inovmedИнновационная медицина КубаниInnovative Medicine of Kuban2541-9897Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 110.35401/2541-9897-2025-10-1-119-127inovmed-1074Research ArticleОБЗОРЫREVIEWSРоль внутрисосудистых методов исследования при выполнении чрескожного коронарного вмешательства у пациентов с бифуркационным поражением ствола левой коронарной артерииRole of Intravascular Imaging in Percutaneous Coronary Interventions for Left Main Coronary Bifurcation Lesionshttps://orcid.org/0009-0000-3808-683XЛогиноваС. К.LoginovaSvetlana K.

Логинова Светлана Константиновна, аспирант, стажерисследователь кафедры госпитальной хирургии с курсом детской хирургии, Медицинский институт

117198, Москва, ул. Миклухо-Маклая, 6

Svetlana K. Loginova, Postgraduate Student, Research Assistant, Department of Hospital Surgery with the Pediatric Surgery Course, Institute of Medicine

ulitsa Miklukho-Maklaya 6, Moscow, 117198

https://orcid.org/0000-0002-1061-0449ФатуллоеваШ. Ш.FatulloevaShoista Sh.

Фатуллоева Шоиста Шавкатовна, аспирант кафедры госпитальной хирургии с курсом детской хирургии, Медицинский институт

117198, Москва, ул. Миклухо-Маклая, 6

Shoista Sh. Fatulloeva, Postgraduate Student, Department of Hospital Surgery with the Pediatric Surgery Course, Institute of Medicine

ulitsa Miklukho-Maklaya 6, Moscow, 117198

https://orcid.org/0009-0004-7668-2033ДечевГ. Р.DechevGumer R.

Дечев Гумер Русланович, аспирант кафедры госпитальной хирургии с курсом детской хирургии, Медицинский институт

117198, Москва, ул. Миклухо-Маклая, 6

Gumer R. Dechev, Postgraduate Student, Department of Hospital Surgery with the Pediatric Surgery Course, Institute of Medicine

 ulitsa Miklukho-Maklaya 6, Moscow, 117198

https://orcid.org/0000-0002-3593-436XМаксимкинД. А.MaximkinDaniil A.

Максимкин Даниил Александрович, к. м. н., доцент кафедры госпитальной хирургии с курсом детской хирургии, Медицинский институт

117198, Москва, ул. Миклухо-Маклая, 6

Daniil A. Maximkin, Cand. Sci. (Med.), Associate Professor at the Department of Hospital Surgery with the Pediatric Surgery Course, Institute of Medicine

ulitsa Miklukho-Maklaya 6, Moscow, 117198

Российский университет дружбы народов им. Патриса ЛумумбыРоссияPatrice Lumumba Peoples’ Friendship University of RussiaRussian Federation202530032025101119127Copyright © Логинова С.К., Фатуллоева Ш.Ш., Дечев Г.Р., Максимкин Д.А., 20252025Логинова С.К., Фатуллоева Ш.Ш., Дечев Г.Р., Максимкин Д.А.Loginova S.K., Fatulloeva S.S., Dechev G.R., Maximkin D.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.innovmedkub.ru/jour/article/view/1074

Ежегодно в Российской Федерации отмечается увеличение оперативных вмешательств у пациентов с поражениями ствола левой коронарной артерии, которые принято считать одними из самых сложных для эндоваскулярного лечения по причине высокого риска развития сердечно-сосудистых осложнений. При такого характера поражениях ангиографическая оценка затруднительна, а врачи-хирурги не редко сталкиваются с рядом сложностей при выполнении вмешательств. Для того, чтобы избежать осложнений и улучшить отдаленные результаты перед проведением вмешательства необходимо точно определить целесообразность его выполнения, оценить особенности поражения и выбрать наиболее эффективный метод лечения. Осуществить эту задачу помогают внутрисосудистые методы исследования, такие как измерение фракционного резерва кровотока, внутрисосудистое ультразвуковое исследование и оптическая когерентная томография.

Последние данные демонстрируют эффективность применения внутрисосудистых методов исследования на каждом из этапов оперативного вмешательства, однако до сих пор остается ряд спорных и дискутабельных вопросов, требующих внимания и дальнейшего изучения.

В статье представлен обзор последних исследований по применению внутрисосудистых методов исследования для оптимизации чрескожных коронарных вмешательств у пациентов с поражениями ствола левой коронарной артерии, а также изучены нерешенные вопросы.

The number of interventions for left main coronary bifurcation lesions in the Russian Federation increase annually. Such lesions are among the most challenging cases for endovascular treatment due to a high risk of cardiovascular complications. They are difficult to assess by angiography, and surgeons frequently encounter difficulties during interventions. To avoid complications and improve long-term outcomes, it is crucial to accurately determine the appropriateness of an intervention, assess characteristics of the lesion, and choose the most effective treatment strategy, and intravascular imaging methods, such as fractional flow reserve measurement, intravascular ultrasonography, and optical coherence tomography, can assist in doing so. Recent research demonstrates the effectiveness of these imaging methods at each stage of surgery; however, several contentious and debatable issues that warrant attention and further investigation remain. This article reviews the latest research regarding the use of intravascular imaging to optimize percutaneous coronary interventions in patients with left main coronary bifurcation lesions, as well as to highlight unresolved issues that require further exploration.

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