The efficacy of diffuse atherosclerotic disease stenting of coronary bed using sirolimus eluting stents

The aim of the research is to study a long-term efficacy of sirolimus eluting stents (SES) using in long stenosis stenting in patients with diffuse atherosclerotic disease of coronary arteries (CA). 180 patients with ischemic heart disease together with cardiac angina, resistant to antianginal therapy were divided into two groups and examined. The first group was composed of patients (n=101) with diffuse CA disease with the length of stent area more than 20 mm; second group (n=79) - patients with local damage and stent area length less than 20 mm. Efficacy was estimated within 12 months of clinical and angiographic monitoring. The average length of stent area was 28,5+0,9 mm in the first group and 13,4+0,5 mm in the control group (pst group patients and 2,5% of 2nd group patients; p=0,12. The leading course of ischemic heart disease return was progression of atherosclerosis on non-stent areas of CA (23,8% - 1st group against 2,5% in the 2nd group; p=0,012). The only fatal myocardial infarction (MI) was registered in the 1st group on the 3rd month of attendance. When defining relative risk of restenosis development in patients of the 1st group it was stated, that it increases 2-3 times in presence of diabetes mellitus, ostial damage and stenting of small-diameter arteries. The increase in restenosis development risk during stent implanting into the extended CA damages depends on concurrent factors: small diameter of stenting artery, ostrial stenosis or diabetes mellitus. The leading cause of ischemia return in patients with diffuse CA damage was the atherosclerosis progression on the non-stent CA areas.