cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLC10.15829/1728-8800-2021-2629cardiovascular-2629Research ArticleОБЗОРЫ ЛИТЕРАТУРЫREVIEW ARTICLESЭффективность отсроченного стентирования коронарных артерий в профилактике феномена no-reflow у пациентов с острым инфарктом миокарда с подъемом сегмента STEffectiveness of deferred coronary artery stenting in the prevention of no-reflow in patients with acute ST-segment elevation myocardial infarctionhttps://orcid.org/0000-0001-7061-337XАзаровА. В.AzarovA. V.

Андрей Сергеевич Журавлев — студент 5 курса Международной школы Медицина Будущего, SPIN-код: 1149-6426, AuthorID: 949656

Москва

Moscow

Azarov_al@mail.ruhttps://orcid.org/0000-0002-9130-707XЖуравлевА. С.ZhuravlevA. S.

Андрей Сергеевич Журавлев — студент 5 курса Международной школы Медицина Будущего.

Москва

Moscow

zhuravlev_and@inbox.ruhttps://orcid.org/0000-0002-1268-5145СемиткоС. П.SemitkoS. P.

Сергей Петрович Семитко — доктор медицинских наук, профессор кафедры интервенционной кардиоангиологии, директор Научно-практического центра интервенционной кардиоангиологии.

Москва

Moscow

Semitko@mail.ruФГАОУ ВО Первый МГМУ им И.М. Сеченова МЗ РФ (Сеченовский Университет), Научно-практический центр интервенционной кардиоангиологииI.M. Sechenov First Moscow State Medical UniversityФГАОУ ВО Первый МГМУ им И.М. Сеченова МЗ РФ (Сеченовский Университет)I.M. Sechenov First Moscow State Medical UniversityФГАОУ ВО Первый МГМУ им И.М. Сеченова МЗ РФ (Сеченовский Университет),Научно-практический центр интервенционной кардиоангиологииI.M. Sechenov First Moscow State Medical University20212903202120226292629Copyright © Азаров А.В., Журавлев А.С., Семитко С.П., 20212021Азаров А.В., Журавлев А.С., Семитко С.П.Azarov A.V., Zhuravlev A.S., Semitko S.P.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://cardiovascular.elpub.ru/jour/article/view/2629

Известно, что даже, несмотря на своевременную реваскуляризацию инфаркт-связанной артерии, у части пациентов миокард остается в состоянии гипоперфузии. Такое состояние известно как феномен no-reflow и связано с худшим прогнозом. Данный обзор посвящен описанию эффективности методики отсроченного стентирования в профилактике no-reflow. У пациентов с массивным коронарным тромбозом методика двухэтапной реваскуляризации, которая представляет собой первичное вмешательство в виде аспирационной тромбэктомии и/или баллонной ангиопластики с последующим стентированием через определенный промежуток времени, является весьма перспективной. Промежуток времени перед стентированием представляет определенное “терапевтическое окно”, которое дает время подействовать различным группам фармакологических препаратов с последующим уменьшением размера тромба и риска развития стент-связанной дистальной эмболизации.

It is known that even in spite of timely revascularization of the infarct-related artery, the myocardium in some patients remains hypoperfused. This condition is known as the no-reflow phenomenon, which is associated with an unfavorable prognosis. The systematic review is devoted to the effectiveness of deferred stenting in noreflow prevention. In patients with severe thrombosis, the two-stage revascularization technique is very promising. It is a primary intervention in the form of aspiration thrombectomy and/or balloon angioplasty followed by stenting after a certain period of time. This interval represents a certain therapeutic space, which allows various drugs to act resulting in reduction of blood clot size and risk of procedure-related distal embolization.

острый коронарный синдроминфаркт-связан-ная артериячрескожные коронарные вмешательствафеномен невосстановленного кровотокареперфузия миокардаострый инфаркт миокарда с подъемом сегмента STтерапия no-reflowпрофилактика no-reflowотсроченное стентированиедвухэтапная реваскуляризацияacute coronary syndromeinfarct-related arterypercutaneous coronary interventionno-reflow phenomenonmyocardial reperfusionST-segment elevation myocardial infarctionno-reflow therapyno-reflow preventiondeferred stentingtwo-stage revascularizationReferencesIbanez B, James S, Agewall S, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J. 2018;39(2):119-77. doi:10.1093/eurheartj/ehx637.Ibanez B, James S, Agewall S, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J. 2018;39(2):119-77. doi:10.1093/eurheartj/ehx637.Gupta S, Gupta MM. No reflow phenomenon in percutaneous coronary interventions in ST-segment elevation myocardial infarction. Indian heart journal. 2016;68(4):539-51. doi:10.1016/j.ihj.2016.04.006.Gupta S, Gupta MM. No reflow phenomenon in percutaneous coronary interventions in ST-segment elevation myocardial infarction. Indian heart journal. 2016;68(4):539-51. doi:10.1016/j.ihj.2016.04.006.Harbaoui B, Motreff P, Lantelme P. Delayed versus immediate stenting during STEMI: Towards a “tailored” strategy for primary PCI? Arch Cardiovasc Dis. 2016;109(6):373-5. doi: 10.1016/j.acvd.2016.03.001.Harbaoui B, Motreff P, Lantelme P. Delayed versus immediate stenting during STEMI: Towards a “tailored” strategy for primary PCI? Arch Cardiovasc Dis. 2016;109(6):373-5. doi: 10.1016/j.acvd.2016.03.001.Ганюков В. И. Отсроченное стентирование инфаркт-зави-симой коронарной артерии при инфаркте миокарда с подъемом сегмента ST. Эндоваскулярная хирургия. 2017;4(1):18-25. doi:10.24183/2409-4080-2017-4-1-18-25.Ganyukov VI. Deferred stent implantation in infarct related coronary artery in patients with ST-segment elevation myocardial infarction. Endovaskulyarnaya Khirurgiya. (Russian Journal of Endovascular Surgery). 2017;4(1):18-25. (In Russ.) doi:10.24183/2409-4080-2017-4-1-18-25.Алексеева Я. В., Вышлов Е. В., Марков В. А., Демьянов С. В. Отсроченное эндоваскулярное вмешательство при остром инфаркте миокарда с массивным тромбозом инфаркт-связанной коронарной артерии. Сибирский медицинский журнал. 2018;33(2):16-20. doi:10.29001/2073-8552-2018-33-2-16-20.Alekseeva YaV, Vyshlov EV, Markov VA, Demyanov SV. Deferred Stent Implantation in Patients with St- Segment Elevation Myocardial Infarction and Massive Coronary Thrombosis. Siberian Medical Journal. 2018;33(2):16-20. (In Russ.) doi:10.29001/2073-8552-2018-33-2-16-20.Вышлов Е. В., Крылов А.Л., Сыркина А. Г. и др. Двухэтапная реваскуляризация у пациентов с острым инфарктом миокарда и массивным тромбозом коронарной артерии. Кардиология. 2019;59(2):5-9. doi: 10.18087/cardio.2019.2.10224.Vyshlov EV, Krylov AL, Syrkina AG, et al. Two-Stage Revascularization in Patients with Acute Myocardial Infarction and Massive Coronary Thrombosis. Kardiologiia. 2019;59(2):5-9. (In Russ.) doi: 10.18087/cardio.2019.2.10224.Yoshitomi Y, Kojima S, Sugi T, et al. Coronary vasoreactivity to ergonovine after angioplasty: difference between the infarct-related coronary artery and the noninfarct-related coronary artery. Coron Artery Dis. 1998;9(2):105-11.Yoshitomi Y, Kojima S, Sugi T, et al. Coronary vasoreactivity to ergonovine after angioplasty: difference between the infarct-related coronary artery and the noninfarct-related coronary artery. Coron Artery Dis. 1998;9(2):105-11.Guo N, Maehara A, Mintz GS, et al. Incidence, mechanisms, predictors, and clinical impact of acute and late stent malapposition after primary intervention in patients with acute myocardial infarction: an intravascular ultrasound substudy of the Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI) trial. Circulation. 