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:

Technological advance in multislice computed tomography (MSCT) set the radiologists all over the world thinking of its application in patients with ischemic heart disease. Proved diagnostic efficiency of 64-slice MSCT coronary angiography nominates the technique to be a first-line screening method for coronary atherosclerosis: it allows quick, accurate, and non-invasive imaging and quantitative assessment of coronary lesions. Though the indications for MSCT has already defined, there still are contro-versies about its place in diagnostic strategy. The aim of our study was to picture the state-of-the-art MSCT capabilities, focusing on MSCT coronary angiography and its place in contemporary clinical medicine.

Reference

1.     Achenbach S. et. al. Top 10 indications forcoronary СТА. Supplement to Applied Radiology.2006; 35 (12): 22-31.

2.     Gaspar T., Halon R., Rubinshtein N. Clinicalapplications and future trends in cardiacСТА. Eur. Radiol. Suppl. 2005; 15 (l4): 10-14.

3.     Jacobs J.E. How to perform coronaryСТА: A to Z, Supplement to Applied Radiology.2006; 12: 10-17.

4.     Синицын В.Е., Воронов Д.А., Морозов С.П.Степень кальциноза коронарных артерийкак прогностический фактор осложнений сердечно-сосудистых заболеваний без клинических проявлений: результаты метаанализа. Терапевтический архив. 2006; 9: 22-27.

5.     Терновой С.К., Синицын В.Е., Гагарина Н.В. Неинвазивная диагностика атеросклероза и кальциноза коронарных артерий. М: Атмосфера. 2003; 144.

6.     Синицын В.Е., Устюжанин Д.В. КТ-ангиография коронарных артерий. Кардиология. 2006; 1: 20-25.

7.     Ehara M., Surmely J.F., Kawai M. et al.Diagnostic accuracy of 64-slice computedtomography for detecting angiographicallysignificant coronary artery stenosis in an unselected consecutive patient population:Comparison with conventional invasiveangiography. Circ.J. 2006; 70: 564-571.

8.     Leschka S. et al. Accuracy of MSCT coronaryangiography with 64-slice technology: firstexperience. Eur. Heart. J. 2005; 26: 1482-1487.

9.     Wann S. Cardiac CT for risk stratification,Supplement to Applied. Radiology. 2006; 12: 41-44.

10.   Hoffmann U., Moelewski F., Cury R.C. et al.Predictive value of 16-slice multidetector spiral computed tomography to detect significant obstructive coronary artery disease 17.in patients at high risk for coronary artery disease. Patient-versus segment-based analysis. Circulation. 2004; 110: 2638-2643.

11.   Rienmuller R., Brekke O., Kampenes V.B. et al. Dimeric versus monomeric nonionic contrast agents in visualization of coronary arteries. Eur.J. Radiol. 2001; 38 (3): 173-178.

12.   Dewey M. et al. Head-to head comparison of multislice computed tomography angiography and exercise electrocardiography for diagnosis of coronary artery disease. Eur. Heart. 2007; 10, 28 (20): 2485-2490.

13.   Schlosser T., Konorza T., Hunold P. et al. Noninvasive visualization of coronary artery bypass grafts using 16-detector row computed tomography. JACC. 2004; 44: 1224-1229.

14.   Chabbert V., Carrie D., Bennaceur M. et al. Evaluation of in-stent restenosis in proximal coronary arteries with multidetector computed tomography (MDCT). Eur Radiol. 2007; 17: 1452-1463.

15.   Schijf J.D., Bax J.J., Jukema J.W. et al. Feasibility of assessment of coronary stent patency using 16-slice computed tomography. Am.J. Cardiol. 2004; 94: 427-430.

16.   Mahnken A.H., Buecker A., WildbergerJ.E. et al. Coronary artery stents in multislice computed tomography: in vitro artefact evaluation. Invest Radiol. 2003; 39: 27-33.

17.   Cademartiri F., Marano R., Runza G. et al. Non-invasive assessment of coronary stent patency with multislice CT: preliminary experience. Radiol. Med. (Torino). 2005; 109 (5-6): 500-507.

Abstract:

Purpose. To assess the effectiveness of palliative endovascular interventions in patients with CTO anatomy infavorable for recanalisation.

