[Clinical and economical effectiveness of outpatient diagnostic coronary angiography].

Introduction into clinical practice of transradial coronary angiography (CA) made it possible to conduct the procedure in outpatients and thus increase number of CA and diminish its cost. Aim of the study was to assess possibility, safety and economical efficacy of outpatient CA. Between April 2004 and August 2007 CA was carried out in 133 outpatients without overt heart failure, unstable angina, complex disturbances of cardiac rhythm or conduction. Comparison group comprised 187 patients subjected to CA within framework of short term hospitalization program. There were no complications associated with the use of either transradial or transfemoral approach. Total average cost of outpatient CA was 19% less than that of inhospital CA. Thus outpatient CA with transradial approach appears to be safe and effective procedure with low risk of complications in patients with stable ischemic heart disease.

[Long-term assessment of clinical parameters in patients with coronary heart disease after balloon angioplasty and stenting balloon angioplasty]. / Otsenka klinicheskikh pokazatelei bol'nykh IBS v otdalennom periode posle ballonnoi angioplastiki i ballonnoi angioplastiki so stentirovaniem.

The aim of this study was to assess clinical parameters in patients with coronary heart disease (CHD) in the late period after balloon coronary angioplasty (BCA) and intracoronary stenting (ICS). The study included 104 patients who underwent repeated coronary angiography (CA) 2-10 months after successful coronary angioplasty. Clinical parameters were analyzed in 2 groups comparable at the moment of its performance in terms of major clinical characteristics. Group 1 comprised 51 patients following BCA and group 2 included 53 patients after ICS. Six months after the first procedure, repeated coronary angioplasty was performed in 19 (37.2%) and 6 (9.4%) patients after BCA and ICS, respectively (p < 0.05). Recurrent angina pectoris was observed in 42 patients from group 1 and in 25 ones from group 2, which was 82.3 and 47.2%, respectively (p < 0.05). Control CA revealed restenosis of the dilated artery in 22 (43.1%) of the 51 patients of group 1 and in 12 (22.6%) of the 53 patients of group 2. There were no differences between the groups in late postoperative bicycle ergometric and 24-hour ECG monitoring findings. The findings have led to the conclusion that implantation of a stent into the coronary artery greatly prolongs the antiischemic effect of coronary angioplasty and reduces a need for repeated endovascular intervention, which appears as lower incidence rates of restenosis and recurrent angina as compared to routine balloon angioplasty.

[Quantitative and qualitative assessment of X-ray morphology of coronary restenosis after balloon angioplasty and stenting]. / Kolichestvennaia i kachestvennaia otsenka rentgenomorfologii restenoza koronarnoi arterii posle ballonnoi angioplastiki i stentirovaniia.

The study was undertaken to compare the data of quantitative angiographic analysis of early and late outcomes of intracoronary stenting (ICS) and balloon coronary angioplasty (BCA) with the X-Ray morphology of restenosis. The prospective study enrolled 67 patients undergone repeated coronary angiography 2-10 months after successful BCA. Group I included 34 patients with coronary restenosis. Group II comprised 33 patients without restenosis signs. Each group was divided into 2 subgroups: A--patients undergone BCA; B--patients undergone ICS. Subgroups IA and IB included 22 and 12 patients, respectively, and subgroups IIA and IIB consisted of 24 and 19. The X-ray morphology of the underlying versus restenosis lesions in the subgroups was quantitatively and qualitatively assessed. The findings have led to the following conclusions that ICS yields more optimal early and late angiographic results than does BCA; according to the site of restenosis against the underlying lesion, the following types of restenosis following BCA and ICS are identified: diffuse, localized, marginal, and mixed; restenosis after ICS is characterized by for concentric morphology while that following BCA preserves the morphology of a primary lesion.