The role of intravascular methods of examination of coronary arteries in the selection of patients with diffuse and multivessel lesions for myocardial revascularization
Objective Assessment of the role of intravascular imaging methods in choosing the surgical strategy of myocardial revascularization.Material and Methods The study included 62 patients with diffuse and multivessel coronary artery disease, who underwent percutaneous coronary infervention (PCI) using i...
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| Language: | Russian |
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Scientific Research Institute, Ochapovsky Regional Clinical Hospital no. 1
2021-12-01
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| Series: | Инновационная медицина Кубани |
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| Online Access: | https://www.innovmedkub.ru/jour/article/view/464 |
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| author | D. A. Maximkin J. M. Bolivogu A. G. Faybushevich A. G. Chepurnoy Z. Kh. Shugushev |
| author_facet | D. A. Maximkin J. M. Bolivogu A. G. Faybushevich A. G. Chepurnoy Z. Kh. Shugushev |
| author_sort | D. A. Maximkin |
| collection | DOAJ |
| description | Objective Assessment of the role of intravascular imaging methods in choosing the surgical strategy of myocardial revascularization.Material and Methods The study included 62 patients with diffuse and multivessel coronary artery disease, who underwent percutaneous coronary infervention (PCI) using intravascular imaging methods. Measurement of fractional flow reserve (FFR) in diffusely altered arteries was performed under conditions of maximum hyperemia, sequentially between stenoses, using the sensor, starting from the distal segment. Initially, the most distal hemodynamically significant stenosis was stented. Then, a repeated measurement of FFR was performed, and the issue of the need for stenting of other stenoses was solved. The results of stenting, as well as determination of the area of stent implantation were carried out by the method of optical coherence tomography (OCT).Results After FFR measurement the number of arteries with hemodynamically significant stenoses decreased by 24.7% (from 93 to 70). It was also noted that in patients with two-vessel lesions, the average number of such stenoses decreased from 2.95 ± 0.65 to 1.82 ± 0.88, and in patients with three-vessel lesions – from 2.96 ± 0.6 to 2.24 ± 0.76 respectively (p = 0.0024). Complete (functionally adequate according to FFR measurements) myocardial revascularization was achieved in 88.7% of patients. The second-generation drug eluting stents were implanted in 82 (47.1%) patients, and the third generation stents – in 92 (52.9%) patients. At the same time, the success rate of recanalization of occlusions was 100%. Overall, optimal stent implantation was achieved in all patients. Major cardiovascular complications were observed in 1 (1.6%) patient, which required additional interventions.Conclusion Complex use of intravascular imaging methods (OCT and FFR measurements) allows a differentiated approach to the assessment of each stenosis of the affected artery in patients with diffuse and multivessel coronary lesions, to achieve a high frequency of complete myocardial revascularization, as well as to reduce the number of unnecessary interventions and intraoperative complications. |
| first_indexed | 2024-03-07T15:36:06Z |
| format | Article |
| id | doaj.art-d051349b51a541aa8a763f4ce2d2931d |
| institution | Directory Open Access Journal |
| issn | 2541-9897 |
| language | Russian |
| last_indexed | 2024-03-07T15:36:06Z |
| publishDate | 2021-12-01 |
| publisher | Scientific Research Institute, Ochapovsky Regional Clinical Hospital no. 1 |
| record_format | Article |
| series | Инновационная медицина Кубани |
| spelling | doaj.art-d051349b51a541aa8a763f4ce2d2931d2024-03-05T11:12:31ZrusScientific Research Institute, Ochapovsky Regional Clinical Hospital no. 1Инновационная медицина Кубани2541-98972021-12-010451210.35401/2500-0268-2021-24-4-5-12299The role of intravascular methods of examination of coronary arteries in the selection of patients with diffuse and multivessel lesions for myocardial revascularizationD. A. Maximkin0J. M. Bolivogu1A. G. Faybushevich2A. G. Chepurnoy3Z. Kh. Shugushev4Peoples' Friendship University of RussiaPeoples' Friendship University of RussiaPeoples' Friendship University of RussiaPeoples' Friendship University of RussiaPeoples' Friendship University of RussiaObjective Assessment of the role of intravascular imaging methods in choosing the surgical strategy of myocardial revascularization.Material and Methods The study included 62 patients with diffuse and multivessel coronary artery disease, who underwent percutaneous coronary infervention (PCI) using intravascular imaging methods. Measurement of fractional flow reserve (FFR) in diffusely altered arteries was performed under conditions of maximum hyperemia, sequentially between stenoses, using the sensor, starting from the distal segment. Initially, the most distal hemodynamically significant stenosis was stented. Then, a repeated measurement of FFR was performed, and the issue of the need for stenting of other stenoses was solved. The results of stenting, as well as determination of the area of stent implantation were carried out by the method of optical coherence tomography (OCT).Results After FFR measurement the number of arteries with hemodynamically significant stenoses decreased by 24.7% (from 93 to 70). It was also noted that in patients with two-vessel lesions, the average number of such stenoses decreased from 2.95 ± 0.65 to 1.82 ± 0.88, and in patients with three-vessel lesions – from 2.96 ± 0.6 to 2.24 ± 0.76 respectively (p = 0.0024). Complete (functionally adequate according to FFR measurements) myocardial revascularization was achieved in 88.7% of patients. The second-generation drug eluting stents were implanted in 82 (47.1%) patients, and the third generation stents – in 92 (52.9%) patients. At the same time, the success rate of recanalization of occlusions was 100%. Overall, optimal stent implantation was achieved in all patients. Major cardiovascular complications were observed in 1 (1.6%) patient, which required additional interventions.Conclusion Complex use of intravascular imaging methods (OCT and FFR measurements) allows a differentiated approach to the assessment of each stenosis of the affected artery in patients with diffuse and multivessel coronary lesions, to achieve a high frequency of complete myocardial revascularization, as well as to reduce the number of unnecessary interventions and intraoperative complications.https://www.innovmedkub.ru/jour/article/view/464diffuse lesionmultivessel lesionoptical coherence tomographyfractional flow reserve |
| spellingShingle | D. A. Maximkin J. M. Bolivogu A. G. Faybushevich A. G. Chepurnoy Z. Kh. Shugushev The role of intravascular methods of examination of coronary arteries in the selection of patients with diffuse and multivessel lesions for myocardial revascularization Инновационная медицина Кубани diffuse lesion multivessel lesion optical coherence tomography fractional flow reserve |
| title | The role of intravascular methods of examination of coronary arteries in the selection of patients with diffuse and multivessel lesions for myocardial revascularization |
| title_full | The role of intravascular methods of examination of coronary arteries in the selection of patients with diffuse and multivessel lesions for myocardial revascularization |
| title_fullStr | The role of intravascular methods of examination of coronary arteries in the selection of patients with diffuse and multivessel lesions for myocardial revascularization |
| title_full_unstemmed | The role of intravascular methods of examination of coronary arteries in the selection of patients with diffuse and multivessel lesions for myocardial revascularization |
| title_short | The role of intravascular methods of examination of coronary arteries in the selection of patients with diffuse and multivessel lesions for myocardial revascularization |
| title_sort | role of intravascular methods of examination of coronary arteries in the selection of patients with diffuse and multivessel lesions for myocardial revascularization |
| topic | diffuse lesion multivessel lesion optical coherence tomography fractional flow reserve |
| url | https://www.innovmedkub.ru/jour/article/view/464 |
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