Material and methods. The authors analyzed the results of interventions in 60 patients (50 male (83,3%), 10 female (16,7%)) aged 38 – 75 years (mean age 53,9±3,2), with occlusive coronary disease. Palliative revascularizations were performed in 30 patients, and CTO recanalization was done in 30 cases. The LV function was assessed echocardiographically in both groups before and after the intervention.

Results. 12 month follow-up showed significant improvement or normalization of LV function in both groups. Results of palliative interventions were shown to be as effective as recanalization of CTO.

Conclusions. Endovascular palliation is effective in treatment of patients with coronary CTO. It results in myocardial function improvement comparable to that in patients with complete coronary revascularization.   

References

1.        Danchin N., Angioi M., Rodriguez R. Angioplasty in chronic coronary occlusion. Arch. Mal. Coeur Vaiss. 1999, 99 (11): 1657–1660.

2.        Meier B. Chronic total coronary acclusion angioplasty. Cathet Cardiovasc. Diagn, 2006; 25: 1–11.

3.        Ганюков В.И., Осиев А.Г. Частные вопросы коронарной ангиопластики. Новосибирск. 2002; 4–23.

4.        Лопотовский П.Ю., Яницкая М.В. Клинический эффект эндоваскулярной реперфузии миокарда в бассейне длительно окклюзированной коронарной артерии. Между народный журнал интервенционной кардиоангиологии. 2006; 10: 22–26.

5.        Султан М.В. Реваскуляризация миокарда при остром коронарном синдроме. Авто-реф. дис. канд. мед. наук. М. 2006: 15–20.  

6.        Иоселиани Д.Г., Громов Д.Г., Сухоруков О.Е., Хоткевич Е.Ю., Семитко С.П., Исаева И.В., Верне Ж.-Ш., Арабаджян И.С., Овесян З.Р., Алигишева З.А. Хирургическая и эндоваскулярная реваскуляризация миокарда у больных с многососудистым поражением венечного русла: сравнительный анализ ближайших и среднеотдаленных результатов. Международный журнал интервенционной кардиоангиологии. 2008; 15: 22–31.

7.        Араблинский А.В. Степень реваскуляризации миокарда с помощью транслюминальной баллонной ангиопластики у больных с многососудистым поражением коронарного русла. Международный медицинский журнал. 2000; 1: 2–6.

8.        Ott R.A., Tobis J.M., Mills T.C., Allen B.J., Dwyer M.L. ECMO assisted angioplasty for cardiomyopathy patients with unstable angina. Department of Cardiothoracic Surgery, University of California. Irvine Medical Center. 2006.  

9.        Gaudino M., Santarelli P., Bruno P., Piancone F.L., Possati G. Palliative coronary artery surgery in patients with severe noncardiac diseases. Department of Cardiac Surgery, Catholic University. Rome. Italy. 2006.  

10.      Гринхальх Т. Основы доказательной медицины. Учебное пособие. М. 2004; 58.  

11.      Петросян Ю.С., Иоселиани Д.Г. О суммарной оценке состояния коронарного русла у больных ишемической болезнью сердца. Кардиология. 1976; 12 (16): 41–46.

12.      Петросян Ю.С., Шахов Б.Е. Коронарное русло у больных с постинфарктной аневризмой левого желудочка сердца. Горький. 1983; 17–37.

13.      Rahimtoola S.H. The hibernating myocardium. Ibid. 1989; 117: 211–221.

Abstract:

Purpose. Оf the study was to determine abilities of multislice spiral tomography (MSCT) in detection coronary artery disease (CAD) in patients with atypical angina..

Material and methods. Sixty patients (39 men) with atypical chest pain and suspected ischemic heart disease underwent complex diagnostic strategy. Value of MSCT in detection of significant (more than 50%) coronary artery stenoses was assessed by segmental analysis, vascular bed involvement, and patient analysis.

Results. Significant CAD in 8% of patients with atypical angina was revealed. In 98,7% (58 of 60 cases) MSCT allowed to specify coronary anatomy. In 53 (88,3%) of patients no significant CAD was found, in 5 cases (8,3%) MSCT confirmed significant coronary artery stenoses. Sensitivity, specificity, positive and negative prognostic value of MSCT were correspondingly 100%, 99,3%, 71,4%, 100% in segmental analysis (n = 295). Vascular territory involvement analysis (n = 91) showed 100% sensitivity, 97,7% specificity, positive prognostic value 71,4% and negative prognostic value 100%.

