Прогрессия атеросклероза как причина рецидива стенокардии у пациента с ишемической болезнью сердца в первый год после ангиопластики и стентирования коронарных артерий

Молохоев Е.Б., Руденко Б.А., Шаноян А.С., Драпкина О.М. Прогрессия атеросклероза как причина рецидива стенокардии у пациента с ишемической болезнью сердца в первый год после ангиопластики и стентирования коронарных артерий. CardioСоматика. 2018; 9 (3): 30–33. DOI: 10.26442/2221-7185_2018.3.30-33

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Molokhoev E.B., Rudenko B.A., Shanoyan A.S., Drapkina O.M. Progression of atherosclerosis as the cause of recurrence of angina in a patient with ischemic heart disease in the first year after angioplasty and stenting of the coronary arteries. Cardiosomatics. 2018; 9 (3): 30–33. DOI: 10.26442/2221-7185_2018.3.30-33

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Аннотация

Оценка доли ятрогенного поражения интимы коронарной артерии в структуре рецидива коронарного синдрома после ангиопластики и стентирования является недостаточно изученным вопросом. Учитывая непрерывно возрастающее количество процедур чрескожного коронарного вмешательства, увеличение степени технической сложности (особенно при многососудистом поражении коронарных артерий с вовлечением в атеросклеротический процесс проксимальных сегментов), изучение этой темы представляется актуальным и практически значимым. В клинической практике агрессивные приемы проведения эндоваскулярной процедуры (глубокая интубация проводникового катетера, использование удлинителя проводникового катетера и др.) все чаще приводят к прогрессии атеросклероза в проксимальных сегментах коронарных артерий, особенно при наличии их начального поражения.

Ключевые слова: ятрогенное поражение интимы коронарной артерии, ангиопластика и стентирование коронарных артерий, рецидив стенокардии, прогрессия атеросклероза.

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Estimation of the proportion of iatrogenic intima lesion of the coronary artery in the structure of recurrence of coronary syndrome after angioplasty and stenting is an insufficiently studied issue. Considering the continuously increasing number of PCI procedures, an increase in the degree of technical complexity (especially in multivessel coronary artery disease involving proximal segments in the atherosclerotic process), the study of this topic seems topical and practically meaningful. In clinical practice, aggressive methods of carrying out the endovascular procedure (deep intubation of the conductor catheter, the use of an extension of the conductor catheter, etc.) increasingly lead to the progression of atherosclerosis in the proximal segments of the coronary arteries, especially in the presence of their initial lesion.

Key words: iatrogenic intima lesion of the coronary artery, angioplasty and stenting of the coronary arteries, recurrence of angina, progression of atherosclerosis.

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Список литературы

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8. Clowes AW, Schwartz SM. Significance of quiescent smooth muscle migration in the injured rat carotid artery. Circ Res 1985; 56: 139–45. DOI: https://doi.org/10.1161/01.RES.56.1.139
9. Wilson VE, Bates ER. Subacute bilateral coronary ostial stenosis following cardiac catheterization and PTCA. Cathet Cardiovasc Diagn 1991; 23: 114–6. DOI: https://doi.org/10.1002/ ccd.1810230210
10. Waller B, Pinkerton C, Foster L. Morphologic evidence of accelerated left main coronary artery stenosis: A late complication of percutaneous transluminal balloon angioplasty of the proximal left anterior descending coronary artery. J Am Coll Cardiol 1987; 9: 1019–23. DOI: https://doi.org/10.1016/S0735-1097(87) 80302-9
11. Lai H, Lee W, Wang K et al. Late proximal coronary artery stenosis complicating percutaneous endovascular catheterization procedures. Neth Heart J 2011; 19: 379–85. DOI: 10.1007/s12471-011-0140-2
12. Ip JH, Fuster V, Badimon L et al. Syndromes of accelerated atherosclerosis: role of vascular injury and smoothmuscle cell proliferation. J Am College Cardiol 1990; 15 (7): 1667–87. DOI: https://doi.org/10.1016/0735-1097(90)92845-S
13. Willerson JT, Yao SK, McNatt J et al. Frequency and severity of cyclic flow alternations and platelet aggregation predict the severity of neointimal proliferation following experimental coronary stenosis and endothelial injury. Proc Natl Acad Sci USA 1991; 88 (23): 10624–8.
14. Wayne VS, Harper RW, Pitt A. Left main coronary artery stenosis after percutaneous transluminal coronary angioplasty. Am J Cardiol 1988; 61: 459–60. DOI: https://doi.org/10.1016/ 0002-9149(88)90305-0
15. Alsaddah J, Alkandari S, Younan H. Iatrogenic left main coronary artery stenosis following aortic and mitral valve replacement. Heart Views 2015; 16 (1): 37–39. DOI: 10.4103/1995-705X.153001
16. Harjula A, Mattila S, Mattila I et al. Coronary endothelial damage after crystalloid cardioplegia. J Cardiovasc Surg 1984; 147–52.

