clinmedКлиническая медицинаClinical Medicine (Russian Journal)0023-21492412-1339ООО «Медицинское информационное агентство»10.30629/0023-2149-2025-103-5-339-345clinmed-1139Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESВыбор способа хирургического лечения пациентов со стабильной стенокардией напряженияТhe choice of surgical treatment for patients with stable angina pectorishttps://orcid.org/0000-0003-2197-8756СуковатыхБ. С.SukovatykhB. S.

Суковатых Борис Семенович – д-р мед. наук, профессор, заведующий кафедрой общей хирургии

Курск

Boris S. Sukovatykh – Doctor of Medical Sciences, Professor, Head of the Department of General Surgery

Kursk

SukovatykhBS@kursksmu.nethttps://orcid.org/0000-0003-0590-2225БоломатовН. В.BolomatovN. V.

Боломатов Николай Владимирович – д-р мед. наук, профессор, заведующий отделением рентгенохирургических методов диагностики и лечения

Курск

Nikolay V. Bolomatov – Doctor of Medical Sciences, Professor, Head of the Department of X-ray Surgical Methods of Diagnosis and Treatment

Kursk

https://orcid.org/0000-0003-3303-1308СередицкийА. В.SereditskyA. V.

Середицкий Алексей Викторович – канд. мед. наук, заведующий отделением рентгенохирургических методов диагностики и лечения

Орел

Alexey V. Sereditsky – Candidate of Medical Sciences, Head of the Department of X-ray Surgical Methods of Diagnosis and Treatment

Orel

https://orcid.org/0000-0001-8964-5937СидоровД. В.SidorovD. V.

Сидоров Дмитрий Владимирович – канд. мед. наук, доцент кафедры общей хирургии; врач отделения рентгенохирургических методов диагностики и лечения

Курск;

Орел

Dmitry V. Sidorov – Candidate of Medical Sciences, Associate Professor of the Department of General Surgery; doctor of the Department of X-ray Surgical Methods of Diagnosis and Treatment

Kursk;

Orel

https://orcid.org/0000-0003-1907-4395СуковатыхМ. Б.SukovatykhM. B.

Суковатых Михаил Борисович – канд. мед. наук, доцент кафедры общей хирургии

Курск

Mikhail B. Sukovatykh – Candidate of Medical Sciences, Associate Professor of the Department of General Surgery

Kursk

ФГБОУ ВПО «Курский государственный медицинский университет» Минздрава РоссииРоссияKursk State Medical University of the Ministry of Healthcare of the RussiaRussian FederationОБУЗ «Курская городская клиническая больница скорой медицинской помощи»РоссияCity Clinical Hospital of Emergency Medical CareRussian FederationБУЗ Орловской области «Орловская областная клиническая больница»РоссияOrel State University named after I.S. Turgenev, Medical InstituteRussian FederationОБУЗ «Курская городская клиническая больница скорой медицинской помощи»; БУЗ Орловской области «Орловская областная клиническая больница»; ФГБОУ ВО «Орловский государственный университет им. И.С. Тургенева», Медицинский институтРоссияCity Clinical Hospital of Emergency Medical Care; Orel region Regional Clinical Hospital; Orel State University named after I.S. Turgenev, Medical InstituteRussian Federation2025220920251035339345Copyright © Суковатых Б.С., Боломатов Н.В., Середицкий А.В., Сидоров Д.В., Суковатых М.Б., 20252025Суковатых Б.С., Боломатов Н.В., Середицкий А.В., Сидоров Д.В., Суковатых М.Б.Sukovatykh B.S., Bolomatov N.V., Sereditsky A.V., Sidorov D.V., Sukovatykh M.B.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.clinmedjournal.com/jour/article/view/1139

В статье представлены обобщенные данные литературы, посвященные проблемам реваскуляризации миокарда у пациентов стенокардией напряжения. Описаны разнообразные методики хирургического лечения этой патологии, существующие на данный момент, уточнены их положительные и отрицательные стороны. Проведено сравнение эффективности открытых хирургических и эндоваскулярных вмешательств у пациентов с хроническим коронарным синдромом. Указано, что наиболее перспективным способом лечения многососудистого поражения пациентов с высоким риском является гибридное вмешательство, сочетающее преимущества открытых и эндоваскулярных вмешательств. Определение гемодинамической значимости пограничного стеноза следует проводить путем оценки функционального резерва коронарного кровотока. Подчеркнуты особенности выбора того или иного способа рева скуляризации на основании общепринятой шкалы поражения коронарных артерий Sуntax Score. Указаны недостатки существующих критериев и обоснована необходимость их дальнейшего совершенствования

The article presents generalized literature data on the relevance of the problem of myocardial revascularization in patients with angina pectoris. Various methods of surgical treatment of this pathology that currently exist are described, their positive and negative sides are clarified. The effectiveness of open surgical and endovascular interventions in patients with chronic coronary syndrome was compared. It is indicated that the most promising method of treating multivessel lesions in hig-hrisk patients is a hybrid intervention combining the advantages of open and endovascular interventions. The hemodynamic significance of borderline stenosis should be determined by evaluating the functional reserve of coronary blood flow. The peculiarities of choosing one or another method of revascularization based on the generally accepted scale of coronary artery lesion Suntax Score are emphasized. The disadvantages of the existing criteria are indicated and justified

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