Abstract
The prevalence of circulatory system diseases rises, as well as the number of patients with coronary artery disease
increase. Severe cohort are patients with chronic kidney disease who needs dialysis. In addition to renal pathology,
clinical severity and long-term prognosis are often equally or predominantly determined by comorbidities. According
to the Russian register of renal replacement therapy, cardiovascular diseases (CVD) is most often diagnosed (51.1%)
comorbidity and 41% of these patients had a combination of different CVD. Patients with recurrent angina in the
long-term after coronary artery bypass grafting (CABG), who are increasingly undergoing percutaneous coronary
interventions (PCI), also have an unfavorable prognosis. At the moment of repeat myocardial revascularization, the
comorbidity rises and concomitant pathology occurs more often, the coronary atherosclerotic burden is infrequently
occlusive, diffuse and calcificated. These factors transfer PCI to the category of extremely high complexity and
high risk in case of multiple graft dysfunction. Endovascular treatment is the only alternative to drug therapy when
repeat CABG is restricted or contraindicated due to severe comorbidities and a high risk of surgical treatment. This
article presents long-term results of successful PCI with second-generation drug eluting stents in a patient with last
functioning coronary bypass graft dysfunction in the chronic total occlusion of the all epicardial arteries, chronic kidney
insufficiency and diabetes mellitus.
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About the authors
- Karen V. Petrosyan, Cand. Med. Sc., Head of Department; orcid.org/0000-0002-3370-0295
-
Ol'ga L. Bockeria, Dr. Med. Sc., Professor, Corresponding Member of Russian Academy of Sciences, Chief Researcher; orcid.org/0000-0002-7711-8520
-
Viktor S. Grigor'ev, Postgraduate, Endovascular Surgeon; orcid.org/0000-0002-1456-4697
-
Marina V. Abramyan, Cand. Med. Sc., Transfuziologist; orcid.org/0000-0001-6200-7855
