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International Journal of Interventional Cardioangiology #41

INTERVENTIONAL CARDIOLOGY

The Intermittent Percutaneous Occlusion of the Coronary Sinus in a Patient with ST­Elevation Acute Coronary Syndrome without Hemodynamically Significant Atherosclerotic Coronary Lesions (A Clinical Case)

B.. Shakhov, .B. Shakhov, D.V. Petrov, D.V. Volkov,
.S. Novikov, .V. Nikolskiy, .. Kosonogov

The Results of Delayed PCI After Thrombolytic Therapy
with Indirect Signs of Effectiveness in Elderly Patients with Acute Myocardial Infarction

Vyshlov .V., Avetisyan V.Yu., Krylov .L., Markov V..

Hybrid Myocardial Revascularization in Multivessel Coronary Disease. The State of Art

A.A. Shilov, N.A. Kochergin, V.I. Ganiukov

INTERVENTIONAL ANGIOLOGY

Interventional Treatment of a Patient with Acute Myocardial Infarction and Cerebrovascular Accident:Two Diseases – One Operating Room

A.G. Kosachenko, .G. Koledinsky, .V. Sidelnikov, V.. Anufriev, .. Nikonorenko

Our First Experience with Prostatic Artery Embolization via Transradial Access

E.R. Khayrutdinov, S.B. Zharikov, I.. Vorontsov, A.V. Arablinskiy

MISCELLANEOUS

Prevalence, Determinants and Prognostic Value of Contrast­induced Acute Kidney Injury after Primary Percutaneous Interventions

A.A. Gaskina, V.V. Maiskov, S.V. Villevalde, S.P. Semitko, Z.D. Kobalava

Acute Left Ventricular Failure in Patients with Type 2 Diabetes Mellitus

S.V. Kakorin, A.V. Stogov, A.M. Mkrtumyan

Complications After Stenting of the Aortic Arch Arteries (Review)

Yu.L. Shevchenko, N.V. Bolomatov, A.G. Viller

 

 

 

The Intermittent Percutaneous Occlusion of the Coronary Sinus in a Patient with ST­Elevation Acute Coronary Syndrome without Hemodynamically Significant Atherosclerotic Coronary Lesions (A Clinical Case)

 

B.. Shakhov1, .B. Shakhov1*, D.V. Petrov2, D.V. Volkov2, .S. Novikov2, .V. Nikolskiy2, .. Kosonogov2

1 Nizhny Novgorod State Medical Academy of the Ministry of Healthcare of Russia

2 City Clinical Hospital No 5, Nizhny Novgorod, Russia

 

New ways of adequate antegrade blood flow restoration in the coronary arteries of patients with ST­elevation acute coronary syndrome (STEACS) without hemodynamically significant atherosclerotic coronary lesions have been insufficiently studied. A clinical case of a patient with STEACS without hemodynamically significant coronary lesions and slow antegrade blood flow in the left anterior descending artery (LAD) is described. The patient underwent a percutaneous intermittent occlusion of the coronary sinus for 10 minutes using the balloon catheter in the “inflation­deflation” mode. The procedure had a direct positive effect on coronary hemodynamics manifested as resolution of distal coronary spasm, improvement of myocardial perfusion and restoration of adequate antegrade flow in the LAD.

Key words: acute coronary syndrome, ST­segment elevation, native coronary arteries, intermittent occlusion of the coronary sinus, peripheral vasospasm.

 

* Address for correspondence:

Dr. Evgeny Shakhov

Nizhny Novgorod State Medical Academy

64, apt 41,  Belinskogo str., Nizhniy Novgorod, 603000

Phone: 8­910­79­550­79

E-mail: es­ngma@yandex.ru

 

References

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2.         2014 ESC/EACT Guidelines on myocardial revascularization/The Task Force on Myocardial Revascalarization of the European Society of Cardiology (ESC) and the European Association for Cardio­Thoracic Surgery (EACT). Eur. Heart J. 2014, 35 (37), 2541–619.

