Endovascular myocardial revascularization in patients with multivessel coronary artery disease with chronic total occlusion and high surgical risk
The main reason for incomplete myocardial revascularization is the presence of chronic coronary total occlusion (CTO), which is detected in every fourth patient during coronary angiography. At the same time, a generally accepted approach to the treatment of CTO has not yet been developed.Aim. To a...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | Russian |
| Published: |
«SILICEA-POLIGRAF» LLC
2020-12-01
|
| Series: | Кардиоваскулярная терапия и профилактика |
| Subjects: | |
| Online Access: | https://cardiovascular.elpub.ru/jour/article/view/2697 |
| _version_ | 1797882381130006528 |
|---|---|
| author | D. K. Vasiliev B. A. Rudenko A. S. Shanoyan F. B. Shukurov D. A. Feshchenko |
| author_facet | D. K. Vasiliev B. A. Rudenko A. S. Shanoyan F. B. Shukurov D. A. Feshchenko |
| author_sort | D. K. Vasiliev |
| collection | DOAJ |
| description | The main reason for incomplete myocardial revascularization is the presence of chronic coronary total occlusion (CTO), which is detected in every fourth patient during coronary angiography. At the same time, a generally accepted approach to the treatment of CTO has not yet been developed.Aim. To assess the rationale of complete myocardial revascularization in patients with multivessel coronary artery disease (CAD) with chronic total occlusion and high surgical risk.Material and methods. This retrospective, open-label, non-randomized clinical trial was carried out included 180 patients multivessel CAD and CTO. The patients underwent endovascular surgery for complete myocardial revascularization. Depending on the success of surgery, the patients were divided into groups of complete and incomplete myocardial revascularization. Endpoints were death, acute coronary syndrome, re-revascularization after 1-year follow-up. Left ventricular (LV) contractility and clinical status of patients in the study groups after 1 year of observation was assessed.Results. The median follow-up was 12,1 months. The successful rate of revascularization was 79,4%. The incidence of main composite endpoint in the group of complete myocardial revascularization was 5,59%, while in the group of incomplete revascularizations — 21,6% (p=0,005).Conclusion. The study showed that low incidence of intraoperative complications and a high successful rate of revascularization are characteristic of complete myocardial revascularization in patients at high surgical risk with multivessel CAD and CTO. Complete myocardial revascularization leads to a significant decrease in the incidence of major coronary events. |
| first_indexed | 2024-04-10T03:34:52Z |
| format | Article |
| id | doaj.art-358fb62c888c4b51bb7fc1a4351c5d1a |
| institution | Directory Open Access Journal |
| issn | 1728-8800 2619-0125 |
| language | Russian |
| last_indexed | 2024-04-10T03:34:52Z |
| publishDate | 2020-12-01 |
| publisher | «SILICEA-POLIGRAF» LLC |
| record_format | Article |
| series | Кардиоваскулярная терапия и профилактика |
| spelling | doaj.art-358fb62c888c4b51bb7fc1a4351c5d1a2023-03-13T07:23:29Zrus«SILICEA-POLIGRAF» LLCКардиоваскулярная терапия и профилактика1728-88002619-01252020-12-0119610.15829/1728-8800-2020-26972188Endovascular myocardial revascularization in patients with multivessel coronary artery disease with chronic total occlusion and high surgical riskD. K. Vasiliev0B. A. Rudenko1A. S. Shanoyan2F. B. Shukurov3D. A. Feshchenko4ФГБУ “Национальный медицинский исследовательский центр терапии и профилактической медицины” Минздрава РоссииФГБУ “Национальный медицинский исследовательский центр терапии и профилактической медицины” Минздрава РоссииФГБУ “Национальный медицинский исследовательский центр терапии и профилактической медицины” Минздрава РоссииФГБУ “Национальный медицинский исследовательский центр терапии и профилактической медицины” Минздрава РоссииФГБУ “Национальный медицинский исследовательский центр терапии и профилактической медицины” Минздрава РоссииThe main reason for incomplete myocardial revascularization is the presence of chronic coronary total occlusion (CTO), which is detected