Puretskiĭ M V, Abugov S A, Saakian Iu M
Russian Surgery Research Center, Russian Academy of Medical Sciences, Moscow.
Vestn Rentgenol Radiol. 2003 Mar-Apr(2):25-31.
Based on the comparison of the immediate and late results of stenting and balloon angioplasty (BA), the authors consider whether it is expedient to perform stenting of coronary arteries (CA) in all cases of BA in patients with coronary heart disease (CHD) and different types of CA stenosis. The study included 410 patients: a group of stenting (n = 197) and a group of traditional BA (n = 213). All the patients in both groups were divided into four subgroups in relation to the type of detected stenosis according to the classification of the American Association of Cardiologists (ACC/AHA). The positive angiographic and clinical results were observed in all 197 patients after stenting. This was associated neither with the type of dilated stenosis nor with the design of an implanted stent. In dilation of types A and B1 stenoses, a stent-like result was significantly more frequently observed than in dilation of types B2 and C stenoses. There was no significant difference in the development of restenosis in patients after routine BA and stenting of types A and B1 stenoses. At the same time, after BA of types B2 and C stenoses, restenosis developed significantly more frequently than in stenting. Thus, on the basis of this study, it may be stated that the traditional BA yields the so-called stent-like result significantly more frequently in patients with uncomplicated forms of CA stenoses than in those with complicated ones. Once the stent-like result is achieved in patients with type A stenoses, stenting should not be performed since the latter fails to improve the immediate and late results of angioplasty. Despite that the stent-like result is achieved in patients with complicated forms of CA stenoses, it is expedient to make stenting. Our findings indicate that the obtained good immediate result reduces the incidence of restenosis.
基于冠状动脉支架置入术与球囊血管成形术（BA）近期和远期结果的比较，作者探讨了在冠心病（CHD）合并不同类型冠状动脉（CA）狭窄的所有BA病例中，对CA进行支架置入术是否合适。该研究纳入了410例患者：支架置入组（n = 197）和传统BA组（n = 213）。根据美国心脏病学会（ACC/AHA）分类，两组所有患者均按检测到的狭窄类型分为四个亚组。197例患者支架置入术后均观察到阳性血管造影和临床结果。这与扩张狭窄的类型和植入支架的设计均无关。在扩张A 型和B1型狭窄时，观察到类似支架的结果明显比扩张B2型和C型狭窄时更频繁。A 型和B1型狭窄患者常规BA和支架置入术后再狭窄的发生率无显著差异。同时，B2型和C型狭窄BA术后再狭窄的发生率明显高于支架置入术。因此，基于本研究，可以说传统BA在CA狭窄的非复杂形式患者中产生所谓类似支架结果的频率明显高于复杂形式患者。一旦A 型狭窄患者获得类似支架的结果，就不应进行支架置入术，因为后者无法改善血管成形术的近期和远期结果。尽管CA狭窄复杂形式的患者获得了类似支架的结果，但进行支架置入术是合适的。我们的研究结果表明，获得的良好近期结果可降低再狭窄的发生率。