3.         Ong P., Athanasiadis A., Hill S. Vogelsberg H. et al. Coronary Artery Spasm as a Frequent Cause of Acute Coronary Syndrome: The CASPAR (Coronary Artery Spasm in Patients With Acute Coronary Syndrome) Study. J. Am. Col. Cardiol. 2008, 52 (7), 528–530.

4.         Gibson C.M., Cannon C.P., Daley W.L., et al. TIMI frame count: a quantitative method of assessing coronary artery flow. Circulation. 1995, 93 (5), 879–88.

5.         Porto I., Hamilton­Craig C., Brancati M., Burzotta F., et al. Angiographic assessment of microvascular perfusion­­myocardial blush in clinical practice. Am. Heart J. 2010, 160 (6), 1015–1022.

6.         Vogelzang M., Vlaar P.J., Svilaas T. et al. Computer­assisted myocardial blush quantification after percutaneous coronary angioplasty for acute myocardial infarction: a substudy from the TAPAS trial. Eur. Heart J. 2009, 30, 594–599.

7.         Van de Hoef T.P., Nolte F., Delewi R. et al. Intracoronary Hemodynamic Effects of Pressure­Controlled Intermittent Coronary Sinus Occlusion (PICSO): Results from the First­In­Man Prepare PICSO Study. J. Intervent. Cardiol. 2012, 25 (6), 549–556.

8.         Komamura K., Mishima M., Kodama K. Preliminary clinical experience with intermittent coronary sinus occlusion in combination with thrombolytic therapy in acute myocardial infarction. Jpn. Circ. J. 1989, 53, 1152–1163.

9.         Mohl W., Gangl C., Jusi€c A., et al. PICSO: from myocardial salvage to tissue regeneration. Cardiovasc. Revasc. Med. 2015, 16, 36–46.

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The Results of Delayed PCI After Thrombolytic Therapy with Indirect Signs of Effectiveness in Elderly Patients with Acute Myocardial Infarction

 

Vyshlov .V.1, 2*, Avetisyan V.Yu.1, Krylov .L.1, Markov V..1,2

1 Research Institute for Cardiology, Tomsk

2  Siberian State Medical University, Tomsk, Russia

 

The retrospective study was aimed  at the investigation of the results of delayed PCI after thrombolytic therapy with indirect signs of effectiveness in elderly patients (≥75 years) with acute myocardial infarction. The authors conclude, that the delayed PCI appropriately performed in patients ≥75 y.o. with acute myocardial infarction who underwent thrombolytic therapy and had indirect ECG signs of coronary reperfusion is relatively safe intervention but its benefit requires additional confirmation.

Key words: myocardial infarction, myocardial reperfusion, thrombolysis, PCI, pharmacoinvasive reperfusion, elderly.

 

* Address for correspondence:

Dr. Evgeny Vyshlov

Research Institute for Cardiology

111A, Kievskaya str., Tomsk, 634012

Phone: 8­913­851­86­82. Fax: (3822) 55­36­89

E-mail : evv@cardio­tomsk.ru

 

References

1.         ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST­segment elevation. Eur. Heart J. 2012, 33, 2569–2619.

2.         Konrat C., Boutron I., Trinquart L. et al. Underrepresentation of Elderly People in Randomised Controlled Trials. The Example of Trials of 4 Widely Prescribed Drugs. PLoS ONE 2012, 7(3), e33559. doi:10.1371/journal.pone.0033559.

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4.         Alexander K.P., Newby L.K., Armstrong P.W. et al.  Acute coronary care in the elderly, part II: ST­segment­elevation myocardial infarction: a scientific statement for healthcare professionals from the American Heart Association Council on Clinical Cardiology: in collaboration with the Society of Geriatric Cardiology. Circulation. 2007, 15 (19), 2570–2589.

