Vol. 19 No. 4 (2015)
CORONARY ARTERY DISEASES

Effect of percutaneous transluminal coronary angioplasty in patients with chronic occlusion of right coronary artery on clinical characteristics and stress MRI indicators in postoperative period

PDF (Русский)
  • A. Obedinskii,
  • V. Kurbatov,
  • N. Obedinskaya,
  • V. Verin,
  • E. Kretov,
  • D. Ponomarev,
  • E. Pokushalov
A. Obedinskii
Academician Ye. Meshalkin Novosibirsk Research Institute of Circulation Pathology, Ministry of Health Care of Russian Federation, 15 Rechkunovskaya St., 630055 Novosibirsk, Russian Federation
V. Kurbatov
Academician Ye. Meshalkin Novosibirsk Research Institute of Circulation Pathology, Ministry of Health Care of Russian Federation, 15 Rechkunovskaya St., 630055 Novosibirsk, Russian Federation
N. Obedinskaya
Academician Ye. Meshalkin Novosibirsk Research Institute of Circulation Pathology, Ministry of Health Care of Russian Federation, 15 Rechkunovskaya St., 630055 Novosibirsk, Russian Federation
V. Verin
Primorskiy Krai Clinical Hospital No. 1, 57 Aleutskaiya St., 690091 Vladivostok, Russian Federation
E. Kretov
Academician Ye. Meshalkin Novosibirsk Research Institute of Circulation Pathology, Ministry of Health Care of Russian Federation, 15 Rechkunovskaya St., 630055 Novosibirsk, Russian Federation
D. Ponomarev
Academician Ye. Meshalkin Novosibirsk Research Institute of Circulation Pathology, Ministry of Health Care of Russian Federation, 15 Rechkunovskaya St., 630055 Novosibirsk, Russian Federation
E. Pokushalov
Academician Ye. Meshalkin Novosibirsk Research Institute of Circulation Pathology, Ministry of Health Care of Russian Federation, 15 Rechkunovskaya St., 630055 Novosibirsk, Russian Federation
DOI: https://doi.org/10.21688/1681-3472-2015-4-48-53

Published 2016-01-11

Keywords

  • chronic occlusion,
  • recanalization,
  • medical therapy,
  • clinical outcome,
  • stress MRI

How to Cite

Obedinskii, A., Kurbatov, V., Obedinskaya, N., Verin, V., Kretov, E., Ponomarev, D., & Pokushalov, E. (2016). Effect of percutaneous transluminal coronary angioplasty in patients with chronic occlusion of right coronary artery on clinical characteristics and stress MRI indicators in postoperative period. Patologiya Krovoobrashcheniya I Kardiokhirurgiya, 19(4), 48–53. https://doi.org/10.21688/1681-3472-2015-4-48-53

Copyright (c) 2016 Obedinskii A.A., Kurbatov V.P., Obedinskaya N.R., Verin V.V., Kretov E.I., Ponomarev D.N., Pokushalov E.A.

Creative Commons License

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

Abstract

Objective. In the last few years CTO angioplasty technique has shown high rates of procedural success and low rates of complications, but benefits from CTO recanalization are still not clear. In this report, the authors try to evaluate the effectiveness of CTO recanalization and discuss the diagnostic tool that might improve the appropriateness of CTO percutaneous coronary intervention.
Methods. We examined and treated 72 patients, with 39 patients undergoing CTO-PCI of the right coronary artery (Group 1) and 33 receiving medical therapy only (Group 2). The perfusion areas of the CTO vessel and the clinical status of patients were evaluated. The follow-up period was 2 and 12 months.
Results. According to stress MRI data, throughout the study, patients who underwent RCA stenting had a significantly higher risk of reducing the functional class of heart failure, the best performance at 6-min treadmill test and a low class of angina (below III), as well as a decreased number of perfusion defect points (less than 5) as compared with those of the control group (p<0.001). In addition, the quality of life of patients in the intervention group consistently exceeded that in the control group.
Conclusion. CTO recanalization as compared to medical therapy only noticeably improves clinical outcomes of isolated CTO. Our findings correlate with stress MRI results.