Conclusions. High prognostic value, as well as high sensitivity and specificity of MSCT allow us to include this method into the CAD diagnostic algorithm in patients with atypical chest pain. This method is highly reliable in eliminating of significant CAD and detecting coronary artery stenoses.

References 

1.      Синицын В.Е., Устюжанин Д-В. КТ-ангио-графия коронарных артерий. Кардиология. 2006; 1: 20-25.

2.      Терновой  С.К.,  Синицын В.Е.,  Гагарина Н.В. Неинвазивная диагностика атеросклероза и кальциноза коронарных артерий.М.: Атмосфера. 2003; 144.

3.      Hoffman M.H. et al. Noninvasive coronary angiography with multislice computed tomography. JAMA. 2005; 293: 2471-2478.

4.      Leber A.W. et al. Quantification of obstructive and nonobstructive coronary lesions by 64-slice computed tomography. A comparative study with quantitative coronary angiography and intravascular ultrasound. J. Am. Coll. Cardiol. 2005; 46: 147-154.

5.      Leschka S. et al. Accuracy of MSCT coronary angiography with 64-slice technology: first experience. Eur. Heart. J. 2005; 26: 1482-1487.

6.      Mollet N.R. et al. Highresolution spiral computed tomography coronary angiography in patients referred for diagnostic conventional coronary angiography. Circulation. 2005; 112: 2318 -2323.

7.      Raff G.L. et al. Diagnostic accuracy of noninvasive coronary angiography using 64-slice spiral computed tomography. J. Am. Coll. Cardiol. 2005; 46: 552-557.

8.      Kopp A.F. et al. Coronary arteries: retrospectively ECG-gated multi-detector row CT angiography with selective optimization  of the image reconstruction window. Radiology. 2001; 221:683-688.

9.      Austen W.G. et al. A reporting system on patients evaluated for coronary artery disease. Report of the Ad-Hoc Committee for Grading of Coronary Artery Disease, Council on Cardiovascular Surgery.   Circulation.   1975;  51:5-40.

10.    Patel M.R. et al. Low diagnostic yield of elective coronary angiography. N. Engl.J. Med. 2010; 362: 886-895.

11.    Leber A.W. et al. Diagnostic accuracy of dual-source multi-slice CT-coronary angiography in patients with an intermediate pretest likelihood for coronary artery disease. Eur. Heart. J. 2007; 28: 2354-2360.

12.    Hausleiter J. et al. Non-invasive coronary computed tomographic angiography for patients with suspected coronary artery disease. Тhe Coronary Angiography by Computed Tomography with the Use of a Submillimeter resolution (CACTUS) trial. Eur. Heart. J. 2007; 28: 3034-3041.

13.    Goldstein J.A. et al. A randomized controlled trial of multi-slice coronary computed tomography for evaluation of acute chest pain. J. Am. Coll. Cardiol. 2007; 49: 863-871.

14.    Hoffmann U. et al. Predictive value of 16-slice multidetector spiral computed tomography to detect significant obstructive coronary artery disease in patients at high risk for coronary artery disease. Patient-versus segment-based analysis. Circulation. 2004; 110: 2638-2643.

Abstract:

Aim: was to analyze long-term results of coronary artery stenting with drug-eluting stents «Zotarolimus» and bare metal stents in patients with a concomitant diabetes mellitus type II.

Materials and methods: 37 patients with ischemic heart disease and concomitant diabetes mellitus type II were selected for analysis; they underwent implantation of stents without drug coverage («Intergrity» «Medtronic») or stents with drug-eluting «Zotarolimus» («Resolute Integrity» «Medtronic»). All patients were divided into 2 groups: first group consisted of 11 patients, who underwent implantation of bare metal stents, second group - 26 patients who underwent implantation of drug-eluting stents, «Zotarolimus». Follow-up period was 26±4 months. Criteria of stenting efficiency were: angiographic assessment of coronary arteries anatomy in control angiography after stent implantation, reccurence of angina or functional class increase, the survival rate in the nearest postoperative period, before discharge, but not more than 30 days, and in the early post-operative period up to 6 months. In the medium-distant post-operative period - 12 months, and in the late postoperative period - 24 months.