5.         TjiaJ., Allison J., Saczynski J.S. et al. Encouraging trends in acute myocardial infarction survival in the oldest old. Am. J. Med. 2013, 126 (9), 798–804.

6.         Yan A.T., Yan R.T., Cantor W.J. et al. for the TRANSFER­AMI Investigators. Relationship between risk stratification at admission and treatment effects of early invasive management following fibrinolysis: insights from the Trial of Routine Angioplasty and Stenting After Fibrinolysis to Enhance Reperfusion in Acute Myocardial Infarction (TRANSFER­AMI). Eur. Heart J. 2011, 32 (16), 1994–2002.

7.         Ehrlich .D., Kharchenko .S., Barbarash .L. et al. Compliance with the guidelines for treatment of acute coronary syndrome in clinical practice of Russian hospitals and in­hospital outcomes (RECORD­2 registry data). Kardiologya (Cardiology). 2013, 1, 14–22. (In Russian)

8. Vyshlov .V., Filyushkina V.Yu., Krylov .L., Markov V.. Effectiveness of reperfusion procedures in patients 70 y.o. with ST­elevation myocardial infarction. Sibirskij Meditsinkij Zhurnal (Siberian Medical Journal) (Tomsk). 2014, 1 (29), 25–30. (In Russian)

9.         Huynh T., Cox J.L., Massel D. et al. Predictors of intracranial hemorrhage with fibrinolytic therapy in unselected community patients: a report from the FASTRAK II project. Am. Heart J. 2004, 148 (1), 86–91.

10.       Rind E., ArbelY., Finkelstein A. et al. Angiographic Evaluation of Epicardial and Microvascular Coronary Flow. Israel. Med. Assoc. J. 2009, 11, 173–177.

11.       Gibson C.M., Cannon C.P., Murphy S.A. et al. Relationship of the TIMI myocardial perfusion grades, flow grades, frame count, and percutaneous coronary intervention to long­term outcomes after thrombolytic administration in acute myocardial infarction. Circulation. 2002, 23, 105 (16), 1909–1913.

 

 

 

Hybrid Myocardial Revascularization in Multivessel Coronary Disease. The State of Art

 

A.A. Shilov*, N.A. Kochergin, V.I. Ganiukov

Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russia

 

This article deals with the issue of hybrid coronary surgery, its role in surgical treatment of patients with multivessel coronary disease and stable CHD. The literature data comparing hybrid myocardial revascularization with coronary artery bypass grafting and percutaneous coronary intervention are presented.

Key words: hybrid myocardial revascularization, percutaneous coronary intervention, coronary artery bypass grafting.

 

* Address for correspondence:

Dr. Aleksander Shilov

Federal State Budgetary Scientific Institution Scientific Research Institute for Complex Issues of Cardiovascular Diseases

6, Sosnovy blvd., Kemerovo, 650002, Russia

Phone. +7 (923) 530­45­78. Fax: +7 (3842) 64­34­10

E-mail: shilik@mail.ru

 

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48.       Bonatti J., Schachner T., Bonaros N. et al. Simultaneous hybrid coronary revascularization using totally endoscopic left internal mammary artery bypass grafting and placement of rapamycin eluting stents in the same interventional session. The COMBINATION pilot study. Cardiology. 2008, 110, 92–95.

49.       Kon Z.N., Brown E.N., Tran R. et al. Simultaneous hybrid coronary revascularization reduces postoperative morbidity compared with results from conventional off­pump coronary artery bypass J. Thorac. Cardiovasc. Surg. 2008, 135, 367–375.

50.       Bachinsky W.B., Abdelsalam M., Boga G. et al. Comparative study of same sitting hybrid coronary artery revascularization versus off­pump coronary artery bypass in multivessel coronary artery dise­ase. Interv. Cardiol. 2012, 25 (5), 460–468.

