ANALYSIS OF SURVIVAL AND CHANGES IN CLINICAL STATUS OF PATIENTS WITH CORONARY ARTERY DISEASE AFTER ENDOVASCULAR RECANALIZATION OF CHRONIC OCCLUSION OF THE RIGHT CORONARY ARTERY

Cover Page


Cite item

Full Text

Abstract

Background: Procedures performed in chronic coronary artery occlusion comprise from 10 to 20% of all transcutaneous coronary interventions, and their efficacy can amount to 90%. Despite this, their appropriateness for this type of disease is still a matter of debate.

Aim: To assess efficacy and safety of interventions compared to medical treatment in patients with isolated chronic occlusion of the right coronary artery.

Materials and methods: We analyzed results of treatment of 72 patients. From these, endovascular recanalization of chronic occlusion of the right coronary artery was performed in 39 patients (group 1), the rest 33 patients received medical treatment only (group 2). Clinical state parameters and adverse event rate were assessed during a follow-up of 12 months.

Results: After 1 year, a notable reduction of functional grade (FG) of exertional angina was seen in the group 1. The number of patients with FG I increased from 3 (7.7%) to 20 (51.3%), р < 0.05; and the number of those with FG III decreased from 22 (56.4%) to 6 (15.4%), р < 0.05. No significant changes of FG of angina were seen in the group 2 (control group) after 2 and 12 months (р > 0.05 at both time points). At 1 year, 94.9% (95% CI: 88,2–99,9%) of patients from the group 1 and 100% of patient in the group 2 were free of adverse clinical events.

Conclusion: Transcutaneous coronary angioplasty for chronic occlusion of the right coronary artery significantly improves clinical course of ischemic heart disease at 2 and 12 months, compared to medical treatment, by decreasing FG of exertional angina. From clinical point of view, adverse events reported in the group of endovascular recanalization for chronic occlusion of the right coronary artery are insignificant.

About the authors

A. A. Obedinskiy

Novosibirsk Scientific Research Institute of Blood Circulation Pathology named after E.N. Meshalkin

Email: fake@neicon.ru

Doctor, Cardiologist of the Center for Interventional Cardiology

Russian Federation

A. G. Osiev

Moscow Regional Research and Clinical Institute (MONIKI)

Author for correspondence.
Email: osiev_ag@mail.ru

MD, PhD, Professor, Head of Department of Cardiovascular Surgery

Russian Federation

E. I. Kretov

Novosibirsk Scientific Research Institute of Blood Circulation Pathology named after E.N. Meshalkin

Email: fake@neicon.ru

PhD, Leading Research Fellow, Doctor, Specialist in Radioendovascular Diagnostics and Treatment of the Center for Interventional Cardiology

Russian Federation

V. P. Kurbatov

Novosibirsk Scientific Research Institute of Blood Circulation Pathology named after E.N. Meshalkin

Email: v_kurbatov@nricp.ru

PhD, Head of Department of X-ray and Computer Tomography

Russian Federation

N. R. Obedinskaya

Novosibirsk Scientific Research Institute of Blood Circulation Pathology named after E.N. Meshalkin

Email: fake@neicon.ru

Doctor, Department of X-ray and Computer Tomography

Russian Federation

D. N. Ponomarev

Novosibirsk Scientific Research Institute of Blood Circulation Pathology named after E.N. Meshalkin

Email: fake@neicon.ru

Doctor, Department of Adult Anesthesiology and Resuscitation

Russian Federation

M. N. Kapustinskiy

Novosibirsk Scientific Research Institute of Blood Circulation Pathology named after E.N. Meshalkin

