Abstract:

Aim: was to provide data of examination of patients of single-center randomized clinical trial ORENBURG (results of angiography, intravascular ultrasound (IVUS), optical coherence tomography (OCT), which were made at different stages of primary operations).

Materials and methods: 1032 patients were enrolled into this trial and uniformly distributed into 6 subgroups, representing 6 different types of drug-eluted stents implanted. Patients in this study were also divided into IVUS guidance and angiography guidance subgroups in 2 to 1 ratio. All patients underwent the OCT examination at the final stage of the procedure, and according to OCT results, no additional interventions were performed. Data of instrumental studies was analyzed with use of modern statistical methods and programs.

Results: according to angiographic data, in-segment lesion length and lumen volume before the operation were higher in IVUS group. After intervention, lumen volume was still higher, and % diameter stenosis and % area stenosis were lower in IVUS group in comparison with angiography group. Comparison of IVUS and angiography data after predilatation showed that IVUS was associated with bigger absolute values of minimum lumen diameter (MLD) and minimum lumen area (MLA), while % diameter stenosis and % area stenosis were similar between two groups. At control IVUS and OCT studies the region of the maximum residual stenosis did not usually match with the site of the baseline maximum stenosis. Quantitative data in these segments significantly differed. According to control IVUS data, additional angioplasty in stent was needed in 10,1 % of patients. Additional procedure allowed to improve all quantitative indicators. Implantations of different types of stents were performed using similar interventional technic but randomized by selection of stent eluting. Nevertheless, initial technical parameters of endoprosthesis affected quantitative results of the implantation. Nobori stent showed biggest differences in quantitative results of implantation in comparison with other types of stents and to the whole group.

Conclusion: ORENBURG is second large trial in terms of volume, and second large trial that was initiated, and which was dedicated to the comparison of interventional strategies using drug-eluting stents under intravascular visualization or angiography guidance. The minimal incidence of MACE was registered during the period of in-hospital stay Only one case of cardiac death was registered, and it was not associated with the region of the treated artery. Results of ORENBURG trial confirm the tendency to absolute measures recieved by intravascular methods of visualization, and used for characterization of defeated vessel excess absolute measures received by angiography.

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