PDF (Русский)

References

  1. Осиев А.Г., Мироненко С.П., Елкина Д.С. Сравнительная характеристика покрытых стентов, использованных при эндоваскулярном лечении больных ишемической болезнью сердца // Патология кровообращения и кардиохирургия. 2013. № 1. С. 91–96.
  2. Бабунашвили А.М., Иванов В.А., Бирюков С.А. Эндопротезирование (стентирование) венечных артерий сердца. М., 2001. 704 с.
  3. Suero J.A., Marso S.P., Jones P.G., Laster S.B., Huber K.C., Giorgi L.V., Johnson W.L., Rutherford B.D. 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. Vol. 38. № 2. P. 409–14.
  4. DeWood M.A., Spores J., Notske R., Mouser L.T., Burroughs R., Golden M.S., Lang H.T. Prevalence of total coronary occlusion during the early hours of transmural myocardial infarction // N. Engl. J. Med. 1980. Vol. 303. № 16. P. 897–902.
  5. Olivari Z., Rubartelli P., Piscione F., Ettori F., Fontanelli A., Salemme L., Giachero C., Di Mario C., Gabrielli G., Spedicato L., Bedogni F. 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. Vol. 41. № 10. P. 1672–8.
  6. Choi J.H., Chang S.A., Choi J.O., Song Y.B., Hahn J.Y., Choi S.H., Lee S.C., Lee S.H., Oh J.K., Choe Y., Gwon H.C. Frequency of myocardial infarction and its relationship to angiographic collateral flow in territories supplied by chronically occluded coronary arteries // Circulation. 2013. Vol. 127. № 6. P. 703–9.
  7. 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 J.R., Gersh B.J., Gitt A.K., Hulot J.S., Marx N., Opie L.H., Pfisterer M., Prescott E., Ruschitzka F., Sabaté M., Senior R., Taggart D.P., van der Wall E.E., Vrints C.J.; ESC Committee for Practice Guidelines, Zamorano J.L., Achenbach S., Baumgartner H., Bax J.J., Bueno H., Dean V., Deaton C., Erol C., Fagard R., Ferrari R., Hasdai D., Hoes A.W., Kirchhof P., Knuuti J., Kolh P., Lancellotti P., Linhart A., Nihoyannopoulos P., Piepoli M.F., Ponikowski P., Sirnes P.A., Tamargo J.L., Tendera M., Torbicki A., Wijns W., Windecker S.; Document Reviewers, Knuuti J., Valgimigli M., Bueno H., Claeys M.J., Donner-Banzhoff N., Erol C., Frank H., Funck-Brentano C., Gaemperli O., Gonzalez-Juanatey J.R., Hamilos M., Hasdai D., Husted S., James S.K., Kervinen K., Kolh P., Kristensen S.D., Lancellotti P., Maggioni A.P., Piepoli M.F., Pries A.R., Romeo F., Rydén L., Simoons M.L., Sirnes P.A., Steg P.G., Timmis A., Wijns W., Windecker S., Yildirir A., Zamorano J.L. 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. Vol. 34. № 38. P. 2949–3003.
  8. Goodlin S.J. End-of-life care in heart failure // Curr. Cardiol. Rep. 2009. Vol. 11. № 3. P. 184–275.
  9. Ware J.E. SF-36 health survey update // Spine. 2000. Vol. 25. P. 3130–9.
  10. Курбатов В.П., Гензель Н.Р., Обединский А.А., Мироненко С.П., Осиев А.Г. Оценка нарушений перфузии миокарда методом магнитно-резонансной томографии с аденозиновым стресс-тестом в бассейне кровоснабжения правой коронарной артерии при обосновании показаний к эндоваскулярной реканализации // Радиология практика. 2012. № 4. С. 27–34.
  11. Cerqueira M.D., Weissman N.J., Dilsizian V., Jacobs A.K., Kaul S., Laskey W.K., Pennell D.J., Rumberger J.A., Ryan T., Verani M.S. 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. Vol. 105. № 4. P. 539–42.
  12. Davies R.F., Goldberg A.D., Forman S., Pepine C.J., Knatterud G.L., Geller N., Sopko G., Pratt C., Deanfield J., Conti C.R. Asymptomatic Cardiac Ischemia Pilot (ACIP) Study Two-Year Follow-up // Circulation. 1997. № 95. P. 2037–2043.