Late complications of percutaneous coronary interventions

D.V. Shumakov, G.G. Shekhyan, D.I. Zybin, A.A. Yalymov, E.V. Stepina, M.A. Popov

Moscow Regional Clinical Research Institute named after M.F. Vladimirsky, Moscow

According to the World Health Organization, cardiovascular diseases occupy first place in the world as the causes of fatal outcomes. At present, percutaneous coronary intervention (PCI) is the standard treatment regimen of patients with atherosclerotic lesions of the coronary arteries. The introduction of second-drug-eluting stents (SDES) into clinical practice has increased the efficacy and safety of PCI by reducing the severity of inflammatory changes, as well as increasing the rate of regeneration and endothelization of the artery at the stent implantation site. However, the technique and technology of intervention itself prevent the complete regeneration of vascular structure and function and are associated with the risk of late stent dysfunction. Patients who have undergone PCI with SDES implantation remain at risk of late stenting complications (stent thrombosis, restenosis, neoa therosclerosis and bleeding), which are described in this review. Neoatherosclerosis plays an important role in the pathogenesis of acute coronary syndrome after stenting, as well as the recurrence of clinical symptoms after PCI. Advanced cardiac imaging and long-term dual antiplatelet therapy may be of fundamental importance for further understanding and treatment of this pathological process.

Keywords: coronary heart disease, percutaneous coronary intervention, drug-eluting stents, restenosis, stent thrombosis, bleeding.

For citation: Shumakov D.V., Shekhyan G.G., Zybin D.I. et al. Late complications of percutaneous coronary interventions. RMJ. 2020;10:25–28.