Results: all patients underwent successfully performed endovascular revascularization. The optimal angiographic result was achieved in all patients. Regression of ischemic changes on ECG data and increase myocardial contractility by echocardiography data also were marked in all patients. In long-term follow-up period, in 5 (45%) patients with bare metal stents we noted the appearence of hemodynamically significant restenosis, that needed performance of secondary angioplasty with stenting.

Conclusion: the use of antiproliferative drug-eluting stents «Zotarolimus» is possible in treatment of patients with coronary artery disease and comorbid diagnosis of diabetes mellitus type II. Bare metal stents in coronary stenting in patients with concomitant diagnosis of diabetes mellitus type II is impractical due to developing in-stent restenosis (45% of patients). 

References

1.     Kereiakes D.J., Cutlip D.E., Applegate R.J., Wang J., Yaqub M., Sood P., Su X., Su G., Farhat N., Rizvi A., Simonton C.A., Sudhir K., Stone G.W. Outcomes in diabetic and nondiabetic patients treated with everolimus- or paclitaxel-eluting stents: results from the SPIRIT IV clinical trial (Clinical Evaluation of the XIENCE V Limus Eluting Coronary Stent System). J. Am. Coll. Cardiol. 2010 Dec 14; 56(25):2084-2089.

2.     Petrova K.N., Kozlov S.G., Ljakishev A.A., Savchenko A.P. Vlijanie saharnogo diabeta 2 tipa na rezul'taty jendovaskuljarnogo lechenija IBS s pomoshhju stentov s lekarstvennym pokrytiem (dannye godichnogo nabljudenija) [Influence of diabetes mellitus type 2 on results of endovascular treatment of IHD with help of drug-eluting stents (data monitoring for one year)]. Kardiohgija. 2006; 12: 22-6 [In Russ].

3.     Abizaid A., Costa M.A., Blanchard D. et al. Sirolimus-Eluting Stents Inhibit Neointimal Hyperplasia in Diabetic Patients. Insights from the RAVEL Trial. Eur. Heart J. 2004; 25: 107-12.

4.     Moussa I., Leon M.B., Baim D.S. et al. Impact of Sirolimus-Eluting Stents on Outcome in Diabetic Patients. Circulation .2004; 109: 2273-8.

5.     Hermiller J.B., Raizner A., Cannon L. et al. TAXUS-IV Investigators. Outcomes With the Polymer-Based Paclitaxel-Eluting TAXUS Stent in Patients With Diabetes Mellitus: the TAXUS-IV trial. JACC. 2005; 45: 1172-9.

6.     Sabate M., Jim Onez-Quevedo P., Angiolillo D.J. et al. Randomized Comparison of Limus-Eluting Stent Versus Standard Stent for Percutaneous Coronary Revascularization in Diabetic Patients. Circulation. 2005; 112: 2175-83.

7.     Jensen J., Lagerqvist B., Aasa M., Sarev T., Nilsson T., Tornvall P. Clinical and angiographic follow-up after coronary drug-eluting and bare metal stent implantation. Do drug-eluting stents hold the promise? J. Intern. Med. 2006 Aug; 260(2):118-24.

8.     Jain A.K., Lotan C., Meredith I.T., Feres F., Zambahari R., Sinha N., Rothman M.T. E-Five Registry Investigators. Twelve-month outcomes in patients with diabetes implanted with a zotarolimus-eluting stent: results from the E-Five Registry. Heart. 2010 Jun; 96(11):848-53. doi: 10.1136/hrt.2009.184150.

9.     Stettler C., Allemann S., Egger M. et al. Efficacy of drug eluting stents in patients with and without diabetes mellitus: indirect comparison of controlled trials. Heart. 2006; 92: 650-7.

10.   Scheen A.J., Warzee F. Diabetes Is Still a Risk Factor for Restenosis After Drug-Eluting Stent in Coronary Arteries. Diabetes Care. 2004; 27: 1840-1.

11.   Park K.W., Lee J.M., Kang S.H., Ahn H.S., Kang H.J., Koo B.K., Rhew J.Y, Hwang S.H., Lee S.Y, Kang T.S., Kwak C.H., Hong B.K., Yu C.W., Seong I.W., Ahn T., Lee H.C., Lim S.W., Kim H.S. Everolimus-eluting xience v/promus versus zotarolimus-eluting resolute stents in patients with diabetes mellitus. JACC. Cardiovasc. Interv. 2014 May;7(5):471-81. doi: 10.1016/j.jcin.2013.12.201. 

Abstract:

Aim: was to perform indirect estimation of pumping function of left ventricle (LV) in patients with ischemic heart disease (IHD), before and after mini-invasive intracoronary procedures or elimination of cardiac arrhythmias, basing on condition of pulmonary circulation.

Material and methods: research includes data of 44 patients with IHD (aged 43-89), who were admitted to the hospital with acute coronary syndrome (ACS) or cardiac arrhythmia. Estimation of pulmonary flow condition in IHD patients was made basing on data of chest multislice computec tomography (MSCT), changes of density of lung parenchyma in selected volume of lung before and after coronary stenting/placement of pacemaker, disruption of ectopic lesions and conduction pathway

Results: sighs of reliable changes in pulmonary circulation as local lung pneumatization changes with increased densitometric value within 10 hounsfield units (HU) after mini-invasive surgical treatment were found in 19 patients.

Conclusions: the study has showed high sensitivity of lung MSCT in diagnostics of left ventricular disfunction within coronary blood flow changes and normalization of cardiac rhythm. 

References

1.     Информационный бюллетень ВОЗ N 317 Март 2013г. http://www.who.int/mediacentre/factsheets/ fs317/ru/. Informacionnyj bjulleten' VOZ N 317 Mart 2013g [WHO Information bulletin # 317, march 2013]. http://www.who.int/mediacentre/factsheets/fs317/ru/ [In Russ]

2.    Demograficheskij ezhegodnik Rossii, 2012 [Demographic yearbook of Russian Federation, 2012]. Stat sb. Rosstat. M: 2012; 535 [In Russ].

3.     Oganov R.G., Maslennikova G.Ja. Demograficheskie tendencii v Rossijskoj Federacii: vklad boleznej sistemy krovoobrashhenija [Demographic trends in Russian Federation: the role of diseases of blood circulation]. Kardiovask. ter. i prof 2012; 1:5-10 [In Russ].

4.     Koncevaja A.V, Kalinina A.M., Koltunov I.E., Oganov R.G. Social'no-jekonomicheskij ushherb ot ostrogo koronarnogo sindroma v Rossijskoj Federacii.GNIC profilakticheskoj mediciny [Social-economic lesion of acute coronary syndrome in Russian Federation]. Racionarnaja farmakoterapija v kardiologii. 2011 7(2): 158-166 [In Russ].

5.     Salvador M.J., Sebaoun, F. Sonntag, P. et. al. European Study of Ambulatory Management of Heart Failure . Rev. Esp. Cardiol. 2004;57(12):1170-8.

6.     Obrezan A.G., Vologdina I.V. Hronicheskaja serdechnaja nedostatochnost [Chronic heart insufficiency]'. «Vita Nova». 2002; 320 s [In Russ].

7.     Belenkov Ju.N., Mareev VJu., Principy racional'nogo lechenija serdechnoj nedostatochnosti [Principles of heart insufficiency treatment]. M. 2000; 173s [In Russ].

8.     Rezcalla S.H., Kloner R.A. Coronary no-reflow phenomenon: from the experimental laboratory to the cardiac catheterization laboratory. Catheter Cardiovasc. Interv. 2008; 72: 950-957.

9.     Tihonov K.B. Funkcional'naja rentgenoanatomija serdca [Functional endovascular anatomy]. Izd. Medicina. M. 1990; 272 s [In Russ].

10.   Sebastian C.A., Bekkers M., Waltenberger J. Microvascular Obstruction: underlying pathophisiology and clinical diagnosis. J. Am. Coll. Car. 2010; 55:16491660.

11.   Abbate A., Kontos M.C. No-Reflow: the next challenge in treatment of ST-elevation acute myocardial infarction. Eur. Heart J. 2008; 29: 1795-1797.

12.   Beljalov F.I Aritmii serdca [Cardiac arrythmias]. RIO IMAPO. 2011; 333s [In Russ].

13.   Trufanov G.E., Zheleznjak I.S., Rud' S.D., Men'kov I.A. MRT v diagnostike ishemicheskoj bolezni serdca [MRI in diagnostics of ischemic heart diseases]. Jelbi-SPb. 2012; 64 s [In Russ].

14.   Гранов А.М., Тютин Л.А. Позитронно-эмиссионная томография. Издательстово Фолиант. 2008;368 c. Granov A.M., Tjutin L.A. Pozitronno-jemissionnaja tomografija [Positron Emission Tomography]. Izdatel'stovo Foliant. 2008;368 s [In Russ].

15.   Turner F., Lau F., Jacobson G. A method for estimation of pulmonary venosus and arterial pressures from the routine chest roentgenogram. Amer. J. Roentgenol. 1972; 116: 97-106.

16.   Petrenko I.E. Rentgenologicheskie projavlenija levozheludochkovoj nedostatochnosti serdca i rentgenodiagnostika nekotoryh oslozhnenij pri ostrom infarkte miokarda [Radiographic manifestations of left ventricle insufficiency and radiographic diagnostics of complications of acute coronary syndrome]. Avtoreferat. dis. uchen. ctep. kand. med. nauk L. 1982 [In Russ].

17.   Storto M.L., Kee S.T., Golden, J.A. Webb W.R. Hydrostatic pulmonary edema: high-resolution CT findings. AJR:165, October 1995: 817-820.

18.   Kato S., Nakamoto T., Iizuka M. Early diagnosis and estimation of pulmonary congestion and edema in patients with left-sided heart disease from histogram. Pulmonary CT Number. ST 1996; 109:1439-45.

19.   Pelosi P, Gama de Abreu M. Lung CT scan. The Open Nuclear Medicine Journal. 2010; 2: 86-98.

20.   Hanneman K., Nguyen E.T., Crean A.M. Hypertrophic cardiomyopathy complicated by pulmonary edema in the postpartum period. Hinduri рublishing corporation сase reports in radiology. V. 2013; Article ID 802352, 3 pages http://dx.doi.org/10.1155/2013/80235.

21.   Claudia M., Cunha R., Edson M., Rodrigeus R., Hydrostatic pulmonary edema: high-resolution computed tomography aspects. J. Bras. Pneumol. 2006; 32 (6): 515-22.

22.   Gonzales J., Verin A. Non-Cardiogenic Pulmonary Edema, Lung Diseases - Selected State of the Art Reviews, Ed. Dr. Elvisegran M. I. 2012, ISBN: 978-953-51-0180-2, InTech, Available from:http://www.intechopen.com/ books/lung-diseases-selected-state-of-the-art- reviews/non-cardiogenic-pulmonary-edema.

23.   Min'ko B.A., Vologdina I.V., Borodich P.L. Rol' kompjuternoj tomografii legkih u bol'nyh ishemicheskoj boleznju serdca v ocenke funkcii levogo zheludochka pri maloinvazivnyh hirurgicheskih vmeshatel'stvah [The role of computed tomography of lungs in estimation of left ventricle function during mini-invasive interventions in patients with ischemic heart disease]. REJR. 2015; 5(1): 64-67 [In Russ]. 

Abstract:

Aim: was to improve the efficiency of diagnosis of patients with coronary heart disease, by estimating of possibilities of cardiac multislice computed tomography in comparison with coronary angiography.

Materials and methods: study included 64 patients (18 women and 46 men, mean age 62,4 ± 9,5 years) with a high risk of developing coronary heart disease. In 34 patients - myocardial infarction in anamnesis (18 patients - in pool right coronary artery in 16 patients - in left anterior descending artery). Clinics of angina pectoris - in 40 patients (functional class (FC) I - 10; FC II - 22, FC III - in 6, FC IV - 2 patients). Selection criteria: the absence of disease progression for at least 6 weeks, and at least 3 months of optimal treatment. All patients underwent cardiac MSCT at 256-slice CT scanner. Obtained data was compared with data of reference method - x-ray coronary angiography.

Results: comparison of MSCT coronary angiography with invasive data showed a high comparability of results of two methods in the evaluation of coronary artery disease. It was revealed that discrepancies between cardiac MSCT and CAG in detection of hemodynamically insignificant stenoses ranging from 0 to 4%, hemodynamically significant stenoses - from 0 to 2.6%, subtotal stenosis - from 0 to 1%, occlusions - 0%. The presence of strong correlations between data of cardiac MSCT and coronary angiography of stenosis, demonstrated the high quality of MSCT imaging of coronary artery segments in the examination with a variety of modes of application method.

Conclusion: multislice computed tomography is a highly effective method for diagnosing of structural and anatomic changes of coronary arteries in patients with coronary heart disease.

References

1.     Chazov E.I. Perspektivy kardiologii v svete progressa fundamental'noj nauki [Cardiology prospects in sight of the progress of fundamental science.]. Ter. arhiv. 2009;9:5-8 [In Russ].

2.     Kokov L.S., Shutihina I.V., Timina I.E. Ispol'zovanie ul'trazvukovyh tehnologij v ocenke ateroskleroticheskih porazhenij sosudistoj stenki [The use of ultrasonic technology in the assessment of atherosclerotic lesions of the vascular wall.]. Molekuljarnaja medicina. 2013;4:15-25 [In Russ].

3.     Sinicyn V.E., Stukalova O.V., Docenko Ju.A. i dr. Kontrastnaja magnitno-rezonansnaja tomografija v ocenke rubcovyh porazhenij miokarda u bol'nyh IBS[Contrast magnetic resonance imaging in the evaluation of myocardial scarring lesions in patients with coronary artery disease.]. Diagnosticheskaja i intervencionnaja radiologija. 2009;3 (4):23-31 [In Russ].

4.     Fedotenkov I.S., Gagarina N.V., Veselova T.N., Sinicyn V.E., Ternovoj S.K. Kolichestvennyj analiz urovnja kal'cinoza koronarnyh arterij: sravnenie informativnosti mul'tispiral'noj komp'juternoj tomografii i jelektronno-luchevoj tomografii[Quantitative analysis of the level of calcification of the coronary arteries: comparison of informativeness of multislice computed tomography and electron beam tomography.]. Terapevticheskij arhiv. 2006;12:15-19 [In Russ].

5.     Ternovoj S.K., Veselova T.N., Sinicyn V.E. i dr. Rol' mul'tispiral'noj komp'juternoj tomografii v diagnostike infarkta miokarda [The role of multislice computed tomography in the diagnosis of myocardial infarction.]. Kardiologija. 2008; 1: 4-8 [In Russ].

6.     Sinicyn V.E., Ternovoj S.K., Ustjuzhanin D.V. i dr. Diagnosticheskoe znachenie KT-angiografii v vyjavlenii gemodinamicheski znachimyh stenozov koronarnyh arterij [The diagnostic value of CT angiography in the detection of hemodynamically significant stenoses of coronary arteries]. Kardiologija. 2008; 1: 9-14 [InRuss].

7.     Ustjuzhanin D.V., Veselova T.N., Sinicyn V.E. i dr. Cravnitel'nyj analiz diagnosticheskogo znachenija neinvazivnoj angiografii koronarnyh arterij s pomoshh'ju jelektronno-luchevoj i mul'tispiral'noj komp'juternoj tomografii [Comparative analysis of the diagnostic value of noninvasive coronary angiography using the electron beam and multislice computed tomography.]. Terapevticheskij arhiv. 2008; 4:12-15[In Russ].

8.     Veselova T.N., Merkulova I.N., Mironov V.M., Merkulov E.V., Ternovoj S.K., Ruda M.Ja. Neinvazivnaja ocenka ateroskleroticheskogo porazhenija koronarnyh arterij u bol'nyh s ostrym koronarnym sindromom metodom mul'tispiral'noj komp'juternoj tomografii[Noninvasive assessment of atherosclerotic lesions of coronary arteries in patients with acute coronary syndrome by multislice computed tomography.]. Medicinskaja vizualizacija. 2010; 4:100-109 [In Russ].

