Morphoimmunohistochemical changes in the coronary arteries early after stenting

Abstract

Introduction: Modern methods of surgical treatment for coronary heart disease include stenting and bypass surgery. In this regard, a morphoimmunohistochemical study of the state of the coronary arteries in the early stages after stenting will make it possible to predict postoperative complications. Materials and methods: The protocols of autopsies of 20 deceased were studied (10 men, mean age 64.7 years, 10 women, mean age 76.9 years). In 85 %, progressive stenosing atherosclerosis of the mouth of the left coronary artery (CA) and the anterior interventricular branch was noted. Taking into account the development of complications after stenting, three chronological groups were identified: 1) up to 3 days; 2) 37 days; 3) 715 days. The computer program ImageJ (US National Institutes of Health, USA) was used for CA morphometry. Statistical processing of the obtained results was carried out on a personal computer using the statistical tools of the Statistica 10 program. Result : It was shown that during the first 3 days after stenting of coronary arteries, acute damage to endothelial cells in the form of desquamation, dystrophic and necrobiotic processes, intramural hemorrhages in the areas of atheromas localization are observed in their walls. After 37 days and later, 715 days after stenting of the coronary artery, parietal mixed (fibrin-leukocytic), fibrin thrombi with signs of organization are observed in the lumens of the coronary artery, which is combined with the phenomena of neoangiogenesis of the artery wall. Conclusions: Damage to endothelial cells and related disturbances in the rheological properties of blood due to the expression of von Willebrand factor can initiate endothelial dysfunction with the development of thrombosis, thromboembolism of small coronary branches, which can cause myocardial perfusion disorders with the development of acute infarction.