Email: fake@neicon.ru

Resident, Center for Interventional Cardiology

Russian Federation

References

  1. Бабунашвили АМ, Иванов ВА, Бирюкова СА. Эндопротезирование (стентирование) венечных артерий сердца. М.: АСВ; 2001. 704 с. Babunashvili AM, Ivanov VA, Biryukova SA. Endoprotezirovanie (stentirovanie) venechnykh arteriy serdtsa [Endoprosthetics (stent placement) of coronary arteries of the heart]. Moscow: ASV; 2001. 704 p. (in Russian).
  2. Suero JA, Marso SP, Jones PG, Laster SB, Huber KC, Giorgi LV, Johnson WL, Rutherford BD. Procedural outcomes and long-term survival among patients undergoing percutaneous coronary intervention of a chronic total occlusion in native coronary arteries: a 20-year experience. J Am Coll Cardiol. 2001;38(2):409–14.
  3. DeWood MA, Spores J, Notske R, Mouser LT, Burroughs R, Golden MS, Lang HT. Prevalence of total coronary occlusion during the early hours of transmural myocardial infarction. N Engl J Med. 1980;303(16):897–902.
  4. Olivari Z, Rubartelli P, Piscione F, Ettori F, Fontanelli A, Salemme L, Giachero C, Di Mario C, Gabrielli G, Spedicato L, Bedogni F; TOASTGISE Investigators. Immediate results and one-year clinical outcome after percutaneous coronary interventions in chronic total occlusions: data from a multicenter, prospective, observational study (TOAST-GISE). J Am Coll Cardiol. 2003;41(10):1672–8.
  5. Choi JH, Chang SA, Choi JO, Song YB, Hahn JY, Choi SH, Lee SC, Lee SH, Oh JK, Choe Y, Gwon HC. Frequency of yocardial infarction and its relationship to angiographic collateral flow in territories supplied by chronically occluded coronary arteries. Circulation. 2013;127(6):703–9.
  6. Task Force Members, Montalescot G, Sechtem U, Achenbach S, Andreotti F, Arden C, Budaj A, Bugiardini R, Crea F, Cuisset T, Di Mario C, Ferreira JR, Gersh BJ, Gitt AK, Hulot JS, Marx N, Opie LH, Pfisterer M, Prescott E, Ruschitzka F, Sabate M, Senior R, Taggart DP, van der Wall EE, Vrints CJ; ESC Committee for Practice Guidelines, Zamorano JL, Achenbach S, Baumgartner H, Bax JJ, Bueno H, Dean V, Deaton C, Erol C, Fagard R, Ferrari R, Hasdai D, Hoes AW, Kirchhof P, Knuuti J, Kolh P, Lancellotti P, Linhart A, Nihoyannopoulos P, Piepoli MF, Ponikowski P, Sirnes PA, Tamargo JL, Tendera M, Torbicki A, Wijns W, Windecker S; Document Reviewers, Knuuti J, Valgimigli M, Bueno H, Claeys MJ, Donner-Banzhoff N, Erol C, Frank H, Funck-Brentano C, Gaemperli O, Gonzalez-Juanatey JR, Hamilos M, Hasdai D, Husted S, James SK, Kervinen K, Kolh P, Kristensen SD, Lancellotti P, Maggioni AP, Piepoli MF, Pries AR, Romeo F, Ryden L, Simoons ML, Sirnes PA, Steg PG, Timmis A, Wijns W, Windecker S, Yildirir A, Zamorano JL. 2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on the management of stable coronary artery disease of the European Society of Cardiology. Eur Heart J. 2013;34(38):2949–3003.
  7. Cerqueira MD, Weissman NJ, Dilsizian V, Jacobs AK, Kaul S, Laskey WK, Pennell DJ, Rumberger JA, Ryan T, Verani MS; American Heart Association Writing Group on Myocardial Segmentation and Registration for Cardiac Imaging. Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart. A statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association. Circulation. 2002;105(4):539–42.
  8. Judkins MP. Percutaneous transfemoral selective coronary arteriography. Radiol Clin North Am. 1968;6(3):467–92.
  9. Moher D, Schulz KF, Altman DG; CONSORT. The CONSORT statement: revised recommendations for improving the quality of reports of parallel group randomized trials. BMC Med Res Methodol. 2001;1:2.

Supplementary files

Supplementary Files
Action
1. JATS XML

Copyright (c) 2015 Obedinskiy A.A., Osiev A.G., Kretov E.I., Kurbatov V.P., Obedinskaya N.R., Ponomarev D.N., Kapustinskiy M.N.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies