Статья
НЕОАТЕРОСКЛЕРОЗ В СТЕНТЕ
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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