Staged endovascular treatment with optical coherencetomography and fractional flow reserve controlin an elderly patient with severe coronary arterydisease and high comorbidity

Authors: Abrosimov A.V.12, Petrosyan K.V.1, Bockeria O.L.1, Grigoryev V.S.13

Company: 1Bakoulev National Medical Research Center for Cardiovascular Surgery, Ministry of Health of the Russian Federation, Rublevskoe shosse, 135, Moscow, 121552, Russian Federation;
2 Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, ulitsa Trubetskaya, 8/2, Moscow, 119992, Russian Federation;
3 Russian Medical Academy of Continuing Professional Education, Ministry of Health of the Russian Federation, ulitsa Barrikadnaya, 2/1, Moscow, 125993, Russian Federation Andrey V. Abrosimov, Cand. Med. Sc., Endovascular Surgeon, orcid.org/0000-0001-5907-9508;

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Type:  Case reports


DOI: https://doi.org/10.24022/1997-3187-2019-13-3-263-273

For citation: Abrosimov A.V., Petrosyan K.V., Bockeria O.L., Grigoryev V.S. Staged endovascular treatment with optical coherence tomography and fractional flow reserve control in an elderly patient with severe coronary artery disease and high comorbidity. Creative Cardiology. 2019; 13 (3): 263–73 (in Russ.). DOI: 10.24022/ 1997-3187-2019-13-3- 263-273

Received / Accepted:  26.08.2019/09.09.2019

Keywords: percutaneous coronary intervention optical coherence tomography fractional flow reserve ischemic heart disease left main coronary artery multivessel disease coronary dissection octogenarian

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Abstract

The prevalence of cardiovascular diseases increases with corresponding increase of percutaneous coronary interventions (PCI) volume in patients with coronary artery disease. It is worth noting that the general trend towards a gradual increase in the number of patients with high comorbidity grows, and elective PCI are increasingly being performed in elderly and senile patients with a long history of hypertension, diabetes, heart rhythm disorders, multifocal atherosclerosis with involvement of both visceral and peripheral arteries. Patients older than 80 years, as well as patients with severe left ventricular dysfunction, compose a special cohort with high surgical risk where endovascular treatment is often preferred. Drug-eluting stents implantation, especially the latest generation, significantly improve the long-term results, particularly in unprotected left main coronary artery disease. Intravascular imaging and fractional flow reserve assessment improve the long-term results of PCI as well. This article presents a clinical case of successful staged PCI with second-generation drug-eluting stents implantation with intravascular imaging and fractional flow reserve control in an elderly patient with high comorbidity, multivessel coronary artery disease with left main coronary artery involvement.

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About Authors

  • Andrey V. Abrosimov, Cand. Med. Sc., Endovascular Surgeon, ORCID;
  • Karen V. Petrosyan, Cand. Med. Sc., Head of Department, ORCID;
  • Ol'ga L. Bockeria, Dr. Med. Sc., Professor, Corresponding Member of RAS, Chief Researcher, ORCID;
  • Viktor S. Grigor'ev, Potgraduate, Endovascular Surgeon, ORCID

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery