rpcardioRational Pharmacotherapy in CardiologyРациональная Фармакотерапия в Кардиологии1819-64462225-3653«SILICEA-POLIGRAF» LLC10.20996/1819-6446-2015-11-6-626-633rpcardio-443Research ArticleINNOVATIVE CARDIOLOGYИННОВАЦИОННАЯ КАРДИОЛОГИЯNeoatherosclerosis in the stentНЕОАТЕРОСКЛЕРОЗ В СТЕНТЕКомковА. А.KomkovA. A.

м.н.с. лаборатории рентгенэндоваскулярных методов диагностики и лечения ГНИЦ ПМ

artemkomkov@gmail.comМазаевВ. П.MazaevV. P.

д.м.н., профессор, руководитель той же лаборатории

РязановаС. В.RyazanovaS. V.

к.м.н., с.н.с. той же лаборатории

Государственный научно-исследовательский центр профилактической медицины 101990, Москва, Петроверигский пер., 10РоссияState Research Centre for Preventive Medicine. Petroverigsky per. 10, Moscow, 101990 RussiaRussian Federation201530122015116626633Copyright © Komkov A.A., Mazaev V.P., Ryazanova S.V., 20152015Комков А.А., Мазаев В.П., Рязанова С.В.Komkov A.A., Mazaev V.P., Ryazanova S.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpcardio.online/jour/article/view/443

Achievements of interventional cardiology in the treatment of coronary artery disease are based on coronary balloon angioplasty with implanting bare metal stents and drug eluting stents. Questions of complications such as early stent thrombosis and restenosis of stent were solved in a considerable degree. However, with the lengthening of the followup period, the problem of late complications became obvious. Except endothelization and fibromuscular proliferation in stented coronary arteries the process of plaque formation has an important influence on later complications in follow-up period more than one year. This process was defined as neoatherosclerosis. This is verified by clinical manifestations of the disease, histological studies, angioscopy, intravascular ultrasound and optical-coherence tomography in stented patients. Dynamic observation of the condition in stentedcoronary arteries showed multistep proliferation with restenosis, its regression, and neoatherosclerosis development. Evidences of neoatherosclerosis formation in stented coronary arteries are considered in this review.

Достижения интервенционной кардиологии в лечении коронарной болезни сердца основаны на использовании баллонной ангиопластики коронарных артерий с применением голометаллических стентов и стентов с лекарственным покрытием. В значительной степени решены вопросы осложнений, таких как ранний тромбоз и рестеноз стента. Однако, по мере удлинения сроков наблюдения, стала очевидной проблема поздних осложнений. Было установлено, что кроме процессов реэндотелизации и фибромышечной пролиферации, развивающихся в коронарных артериях после стентирования при сроках наблюдения продолжительностью более одного года, важную роль в развитии поздних осложнений играет процесс формирования атеросклеротической бляшки, обозначенный как неоатеросклероз. Это подтверждается клиническими проявлениями болезни у пациентов, подвергшихся коронарному стентированию, результатами гистологических исследований, ангиоскопической картиной, данными внутрисосудистого ультразвука и оптической когерентной томографии. Динамическое наблюдение за состоянием в стентированных артериях показали многоэтапность пролиферативных процессов с формированием рестеноза, его регрессией и развитием неоатеросклероза. В данном обзоре рассматриваются доказательства развития неоатеросклероза в стентированных коронарных артериях.

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The authors declare that there are no conflicts of interest present.