Abstract:

Aim. Was to study long-term results of drug eluting stents implantation: angiographic frequency of prolong stenosis, frequency of restenosis, endotelization dynamics, and other morphological indicators on the base of intravascular ultrasound (IV-US)

Materials and methods. The research consisted of 220 patients with angina pectoris or/and myocardial ischemic indexes: all of them were after drug eluting stents implantation. 174 patients on the first year and 82 on the second were underwent coronaroventriculography Double antiaggregant theraphy was given on the first year to 198(90%) patients, on the second - 21(9,5%)

Results. The whole angiographic success was 89,5%. 44% patients were underwent of lateral arterial branches defense. Unsuccessfu stenting was due to technical impossibility of movement threw variated coronar arteries segment in 5%; 1,8% was due to incomplete disclosing of stent; 2,7% - occlusion of lateral arterial branch

Conclusions. On the base of IV-US, at the end of the 1st year, 40% stents had full endotelization, at the end of the 2nd - 91%. Double antiaggregant theraphy was given to 99,1% patients on the first year. All coronary situations (morbidity, heart stroke, restenosis) was much more ess, than on the 2nd years, on which drug therapy was given only to 9,6% patients.

References 

1.    G. Ertaio et al. Late stent thrombosis, endothelialisation and drug-eluting stents. Neth. Heart. J. 2009l; 17 (4): 177-180.

2.    Ako J. et al. Late incomplete stent apposition after sirolimus-eluting stent implantation. A serial intravascular ultrasound analysis. J. Am. Coll. Cardiol. 2005; 46 (6): 1002-1005.

3.    Virmani R. et al. Localized hypersensitivity and late coronary thrombosis secondary to a sirolimus-eluting stent. Should we be cautious? Circulation. 2004; 109 (6): 701-705.

4.    Lee S.H., Chae J.K., Ko J.K. Consecutively developed late stent malappositions following the implantation of two different kinds of drug-eluting stents associated with spontaneous healing. Int. J. Cardiol. 2009; 134 (1): 7-10.

5.    Yamen E. et al. Late incomplete apposition and coronary artery aneurysm formation following paclitaxel-eluting stent deployment. Does size matter? J. Invasive. Cardiol. 2007; 19 (10): 449-450.

6.    Yasumi U. and Yasuto U. Angioscopic evaluation of neointimal coverage of coronary stents. Curr. Cardiovasc. Imaging. Rep. 2010; 3 (5): 317-323.

7.    Mayraj A. et al. Comparison of one year clinical outcomes with paclitaxel-eluting stents versus bare metal stents in everyday practice. Can. J. Cardiol. 2008; 24 (10): 771-775.

8.    Kim J.S. et al. Comparison of neointimal coverage of sirolimus-eluting stents and paclitaxel-eluting stents using optical coherence tomography at 9 months after implantation. Circ. J. 2010; 74: 320-326.

9.    Suwaidi J.A. et al. Long-term follow-up of patients with mild coronary artery disease and endothelial dysfunction. Circulation. 2000; 101: 948-954.

10.  Hofma S.H. et al. Indication of long-term endothelial dysfunction after sirolimus-eluting stent implantation. Eur. Heart. J. 2006; 27: 166-170.

11.  Togni M. et al. Sirolimus-eluting stents associated with paradoxic coronary vasoconstriction. J. Am. Col. Cardiol. 2005; 46: 231-236.

12.  Shin D.I. et al. Drugeluting stent implantation could be associated with long-term coronary endothelial dysfunction. Comparison between sirolimus-eluting stent and paclitaxel-eluting stent. Int. Heart. J. 2007; 48: 553-567.

13.  Takano M. et al. Angioscopic differences in neointimal coverage and in persistence of thrombus between sirolimus-eluting stents and bare-metal stents after 6-month implantation.     Eur.     Heart.    J.     2006; 27: 2189-2195.

14.  Moore P. et al. A randomized optical coherence tomography study of coronary stent strut coverage and luminal protrusion with rapamycin-eluting stents. JACC Cardiovasc. Interv. 2009.

15.  Oyabu J. et al.   Angioscopic evaluation of neointimal coverage. Sirolimus drug-eluting stent      versus bare metal stent. Am. Heart. J. 2006; 52: 1168-1174.

16.  Kotani J. et al. Incomplete neointimal coverage of sirolimus-eluting stents: angioscopic findings. J. Am. Col. Cardiol. 2006; 47: 2108.

17.  Wilson G.J. et al. Comparison of inflammatory response after implantation of sirolimus- and paclitaxel-eluting stents in porcine coronary arteries. Circulation. 2009; 120: 141-149.

18.  Higo T. et al. Atherosclerotic and thrombogenic neointima formed over SES. JACC Cardiovasc. Imaging. 2009; 2: 616-624

19.  Latchumanadhas K. et al. Early coronary aneurysm with paclitaxel-eluting stent. Indian. Heart. J. 2006; 58 (1): 57-60.

20.  Levisay J.P., Roth R.M., Schatz R.A. Coronary artery aneurysm formation after drug-eluting stent implantation. Cardiovasc. Revasc. Med. 2008; 9 (4): 284-287.

21.  Chen D. et al. Spontaneous resolution of coronary artery pseudoaneurysm consequent to percutaneous intervention with paclitaxel-eluting  stent.   Tex.  Heart.   Inst. J.   2008; 35 (2): 189-192.

22.  Lee S.E. et al. Very late stent thrombosis associated with multiple stent fractures and peri-stent aneurysm formation after sirolimus-eluting stent implantation. Circ. J. 2008; 72 (7): 1201-1204.

23.  Kim J.S. et al. Delayed stent fracture after successful sirolimus-eluting stent (Cypher®)  implantation.  Korea