kpcczКомплексные проблемы сердечно-сосудистых заболеванийComplex Issues of Cardiovascular Diseases2306-12782587-9537Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”10.17802/2306-1278-2022-11-2-116-124kpccz-1075Research ArticleАНАЛИТИЧЕСКИЙ ОБЗОР. Сердечно-сосудистая хирургияREVIEWS. Cardiovascular surgeryСовременные взгляды на использование анатомических и клинико-анатомических шкал, основанных на данных исследования SYNTAX, при выборе стратегии реваскуляризации миокардаState-of-the-art development of anatomical and clinical-anatomical scores for choosing a myocardial revascularization strategy based on the SYNTAX studyhttps://orcid.org/0000-0001-6509-566XАлекянБ. Г.AlekyanB. G.

Алекян Баграт Гегамович, академик РАН, доктор медицинских наук, профессор заместитель директора по науке

ул. Большая Серпуховская, 27, Москва, 115093

Alekyan Bagrat G., Dr. Med. Sc., Professor, Academician of RAS, Head of Endovascular Surgery Center

27, Bol'shaya Serpuhovskaya, Moscow, 115093

https://orcid.org/0000-0002-7623-8635КарапетянН. Г.KarapetyanN. G.

Карапетян Нарек Григорьевич, кандидат медицинских наук старший научный сотрудник центра рентгенэндоваскулярной хирургии, врач по рентгенэндоваскулярным диагностике и лечению отдела рентгенэндоваскулярной хирургии

ул. Большая Серпуховская, 27, Москва, 115093

Karapetyan Narek G., PhD, leading researcher, endovascular surgeon

27, Bol'shaya Serpuhovskaya, Moscow, 115093

https://orcid.org/0000-0002-6018-5831КишмирянД. О.KishmiryanD. O.

Кишмирян Давид Оганесович, аспирант центра рентгенэндоваскулярной хирургии

ул. Большая Серпуховская, 27, Москва, 115093

Kishmiryan David O., postgraduate of the center, endovascular surgeon

27, Bol'shaya Serpuhovskaya, Moscow, 115093

dkishmiryan@gmail.comhttps://orcid.org/0000-0003-1791-9163РевишвилиА. Ш.RevishviliA. Sh.

Ревишвили Амиран Шотаевич, академик РАН, доктор медицинских наук, профессор, директор

ул. Большая Серпуховская, 27, Москва, 115093

Revishvili Amiran Sh., Dr. Med. Sc., Professor, Academician of RAS, Director

27, Bol'shaya Serpuhovskaya, Moscow, 115093

Федеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр хирургии имени А.В. Вишневского» Министерства здравоохранения Российской ФедерацииРоссияA.V. Vishnevsky National Medical Research Center of SurgeryRussian Federation202211052022112116124Copyright © Алекян Б.Г., Карапетян Н.Г., Кишмирян Д.О., Ревишвили А.Ш., 20222022Алекян Б.Г., Карапетян Н.Г., Кишмирян Д.О., Ревишвили А.Ш.Alekyan B.G., Karapetyan N.G., Kishmiryan D.O., Revishvili A.S.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.nii-kpssz.com/jour/article/view/1075

Лечение пациентов с трехсосудистым поражением коронарных артерий, согласно европейским и американским рекомендациям, включает чрескожное коронарное вмешательство или коронарное шунтирование. В зависимости от анатомической сложности поражения коронарных артерий с использованием шкалы SYNTAX score выбирают одну из стратегий лечения. Однако в последние годы в научной литературе активно обсуждают недостатки указанной шкалы, которая не полностью соответствует возможностям современной клинической практики. В обзоре освещены современные взгляды на анатомические и клинико-анатомические шкалы, которые позволяют выбрать оптимальный метод прямой реваскуляризации миокарда у больных с трехсосудистым поражением и/или поражением ствола левой коронарной артерии.

Treatment of patients with multivessel coronary artery disease is percutaneous coronary intervention or coronary artery bypass grafting according to current European and American guidelines. Depending on the anatomical complexity of the coronary artery lesion, one of the methods is chosen, with usage of a risk scale based on the SYNTAX study. However, Syntax score is actively discussed as not an optimal risk scale, because of unmatched with modern clinical possibilities This article presents current, different opinions on anatomical and clino-anatomical risk scores, which allows to choose the optimal method of revascularization for patients with three-vessel disease and/or left main coronary artery lesions.

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Prognostic value of SYNTAX score and SYNTAX score II in an 'all-comers' population treated with angoplastyPatrick W Serruys 1, Norihiro Kogame, Yuki Katagiri, Rodrigo Modolo, Pawel E Buszman, Andrés Íñiguez-Romo, Javier Goicolea, David Hildick-Smith, Andrzej Ochala, Dariusz Dudek, Jan J Piek, Joanna J Wykrzykowska, Javier Escaned, Adrian P Banning, Vasim Farooq, Yoshinobu Onuma Clinical outcomes of state-of-the-art percutaneous coronary revascularisation in patients with three-vessel disease: two-year follow-up of the SYNTAX II studyPatrick W Serruys, Norihiro Kogame, Yuki Katagiri, Rodrigo Modolo, Pawel E Buszman, Andres Iniguez-Romo, Javier Goicolea, David Hildick-Smith, Andrzej Ochala, Dariusz Dudek, Jan J Piek, Joanna J Wykrzykowska, Javier Escaned, Adrian P Banning, Vasim Farooq, Yoshinobu Onuma. 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Epub 2020 Oct 8.Kuniaki Takahashi, Patrick W Serruys, Valentin Fuster, Michael E Farkouh, J ohn A Spertus, David J Cohen, Seung-Jung Park, Duk-Woo Park, Jung-Min Ahn, Arie Pieter Kappetein, Stuart J Head, Daniel Jfm Thuijs, Yoshinobu Onuma, David M Kent, Ewout W Steyerberg, David van Klaveren. SYNTAXES, FREEDOM, BEST, and PRECOMBAT trial investigators. Redevelopment and validation of the SYNTAX score II to individualise decision making between percutaneous and surgical revascularisation in patients with complex coronary artery disease: secondary analysis of the multicentre randomised controlled SYNTAXES trial with external cohort validation Lancet 2020 Oct 31;396(10260):1399-1412. DOI: 10.1016/S01406736(20)32114-0. Epub 2020 Oct 8.Алекян Б.Г., Карапетян Н.Г., Кишмирян Д.О., Ревишвили А.Ш. Эффективность использования шкалы риска SYNTAX Score II при выборе стратегии реваскуляризации миокарда у пациентов с трехсосудистым поражением венечных артерий и ствола левой коронарной артерии. Эндоваскулярная хирургия. 2020; 7 (4): 334–44. DOI: 10.24183/2409-4080-2020-7-4-334-344Алекян Б.Г., Карапетян Н.Г., Кишмирян Д.О., Ревишвили А.Ш. Эффективность использования шкалы риска SYNTAX Score II при выборе стратегии реваскуляризации миокарда у пациентов с трехсосудистым поражением венечных артерий и ствола левой коронарной артерии. Эндоваскулярная хирургия. 2020; 7 (4): 334–44. DOI: 10.24183/24094080-2020-7-4-334-344

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