2010; 122(11 ):1077-84. doi:10.1161/circulationaha.109.906040.Guo N, Maehara A, Mintz GS, et al. Incidence, mechanisms, predictors, and clinical impact of acute and late stent malapposition after primary intervention in patients with acute myocardial infarction: an intravascular ultrasound substudy of the Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI) trial. Circulation. 2010; 122(11 ):1077-84. doi:10.1161/circulationaha.109.906040.Carrick D, Oldroyd KG, McEntegart M, et al. A randomized trial of deferred stenting versus immediate stenting to prevent no-or slow-reflow in acute ST-segment elevation myocardial infarction (DEFER-STEMI). J Am Coll Cardiol. 2014;63(20):2088-98. doi:10.1016/j.jacc.2014.02.530.Carrick D, Oldroyd KG, McEntegart M, et al. A randomized trial of deferred stenting versus immediate stenting to prevent no-or slow-reflow in acute ST-segment elevation myocardial infarction (DEFER-STEMI). J Am Coll Cardiol. 2014;63(20):2088-98. doi:10.1016/j.jacc.2014.02.530.Belle L, Motreff P, Mangin L, et al. Comparison of Immediate With Delayed Stenting Using the Minimalist Immediate Mechanical Intervention Approach in Acute ST-Segment-Elevation Myocardial Infarction: The MIMI Study. Circulation: Cardiovasc Interv. 2016;9(3):e003388. doi: 10.1161/CIRCINTERVENTIONS.115.003388.Belle L, Motreff P, Mangin L, et al. Comparison of Immediate With Delayed Stenting Using the Minimalist Immediate Mechanical Intervention Approach in Acute ST-Segment-Elevation Myocardial Infarction: The MIMI Study. Circulation: Cardiovasc Interv. 2016;9(3):e003388. doi: 10.1161/CIRCINTERVENTIONS.115.003388.Kelb®k H, Hofsten DE, Kober L, et al. Deferred versus conventional stent implantation in patients with ST-segment elevation myocardial infarction (DANAMI 3-DEFER): an open-label, randomisedcontrolled trial. The Lancet. 2016;387(10034):2199-206. doi:10.1016/S0140-6736(16)30072-1.Kelb®k H, Hofsten DE, Kober L, et al. Deferred versus conventional stent implantation in patients with ST-segment elevation myocardial infarction (DANAMI 3-DEFER): an open-label, randomisedcontrolled trial. The Lancet. 2016;387(10034):2199-206. doi:10.1016/S0140-6736(16)30072-1.Isaaz K, Gerbay A. Deferred stenting in acute ST elevation myocardial infarction. The Lancet. 2016;388(10052):1371. doi:10.1016/S0140-6736(16)31739-1.Isaaz K, Gerbay A. Deferred stenting in acute ST elevation myocardial infarction. The Lancet. 2016;388(10052):1371. doi:10.1016/S0140-6736(16)31739-1.Isaaz K, Robin C, Cerisier A, et al. A new approach of primary angioplasty for ST-elevation acute myocardial infarction based on minimalist immediate mechanical intervention. Coron Artery Dis. 2006;17(3):261-9. doi: 10.1097/00019501-200605000-00010.Isaaz K, Robin C, Cerisier A, et al. A new approach of primary angioplasty for ST-elevation acute myocardial infarction based on minimalist immediate mechanical intervention. Coron Artery Dis. 2006;17(3):261-9. doi: 10.1097/00019501-200605000-00010.Kim DW, Her SH, Park MW, et al. Impact of postprocedural TIMI flow on long-term clinical outcomes in patients with acute myocardial infarction. Intern Heart J. 2017;58(5):16-448. doi:10.1536/ihj.16-448.Kim DW, Her SH, Park MW, et al. Impact of postprocedural TIMI flow on long-term clinical outcomes in patients with acute myocardial infarction. Intern Heart J. 2017;58(5):16-448. doi:10.1536/ihj.16-448.Ndrepepa G, Mehilli J, Schulz S, et al. Prognostic significance of epicardial blood flow before and after percutaneous coronary intervention in patients with acute coronary syndromes. J Am Coll Cardiol. 2008;52(7):512-7 doi:10.1016/j.jacc.2008.05.009.Ndrepepa G, Mehilli J, Schulz S, et al. Prognostic significance of epicardial blood flow before and after percutaneous coronary intervention in patients with acute coronary syndromes. J Am Coll Cardiol. 