Long-term Clinical and Angiographic Results of Recanalization of Small Diameter Coronary Arteries in Patients with Ischemic Heart Disease

Cardiovascular disease is one of the leading causes of death worldwide. The main contribution to its structure belongs to ischemic heart disease (IHD), which has become the greatest threat to the health of the population all over the world. The purpose of the study is to study of the results of endovascular procedures in the revascularization of coronary arteries of small diameter. Materials and methods. The study included 315 patients aged 66.96 ± 1.81 years, with a mean diameter of the true internal lumen of the arteries of 2.53±0.011 mm, which had a revascularization of the myocardium through stenting or percutaneous transluminal balloon angioplasty. In patients undergoing stenting of Ca (N=187), the mean diameter of the true internal lumen of arteries was 2.53±0.011 mm. In the group of patients who used percutaneous transluminal balloon angioplasty (PTCA) (N=128), this indicator was determined at 2.61±0.09 mm. The average degree of stenosis was 81.3±4.07%. The length of the defeat was 11.6±0.73 mm. All patients and groups had the history of Q-infarction of the myocardium (IM) of more than 3 months, which made it possible to diagnose postinfarction cardiosclerosis. Duration of ischemic history more than 5 years was noted in 26 patients of this group (8.25% of cases), up to one year – in 221 patients (70.2% of cases), from one to two years – in 39 patients (12.4% cases) and from 3 to 4 years – in 29 people (9.2% of cases). Results and discussion. As a result of the studies, it was found that in patients with eccentric type of stenosis who used balloon angioplasty, restenosis in the remote postoperative period was 21% more frequent, compared to a similar contingent of patients with implanted stents. In addition, the restenosis of the stenosed area of the coronary artery >15 mm, in the distant period, was found to be 14.9% more commonly when percutaneous transluminal balloon angioplasty was performed. And the frequency of remote restenosis (with complex morphology of initial damage of the arteries) in the stenting group was 14.2% lower than in the group of percutaneous transluminal balloon angioplasty. Conclusions. Restenosis in the remote postoperative period was 21% more frequent in patients with eccentric stenosis for whom balloon angioplasty was used than in patients with implanted stents. At the same time restenosis of the stenosed area of CA >15 mm in the distant period was found to be 14.9% more frequent during PTCA. The frequency of remote restenosis (with complicated morphology of basal damage of arteries) in the stenting group was 14.2% lower than in the PTCA group. Thus, we plan to further study and analyze the direct and long-term results of X-ray and endovascular operations in patients with coronary artery disease and small coronary artery diameter.