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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">pirogovestnik</journal-id><journal-title-group><journal-title xml:lang="ru">Вестник Национального медико-хирургического центра им. Н.И. Пирогова</journal-title><trans-title-group xml:lang="en"><trans-title>Bulletin of Pirogov National Medical &amp; Surgical Center</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2072-8255</issn><issn pub-type="epub">2782-3628</issn><publisher><publisher-name>Национальный медико-хирургический Центр им. Н.И. Пирогова</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.25881/20728255_2025_20_4_14</article-id><article-id custom-type="elpub" pub-id-type="custom">pirogovestnik-463</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОРИГИНАЛЬНЫЕ СТАТЬИ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ORIGINAL ARTICLES</subject></subj-group></article-categories><title-group><article-title>ДВУХЛЕТНИЕ РЕЗУЛЬТАТЫ ПРИМЕНЕНИЯ БАЛЛОННЫХ КАТЕТЕРОВ С ЛЕКАРСТВЕННЫМ ПОКРЫТИЕМ В ЛЕЧЕНИИ ПАЦИЕНТОВ С БИФУРКАЦИОННЫМИ СТЕНОЗАМИ СТВОЛА ЛЕВОЙ КОРОНАРНОЙ АРТЕРИИ</article-title><trans-title-group xml:lang="en"><trans-title>DRUG-COATED BALLOON CATHETERS IN THE TREATMENT OF BIFURCATION STENOSIS OF THE LEFT MAIN CORONARY ARTERY: RESULTS OF A TWO-YEAR FOLLOW-UP</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Сафонова</surname><given-names>О. О.</given-names></name><name name-style="western" xml:lang="en"><surname>Safonova</surname><given-names>O. O.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Москва</p></bio><bio xml:lang="en"><p>Moscow</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Максимкин</surname><given-names>Д. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Maximkin</surname><given-names>D. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Москва</p></bio><bio xml:lang="en"><p>Moscow</p></bio><email xlink:type="simple">danmed@bk.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ким</surname><given-names>И. Е.</given-names></name><name name-style="western" xml:lang="en"><surname>Kim</surname><given-names>I. E.</given-names></name></name-alternatives><bio xml:lang="ru"><p> Москва </p></bio><bio xml:lang="en"><p>Moscow</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Логинова</surname><given-names>С. К.</given-names></name><name name-style="western" xml:lang="en"><surname>Loginova</surname><given-names>S. K.</given-names></name></name-alternatives><bio xml:lang="ru"><p> Москва </p></bio><bio xml:lang="en"><p>Moscow </p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шугушев</surname><given-names>З. Х.</given-names></name><name name-style="western" xml:lang="en"><surname>Shugushev</surname><given-names>Z. Kh.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Москва </p></bio><bio xml:lang="en"><p>Moscow</p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГАОУ ВО «Российский университет дружбы народов им. Патриса Лумумбы»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Peoples’ Friendship University of Russia named after Patrice Lumumba</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ЧУЗ «Центральная клиническая больница «РЖД-Медицина»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Private Central Clinical Hospital. Russian Railways-Medicine</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>05</day><month>12</month><year>2025</year></pub-date><volume>20</volume><issue>4</issue><fpage>14</fpage><lpage>20</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Сафонова О.О., Максимкин Д.А., Ким И.Е., Логинова С.К., Шугушев З.Х., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Сафонова О.О., Максимкин Д.А., Ким И.Е., Логинова С.К., Шугушев З.Х.</copyright-holder><copyright-holder xml:lang="en">Safonova O.O., Maximkin D.A., Kim I.E., Loginova S.K., Shugushev Z.K.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://submit.pirogov-vestnik.ru/jour/article/view/463">https://submit.pirogov-vestnik.ru/jour/article/view/463</self-uri><abstract><p>Обоснование: несмотря на имплантацию стентов с лекарственным покрытием последнего поколения и снижение частоты рестенозов и тромбозов стентов, проблема рестеноза в устье боковой ветви остается актуальной.Цель: оценить отдаленные (24 месяца) результаты применения баллонных катетеров с лекарственным покрытием в лечении пациентов с бифуркационными стенозами ствола левой коронарной артерии.