Authors
Shevchenko Yu.L., Chotchaev Sh.A., Ermakov D.Yu.
Pirogov National Medical and Surgical Center, Moscow
Abstract
Currently, the problem of repeat in-stent restenosis (ISR) of coronary arteries (CA) remains the main limiting factor for PCI in the long-term follow-up period.
Objective. To develop a comprehensive clinical and morphofunctional classification and evaluate the frequency, structure, and clinically significant types of repeat in-stent restenoses.
Materials and methods. This retrospective study included 168 patients with recurrent coronary restenosis who underwent endovascular revascularization at the St. George Thoracic and Cardiovascular Surgery Clinic of the N. I. Pirogov National Medical Surgical Center of the Ministry of Health of the Russian Federation.
Results. Based on the obtained data, restenoses were classified as follows: 1. Clinical stratification: asymptomatic (43.5%), stable (47.6%), ACS-associated (8.9%); 2. Chronological: early (25.6%), late (36.3%), distant (38.1%); 3. Anatomical: local (35.5%), diffuse (27.3%), proliferative (27.1%), occlusive (10.1%); 4. Etiologic: malposition (74.4%), no malposition (25.6%); 5. Anamnestic: recurrence after BLP (42.3%), after stent implantation (33.3%), residual restenosis (24.4%).
Conclusion. The developed clinical and morphofunctional classification of repeated in-stent restenoses allows for an objective description of the structure, frequency and characteristics of the clinical course.
Keywords: ischemic heart disease, in-stent restenosis, recurrent myocardial ischemia, percutaneous coronary intervention.
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