in every fourth patient during coronary angiography. At the same time, a generally accepted approach to the treatment of CTO has not yet been developed.Aim. To assess the rationale of complete myocardial revascularization in patients with multivessel coronary artery disease (CAD) with chronic total occlusion and high surgical risk.Material and methods. This retrospective, open-label, non-randomized clinical trial was carried out included 180 patients multivessel CAD and CTO. The patients underwent endovascular surgery for complete myocardial revascularization. Depending on the success of surgery, the patients were divided into groups of complete and incomplete myocardial revascularization. Endpoints were death, acute coronary syndrome, re-revascularization after 1-year follow-up. Left ventricular (LV) contractility and clinical status of patients in the study groups after 1 year of observation was assessed.Results. The median follow-up was 12,1 months. The successful rate of revascularization was 79,4%. The incidence of main composite endpoint in the group of complete myocardial revascularization was 5,59%, while in the group of incomplete revascularizations — 21,6% (p=0,005).Conclusion. The study showed that low incidence of intraoperative complications and a high successful rate of revascularization are characteristic of complete myocardial revascularization in patients at high surgical risk with multivessel CAD and CTO. Complete myocardial revascularization leads to a significant decrease in the incidence of major coronary events.https://cardiovascular.elpub.ru/jour/article/view/2697чрескожное коронарное вмешательствохронические окклюзии коронарных артерийишемическая болезнь сердцааортокоронарное шунтированиеоптимальная медикаментозная терапия |
| spellingShingle | D. K. Vasiliev B. A. Rudenko A. S. Shanoyan F. B. Shukurov D. A. Feshchenko Endovascular myocardial revascularization in patients with multivessel coronary artery disease with chronic total occlusion and high surgical risk Кардиоваскулярная терапия и профилактика чрескожное коронарное вмешательство хронические окклюзии коронарных артерий ишемическая болезнь сердца аортокоронарное шунтирование оптимальная медикаментозная терапия |
| title | Endovascular myocardial revascularization in patients with multivessel coronary artery disease with chronic total occlusion and high surgical risk |
| title_full | Endovascular myocardial revascularization in patients with multivessel coronary artery disease with chronic total occlusion and high surgical risk |
| title_fullStr | Endovascular myocardial revascularization in patients with multivessel coronary artery disease with chronic total occlusion and high surgical risk |
| title_full_unstemmed | Endovascular myocardial revascularization in patients with multivessel coronary artery disease with chronic total occlusion and high surgical risk |
| title_short | Endovascular myocardial revascularization in patients with multivessel coronary artery disease with chronic total occlusion and high surgical risk |
| title_sort | endovascular myocardial revascularization in patients with multivessel coronary artery disease with chronic total occlusion and high surgical risk |
| topic | чрескожное коронарное вмешательство хронические окклюзии коронарных артерий ишемическая болезнь сердца аортокоронарное шунтирование оптимальная медикаментозная терапия |
| url | https://cardiovascular.elpub.ru/jour/article/view/2697 |
| work_keys_str_mv | AT dkvasiliev endovascularmyocardialrevascularizationinpatientswithmultivesselcoronaryarterydiseasewithchronictotalocclusionandhighsurgicalrisk AT barudenko endovascularmyocardialrevascularizationinpatientswithmultivesselcoronaryarterydiseasewithchronictotalocclusionandhighsurgicalrisk AT asshanoyan endovascularmyocardialrevascularizationinpatientswithmultivesselcoronaryarterydiseasewithchronictotalocclusionandhighsurgicalrisk AT fbshukurov endovascularmyocardialrevascularizationinpatientswithmultivesselcoronaryarterydiseasewithchronictotalocclusionandhighsurgicalrisk AT dafeshchenko endovascularmyocardialrevascularizationinpatientswithmultivesselcoronaryarterydiseasewithchronictotalocclusionandhighsurgicalrisk |