________________________________________________

1. Kaehler J, Koester R, Billmann W. 13-year follow-up of the German angioplasty bypass surgery investigation. Eur Heart J 2005; 26: 2148–53. DOI: 10.1093/eurheartj/ehi385
2. Chakravarty T, Buch MH, Naik H et al. Predictive accuracy of SYNTAX score for predicting long-term outcomes of unprotected left main coronary artery revascularization. Am J Cardiol 2011; 107: 360–6. DOI: 10.1016/j.amjcard.2010.09.029
3. Akchurin R.S., Shiryaev A.A., Rudenko B.A. I dr. Koronarnoe shuntirovanie pri recidive stenokardii posle angioplastiki so stentirovaniem koronarnyh arterij. Kardiologicheskij vestn. 2013; 8, 2 (20): 12–7. [in Russian]
4. And G, Frigione PP, Saporito F. Iatrogenic coronary artery stenosis: A multiform disease. Department of Clinical and Experimental Medicine, University of Messina, Italy article info Article history, 2016. DOI: 10.1016/j.ijcard.2016.06.314
5. Faggian G, Rigatelli G, Santini F et al. Clinical Research Left main coronary stenosis as a late complication of percutaneous angioplasty:an old problem, but still a problem. J Geriat Cardiol 2009; 6 (1).
6. Clowes AW, Reidy MA, Clowes MM. Mechanisms of stenosis after arterial injury. Lab Invest 1983; 49: 208–15.
7. Manderson JA, Mosse PR, Safatrom JA, Young SB et al. Balloon catheter injury to rabbit carotid artery. Changes in smooth muscle phenotype. Arteriosclerosis 1989; 9: 289–98. DOI: 10.1161/ 01.ATV.9.3.289
8. Clowes AW, Schwartz SM. Significance of quiescent smooth muscle migration in the injured rat carotid artery. Circ Res 1985; 56: 139–45. DOI: https://doi.org/10.1161/01.RES.56.1.139
9. Wilson VE, Bates ER. Subacute bilateral coronary ostial stenosis following cardiac catheterization and PTCA. Cathet Cardiovasc Diagn 1991; 23: 114–6. DOI: https://doi.org/10.1002/ ccd.1810230210
10. Waller B, Pinkerton C, Foster L. Morphologic evidence of accelerated left main coronary artery stenosis: A late complication of percutaneous transluminal balloon angioplasty of the proximal left anterior descending coronary artery. J Am Coll Cardiol 1987; 9: 1019–23. DOI: https://doi.org/10.1016/S0735-1097(87) 80302-9
11. Lai H, Lee W, Wang K et al. Late proximal coronary artery stenosis complicating percutaneous endovascular catheterization procedures. Neth Heart J 2011; 19: 379–85. DOI: 10.1007/s12471-011-0140-2
12. Ip JH, Fuster V, Badimon L et al. Syndromes of accelerated atherosclerosis: role of vascular injury and smoothmuscle cell proliferation. J Am College Cardiol 1990; 15 (7): 1667–87. DOI: https://doi.org/10.1016/0735-1097(90)92845-S
13. Willerson JT, Yao SK, McNatt J et al. Frequency and severity of cyclic flow alternations and platelet aggregation predict the severity of neointimal proliferation following experimental coronary stenosis and endothelial injury. Proc Natl Acad Sci USA 1991; 88 (23): 10624–8.
14. Wayne VS, Harper RW, Pitt A. Left main coronary artery stenosis after percutaneous transluminal coronary angioplasty. Am J Cardiol 1988; 61: 459–60. DOI: https://doi.org/10.1016/ 0002-9149(88)90305-0
15. Alsaddah J, Alkandari S, Younan H. Iatrogenic left main coronary artery stenosis following aortic and mitral valve replacement. Heart Views 2015; 16 (1): 37–39. DOI: 10.4103/1995-705X.153001
16. Harjula A, Mattila S, Mattila I et al. Coronary endothelial damage after crystalloid cardioplegia. J Cardiovasc Surg 1984; 147–52.

Авторы

Е.Б.Молохоев*, Б.А.Руденко, А.С.Шаноян, О.М.Драпкина

ФГБУ «Национальный медицинский исследовательский центр профилактической медицины» Минздрава России. 101990, Россия, Москва, Петроверигский пер., д. 10, стр. 3
*dr.molokhoev@mail.ru

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E.B.Molokhoev*, B.A.Rudenko, A.S.Shanoyan, O.M.Drapkina

National Medical Research Center for Preventive Medicine of the Ministry of Health of the Russian Federation. 101990, Russian Federation, Moscow, Petroverigskii per., d. 10, str. 3
*dr.molokhoev@mail.ru

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