REACTION OF THE HOMEOSTATIC SYSTEM TO THE STENTING OF ANTERIOR DESCENDING ARTERY

For more than 50 years, the concept of balloon angioplasty and coronary artery stenting has been included in practice. Over a period of development of the technique and new mechanisms of pharmacological influence, factors causing thrombosis of the stents have occurred.Purpose - to compare and analyze clinical and instrumental data before and after stenting.From 2007 to 2016, a total of 207 patients were included in a retrospective study. They underwent intervention in the anterior interventricular artery in the proximal segment. The patients were divided into 3 groups: Group I - no complications (N = 139),Group II - the presence of one of the complications (N = 54), III - the presence of two or more complications (N = 14). Data frombiochemical, general blood tests, coagulation, echocardiography, etc were evaluated in all patients. In total, 73 characteristics were included in the analysis.Based on the obtained data, 18 parameters were significant for the risk of complications, 14 were before stenting, 4 after. Com-paring the obtained numerical values, there are significant differences of group 3 compared with the first and second.It is becoming obvious that patients of group 3, were more severe in their comorbid background. In patients who had deliberately unsatisfactory results on the homeostasis system, the effect of the treatment was much better.

тромбоз, рестеноз, коронарный стент, инфаркт миокарда, феномен «no-reflow», thrombosis, restenosis, coronary stent, myocardial infarction, the phenomenon of "no-reflow"

1. Мышечные мосты как предикторы тромбозов стентов / В.В. Плечев [и др.] // Пермский медицинский журнал. - 2017. - Т. XXXIV, № 1. - С. 6-11

2. Antman EM, Cohen M, Bernink PJ, McCabe CH, Horacek T, Papuchis G. The TIMI risk score for unstable angina/non-ST elevation MI: A method for prognostication and therapeutic decision making. JAMA. 2000 Aug 16. 284(7):835-42

3. Biondi-Zoccai GG, Agostoni P, Sangiorgi GM, [et al.] Incidence, predictors, and outcomes of coronary dissections left untreated after drug-eluting stent implantation. Eur Heart J 2006;27:540-6

4. Colombo A, Moses JW, Morice MC, [et al.] Randomized study to evaluate sirolimus-eluting stents implanted at coronary bifurcation lesions. Circulation2004;109:1244-9

5. Daemen J, Wenaweser P, Tsuchida K, [et al.] Early and late coronary stent thrombosis of sirolimus-eluting and paclitaxel-eluting stents in routine clinical practice: data from a large two-institutional cohort study. Lancet 2007;369:667-78

6. DotterC.T., JudkinsM.P. Transluminal treatment of arterosclerotic obstruction. Description of a new technic and a preliminary report of its application. Circulation. 1964;30:654-670

7. Iakovou I, Schmidt T, Bonizzoni E, [et al.] Incidence, predictors, and outcome of thrombosis after successful implantation of drugeluting stents. JAMA 2005;293:2126 -30

8. Ellis SG, Colombo A, Grube E, [et al.] Incidence, timing, and correlates of stent thrombosis with the polymeric paclitaxel drug-eluting stent: a TAXUS П, IV, V, and VI meta-analysis of 3,445 patients followed for up to 3 years. J Am CollCardiol 2007;49:1043-51

9. Feyter PJ, De Scheerder I, van den Brand M,[et al.] Emergency stenting for refractory acute coronary artery occlusion during coronary angioplasty. Am J Cardiol. 1990;66:1147-1150

10. Fischman DL, Leon MB, Baim DS, [et al.] A randomized comparison of coronary-stent placement and balloon angioplasty in the treatment of coronary artery disease: Stent Restenosis Stu13

11. Kuchulakanti PK, Chu WW, Torguson R, [et al.] Correlates and long-term outcomes of angiographically proven stent thrombosis with sirolimus- and paclitaxel-eluting stents. Circulation 2006; 113:1108-13.dy Investigators. N Engl J Med. 1994;331:496 -501

12. Savage MP, Douglas JSJ, Fischman DL, [et al.] Stent placement compared with balloon angioplasty for obstructed coronary bypass grafts: Saphenous Vein De Novo Trial Investigators. N Engl J Med. 1997;337:740-747

13. Serruys PW, Strauss BH, Beatt KJ, [et al.] Angiographic follow-up after placement of a self-expanding coronary-artery stent. N Engl J Med. 1991; 324:13-17