2008;52(7):512-7 doi:10.1016/j.jacc.2008.05.009.Ke D, Zhong W, Fan L, Chen L. Delayed versus immediate stenting for the treatment of ST-elevation acute myocardial infarction with a high thrombus burden. Coron Artery Dis. 2012; 23(7):497-506. doi:10.1097/MCA.0b013e328358a5ad.Ke D, Zhong W, Fan L, Chen L. Delayed versus immediate stenting for the treatment of ST-elevation acute myocardial infarction with a high thrombus burden. Coron Artery Dis. 2012; 23(7):497-506. doi:10.1097/MCA.0b013e328358a5ad.Pascal J, Veugeois A, Slama M, et al. Delayed stenting for ST-elevation acute myocardial infarction in daily practice: a single-centre experience. Can J Cardiol. 2016;32(8):988-95. doi:10.1016/j.cjca.2015.09.015.17 Pascal J, Veugeois A, Slama M, et al. Delayed stenting for ST-elevation acute myocardial infarction in daily practice: a single-centre experience. Can J Cardiol. 2016;32(8):988-95. doi:10.1016/j.cjca.2015.09.015.Harbaoui B, Courand PY, Besnard C, et al. Deferred vs immediate stenting in ST elevation myocardial infarction: potential interest in selected patients. La Presse Medicale. 2015;44(11):e331-9. doi:10.1016/j.lpm.2015.06.013.Harbaoui B, Courand PY, Besnard C, et al. Deferred vs immediate stenting in ST elevation myocardial infarction: potential interest in selected patients. La Presse Medicale. 2015;44(11):e331-9. doi:10.1016/j.lpm.2015.06.013.Souteyrand G, Amabile N, Combaret N, et al. Invasive management without stents in selected acute coronary syndrome patients with a large thrombus burden: a prospective study of optical coherence tomography guided treatment decisions. Euro Intervention. 2015;11(8):895-904. doi:10.4244/EIJY14M07_18.Souteyrand G, Amabile N, Combaret N, et al. Invasive management without stents in selected acute coronary syndrome patients with a large thrombus burden: a prospective study of optical coherence tomography guided treatment decisions. Euro Intervention. 2015;11(8):895-904. doi:10.4244/EIJY14M07_18.Rioufol G, Gilard M, Finet G, et al. Evolution of spontaneous atherosclerotic plaque rupture with medical therapy: longterm follow-up with intravascular ultrasound. Circulation. 2004;110(18):2875-80. doi:10.1161/01.CIR.000014633705073.22.Rioufol G, Gilard M, Finet G, et al. Evolution of spontaneous atherosclerotic plaque rupture with medical therapy: longterm follow-up with intravascular ultrasound. Circulation. 2004;110(18):2875-80. doi:10.1161/01.CIR.000014633705073.22.De Maria GL, Alkhalil M, Oikonomou EK, et al. Role of deferred stenting in patients with ST elevation myocardial infarction treated with primary percutaneous coronary intervention: A systematic review and meta-analysis. J Interv Cardiol. 2017;30(3):264-73. doi:10.1111/joic.12380.De Maria GL, Alkhalil M, Oikonomou EK, et al. Role of deferred stenting in patients with ST elevation myocardial infarction treated with primary percutaneous coronary intervention: A systematic review and meta-analysis. J Interv Cardiol. 2017;30(3):264-73. doi:10.1111/joic.12380.Qiao J, Pan L, Zhang B, et al. Deferred versus immediate stenting in patients with ST-segment elevation myocardial infarction: a systematic review and meta-analysis. J Am Heart Assoc. 2017;6(3):e004838. doi:10.1161/JAHA.116.004838.Qiao J, Pan L, Zhang B, et al. Deferred versus immediate stenting in patients with ST-segment elevation myocardial infarction: a systematic review and meta-analysis. J Am Heart Assoc. 2017;6(3):e004838. doi:10.1161/JAHA.116.004838.Lee JM, Rhee TM, Chang H, et al. Deferred versus conventional stent implantation in patients with acute ST-segment elevation myocardial infarction: An updated meta-analysis of 10 studies. Int J Cardiol. 2017; 230:509-17 doi:10.1016/j.ijcard.2016.12.071.Lee JM, Rhee TM, Chang H, et al. Deferred versus conventional stent implantation in patients with acute ST-segment elevation myocardial infarction: An updated meta-analysis of 10 studies. Int J Cardiol. 2017; 230:509-17 doi:10.1016/j.ijcard.2016.12.071.

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