51.       Serruys P.W.,  Morice M., Kappetein A.P. et al. Percutaneous Coronary Intervention versus Coronary­Artery Bypass Grafting for Severe Coronary Artery Disease. N. Eng. J. Med. 2009, 360, 961–972.

52.       Bonaros N., Schachner T., Wiedemann D. et al. Closed chest hybrid coronary revascularization for multivessel disease – current concepts and techniques from a two­center experience. Eur. J. Cardiothorac. Surg. 2011, 40, 783–787.

53.       Halkos M.E., Vassiliades T.A., Douglas J.S. et al. Hybrid coronary revascularization versus off­pump coronary artery bypass grafting for the treatment of multivessel coronary artery disease. Ann. Thorac. Surg. 2011, 92 (5), 1695–1701.

54.       2014 ESC/EACTS Guidelines on myocardial revascularization. The Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio­Thoracic Surgery (EACTS). Eur. Heart J. 2014, 35, 2541–2619.

 

 

Interventional Treatment of a Patient with Acute Myocardial Infarction
and Cerebrovascular Accident: Two Diseases – One Operating Room

 

A.G. Kosachenko, .G. Koledinsky*, .V. Sidelnikov, V.. Anufriev, .. Nikonorenko

City Clinical hospital N79, Moscow, Russia

 

The possibility of managing the patients with cerebrovascular accidents with the use of interventional techniques by endovascular surgeons who specialize in emergency cardiological care.

Key words: management of cerebrovascular accident, endovascular surgery, thrombus extraction.

 

* Address for correspondence:

Dr. Anton Koledinsky

City Clinical  Hospital N79

1, Akademika Millionschikova str., Moscow, 115487, Russia

E-mail: koledant@mail.ru

 

References

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8.         Suzuki S., et al. Access to intra­arterial therapies for acute ischemic stroke: an analysis of the US population. Am. J. Neuroradiol. 2004, 25, 1802–1806.

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Our First Experience with Prostatic Artery Embolization via Transradial Access

 

E.R. Khayrutdinov1*, S.B. Zharikov1, I.. Vorontsov2, A.V. Arablinskiy1

1 S.P. Botkin City Clinical Hospital, Moscow

2 City Clinical Hospital of Emergency Medical Care No.1, Omsk, Russia

 

The clinical case of successful prostatic artery embolization via transradial access is presented. The main advantages of this vascular access compared to transfemoral access are described.

Key words: prostatic artery embolization, transradial access, transfemoral access, benign prostatic hyper­plasia.

 

* Address for correspondence:

Evgeny Rafailovich Khayrutdinov

S.P. Botkin City Clinical Hospital

5, Vtoroy Botkinskiy proezd, Moscow, 125284, Russia

Phone: +7­916­830­49­64

E-mail: eugkh@yandex.ru

 

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6.         Appleton D.S., Sibley G.N., Doyle P.T. Internal iliac artery embolisation for the control of severe bladder and prostate haemorrhage. Br. J. Urol. 1988, 61 (1), 45–47.

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8.         Rastinehad A.R., Caplin D.M., Ost M.C. et al. Selective arterial prostatic embolization (SAPE) for refractory hematuria of prostatic origin. Urology. 2008, 71 (2), 181–184.

9.         DeMeritt J.S., Elmasri F.F., Esposito M.P. et al. Relief of benign prostatic hyperplasia­related bladder outlet obstruc­tion after transarterial polyvinyl alcohol prostate embolization. J. Vasc. Interv. Radiol. 2000, 11 (6), 767–770.

10.       Carnevale F.C., Antunes A.A., da Motta Leal Filho J.M. et al. Prostatic artery embolization as a primary treatment for benign prostatic hyperplasia: preliminary results in two patients. Cardiovasc. Intervent. Radiol. 2010, 33 (2), 355–361.

11.       Camara­Lopes G., Mattedi R., Antunes A.A. et al. The histology of prostate tissue following prostatic artery embolization for the treatment of benign prostatic hyperplasia. Int. Braz. J. Urol. 2013, 39 (2), 222–227.