Методы: в контролируемое рандомизированное проспективное исследование вошли 150 пациентов, которым выполнялось провизионное Т-стентирование ствола левой коронарной артерии (СЛКА). Методом конвертов пациенты были рандомизированы в 2 группы. В группе 1 (n = 75) – финальная дилатация методом «целующихся» баллонов после провизионного Т-стентирования СЛКА, выполнялась баллонным катетером с лекарственным покрытием (БКЛП) – в боковой ветви бифуркации и стандартным некомплаенсным баллонным катетером (НКБК) – в основной ветви. В группе 2 (n = 75) – финальная дилатация методом «целующихся» баллонов выполнялась некомплаенсным баллонным катетером в основной ветви бифуркации, и комплаенсным баллонным катетером в боковой ветви бифуркации. Пациенты обеих групп дополнительно были рандомизированы в подгруппы «истинных» и «ложных» бифуркационных стенозов (по классификации А. Medina). Критерии включения: бифуркационные поражения ствола левой коронарной артерии по данным внутрисосудистых методов визуализации; диаметр боковой ветви не менее 2,5 мм; подтвержденная ишемия миокарда в бассейне бифуркационного поражения (по данным ФРК, нагрузочных тестов, сцинтиграфии); стабильная стенокардия напряжения II–IV функционального класса или доказанная безболевая ишемия. Критерии исключения: имплантация двух стентов при бифуркационном поражении СЛКА (culotte/ crush); выраженный кальциноз ствола ЛКА; протяженное поражение (более 25 мм); острый коронарный синдром; перенесенные ранее вмешательства на стволе ЛКА; диаметр боковой ветви менее 2,5 мм; отказ пациента от вмешательства. Отдаленные результаты оценивались спустя 24 месяца.Результаты: отдаленные результаты были отслежены у 133 пациентов. Спустя 24 месяца частота рестеноза в устье боковой ветви была достоверно выше во 2 группе, по сравнению с 1 группой и составила 19,2 % и 8%, соответственно (р = 0,044), (используемый метод: Хи-квадрат Пирсона). Однако при анализе куммулятивный МАСЕ через 24 месяца не удалось установить статистически значимых различий (p = 0,303) (используемый метод: Хи-квадрат Пирсона).Заключение: применение баллонных катетеров с лекарственным покрытием у пациентов с бифуркационными стенозами ствола ЛКА является эффективным и безопасным методом лечения, а в некоторых случая может быть альтернативным вариантом эндоваскулярного лечения, способным снизить металлическую нагрузку и уменьшить частоту рестенозов в устье боковой ветви.</p></abstract><trans-abstract xml:lang="en"><p>Purpose: To evaluate the long-term (24 months) results of drug-coated balloon catheters in the treatment of bifurcation stenoses of the left main coronary artery (LMCA).Methods: A controlled, randomized, prospective study included 150 patients who underwent provisional T-stenting left main coronary artery were included in the study. Patients were randomised into 2 groups by envelope method. In group 1 (n = 75) – final kissing-dilatation after provisional LMCA T-stenting was performed with a drug-coated balloon (DCB) – in the lateral bifurcation branch and with a standard uncoated balloon catheter – in the main branch. In group 2 (n = 75) – final kissing-dilatation was performed with a non-plaque balloon catheter in both the main and lateral bifurcation branches. Patients of both groups were additionally randomized into subgroups of ‘true’ and ‘false’ bifurcation stenoses (Medina classification). Inclusion criteria: bifurcation lesions of the left main coronary artery according to intravascular imaging methods (OST, IVUS); side branch diameter of at least 2.5 mm; confirmed myocardial ischemia in the bifurcation lesion basin (according to FFR, exercise tests, scintigraphy); stable angina of functional class II-IV or proven painless ischemia. Exclusion criteria: implantation of two stents for bifurcation lesion of the LMCA (culotte/crush); severe calcification of the LMCA; extended lesion (more than 25 mm); acute coronary syndrome; previous interventions on the LMCA; side branch diameter less than 2.5 mm; patient’s refusal of intervention. The long-term results were evaluated after 24 months.Results: The long-term results were followed up in 133 patients. After 24 months, the rate of restenosis at the side branch orifice was significantly higher in Group 2 compared to Group 1, amounting to 19.2% and 8%, respectively (p = 0.044) (method used: Pearson Chi-square). However, when analyzing the cumulative MACE value after 24 months, no statistically significant differences were found (p = 0.303) (method used: Pearson Chi-square).Conclusions: the use of drug-coated balloon catheters in patients with bifurcation stenosis of the left main coronary artery is an effective and safe method of treatment, and in some cases, it is the most effective and safe method of treatment.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>ствол левой коронарной артерии</kwd><kwd>баллонные катетеры с лекарственным покрытием</kwd><kwd>бифуркационные стенозы</kwd></kwd-group><kwd-group xml:lang="en"><kwd>drug coated balloon</kwd><kwd>bifurcation stenosis</kwd><kwd>bifurcation stenting</kwd><kwd>left main coronary artery</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Louvard Y, Medina A. Definitions and classifications of bifurcation lesions and treatment. 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