) implantation for coronary artery disease (CAD).

Materials and methods. 230 patients with CAD were divided in 2 groups: patients in group 1 received DES; in group 2 we performed BMS implantation.

Results. Long-term results (over 12 months follow-up) of DES primary implantation reduces risk of the angiographic restenosis by 15% compared to BMS (р < 0,001).

Conclusions. Notwithstanding low basic risk of restenosis, DES demonstrate no statistically significant advantages in MACE rate. It is also shown that DES implantation is associated with higher mortality and greater risk of non-cardiac complications, related to prolonged antiplatelet therapy. Thus, decision of DES implantation should be made in consideration of the patients' tolerance for double antiplatelet therapy, risk of bleeding, possible elective surgery, as well as any pre-procedure immune system disturbances. 

 

References 

 

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2.    Van der Giessen W.J., Lincoff A.M., Schwartz R.S.  et al.  Marked inflammatory sequel to implantation of biodegradable and nonbiode-gradable polymers in porcine coronary arteries. Circulation. 1996; 94: 1690-1697.

 

 

 

 

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5.    Bauters C., Lablanche J.M., McFadden E.P. et al. Clinical characteristics and angiographic follow-up of patients undergoing early or late repeat dilation for a first restenosis. J. Am. Coll. Cardiol. 1992; 20: 845-848.

 

 

 

 

6.    Бабунашвили А.М., Юдин И.Е., Дундуа Д.П. и др. Стенты с лекарственным покрытием при лечении диффузных атеросклеротиче-ских поражений коронарных артерий. Актуальные вопросы болезней сердца и сосудов. 2007; 4: 57-63.

 

 

 

 

7.    Waters R.E. 3 cases following DES for in-stent-restenosis (at 16, 20, 43 mo) - shortly after interruption of antiplatelet Tx. Catheter. Car-diovasc. Interv. 2005; 4: 107-115.

 

 

 

 

8.    PeterJ., Fitzgerald S. etal. Is angiographic late loss still a worthwhile surrogate endpoint in DES trials? Circulation. 2006; 54: 237-291.

 

 

 

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