9.     Petcherski O., Gaspar T., Halon D. et al. Diagnostic accuracy of 256-row computed tomographic angiography for detection of obstructive coronary artery disease using invasive quantitative coronary angiography as reference standard. Am. J. Cardiol. 2013;111:510-515.

10.   Gaudio C., Pelliccia F., Evangelista A. et al. 320-row computed tomography coronary angiography vs. conventional coronary angiography in patients with suspected coronary artery disease: a systematic review and metaanalysis. Int. J. Cardiol. 2013;168:1562-1564.

11.   Fedotenkov I.S., Veselova T.N., Ternovoj S.K., Sinicyn V.E. Rol' mul'tispiral'noj komp'juternoj tomografii v diagnostike kal'cinoza koronarnyh arterij [The role of multislice computed tomography in the diagnosis of coronary artery calcification]. Kardiologicheskij vestnik. 2007; 11 (XIV): 45-48 [In Russ].

12.   Ternovoj S.K., Nikonova M.Je., Akchurin R.S. i dr. Vozmozhnosti mul'tispiral'noj komp'juternoj tomografii (MSKT) v ocenke koronarnogo rusla i ventrikulografii v sravnenii s intervencionnoj koronaroventrikulografiej [Possibilities of multislice computed tomography (MSCT) in the evaluation of coronary arteries and ventriculography in comparison with interventional coronaroventriculography.]. Rossijskij jelektronnyj zhurnal luchevoj diagnostiki. 2013;3 (9): 28-36 [In Russ].

13.   Ternovoj S.K., Veselova T.N. Vyjavlenie nestabil'nyh bljashek v koronarnyh arterijah s pomoshh'ju mul'tispiral'noj kompjuternoj tomografii [Identification of unstable plaques in coronary arteries using a multislice computed tomography.]. Rossijskij jelektronnyj zhurnal luchevoj diagnostiki. 2014:4(13):7- 14 [In Russ].

14.   Sabarudin A., Sun Z. Coronary CT angiography: Diagnostic value and clinical challenges. World J. Cardiol. 2013;26;5(12):473-483.

15.   Pelliccia F., Pasceri V., Evangelista A. et al. Diagnostic accuracy of 320-row computed tomography as compared with invasive coronary angiography in unselected. consecutive patients with suspected coronary artery disease. Int. J. Cardiovasc. Imaging. 2013;29(2):443-452.

16.   Obaid D.R., Calvert PA., Gopalan D. et al. Dualenergy computed tomography imaging to determine atherosclerotic plaque composition: a prospective study with tissue validation. J Cardiovasc Comput Tomogr. 2014; 8(3):230-237. [PubMed: 24939072]

17.   Gbaid D.R., CalvertPA., Gopalan D. et al. Atherosclerotic plaque composition and classification identified by coronary computed tomography: assessment of computed tomography-generated plaque maps compared with virtual histology intravascular ultrasound and histology. Circ Cardiovasc Imaging. 2013;6(5):655-664. [PubMed: 23960215] 

18.   Stehli J., Clerc O.F., Fuchs T.A. et al. Impact of monochromatic coronary computed tomography angiography from single-source dual-energy CT oncoronary stenosis quantification. J Cardiovasc Comput Tomogr. 2016;10(2):135-140.

19.   DanadI., Hartaigh B., Min J.K. Dual-energy computed tomography for detection of coronary artery disease. Expert Rev Cardiovasc Ther. 2015;13(12):1345- 1356.

20.   Petranovic M., Soni A., Bezzera H. et al. Assessment of nonstenotic coronary lesions by 64-slice multidetector computed tomography in comparison to intravascular ultrasound: evaluation of nonculprit coronary lesions. J Cardiovasc. Comput. Tomogr. 2009;3(1):24-31.

21.   Leber A.W., Knez A., Becker A. et al. Accuracy of multidetector spiral computed tomography in identifying and differentiating the composition of coronary atherosclerotic plaques: a comparative study with intracoronary ultrasound. J. Am. Coll. Cardiol. 2004;43(7):1241-1247.

22.   Wu Y, Zheng M., Zhao H. et al. Low-concentration contrast material for dual-source computed tomography coronary angiography by a combination of iterative reconstruction and low-tube-voltage technique: feasibility study. Zhonghua YiXueZaZhi. 2014;94(29):2260-2263.