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18.       Khayrutdinov E.R., Vorontsov I.., Arablinskiy A.V. Advantages of transradial access in urinary artery embolization. Diagnosticheskaya I interventsionnaya radiologia (Diagnostic and interventional radiology), 2015, 9 (1), 64–70. (in Russian)

 

 

 

Prevalence, Determinants and Prognostic Value of Contrast­induced Acute Kidney Injury after Primary Percutaneous Interventions

 

A.A. Gaskina1, V.V. Maiskov2,3, S.V. Villevalde1, S.P. Semitko3, Z.D. Kobalava1

1 Peoples' Friendship University of Russia, department of propaedeutics 

2  City clinical hospital 64, endovascular surgery department 

3  Pirogov Russian National Research Medical University. Department of endovascular methods
of diagnostics and treatment.
Moscow, Russia

 

Purpose of study: to determine the incidence, the predictors and prognostic value of contrast­induced acute kidney injury (CIAKI) in patients with ST­elevation acute coronary syndrome (STE­ACS) after primary percutaneous coronary intervention.

Material and methods. CIAKI incidence was estimated using KDIGO 2012 criteria in 216 patients who were admitted to the hospital with STE­ACS and received PPCI (mean age 64 ± 13 years, arterial hypertension in 90%, history of MI in 27%, chronic kidney disease in 7%, diabetes mellitus type 2 in 21%). Logistic regression analysis was used to determine predictors of CIAKI. Patient prognosis was evaluated after 30 days and 12 months using telephone inquiry.

Results. CIAKI was diagnosed in 43 patients (20%);  stage I in 81% and stage II in 19%. Patients with CIAKI were older (69 ± 13 and 63 ± 12 years, p <0.01), their baseline serum creatinine level was higher (104 ± 31 and 87 ± 22 µmol/l, p <0.001) as were the amount of contrast medium (CM) (282 ± 94 ml and 236 ± 85 ml, p <0.05) and CM volume to glomerular filtration rate (GFR) ratio (4.02 ± 2.15 and 2.32 ± 1.08, p <0.05), and left ventricle ejection fraction (LVEF) was lower (37 ± 10 and 41 ± 14%, p <0,05). Following independent predictors of CIAKI were revealed (listed according to their importance): CM volume to GFR ratio ³5.3, chronic kidney disease (CKD), in­hospital admission of nephrotoxic antibiotics, baseline GFR £ 56.6 ml/min/1,73m2, in­hospital admission of loop diuretics, multivessel disease, LVEF £39.5%, CM volume ³250 ml, baseline serum creatinine level ³114 µmol/l, age ³65.5 years, in­hospital admission of mineralocorticoid receptor antagonists. CIAKI was associated with adverse outcomes: higher 30­days mortality (10 and 3%), higher readmission rate due to cardiovascular diseases (66 and 46%).

Key words: contrast­induced acute kidney injury, ST­elevation acute coronary syndrome, primary percutaneous coronary intervention.

 

*Address for correspondence:

DR. Victor Mayskov

City Clinical Hospital N64

61, ul. Vavilova

Moscow, 117292, Russia

E-mail : Maiskov­angio@yandex.ru

 

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Acute Left Ventricular Failure in Patients with Type 2 Diabetes Mellitus

 

S.V. Kakorin1, A.V. Stogov1, A.M. Mkrtumyan2*

1 City Clinical Hospital No 4 of Moscow

2 A.I. Evdokimov Moscow State Medical Dentistry University, Moscow, Russia

 

The article presents a literature review on the prevalence, pathogenesis, and treatment of myocardial infarction (MI) complicated by acute left ventricular failure (ALVF) in patients with type 2 diabetes mellitus (T2DM).

Diabetes mellitus contributes to reduction of myocardial contractility. Myocardial remodeling in T2DM is affected by combination of factors associated with diabetic cardiomyopathy, reduction of the metabolic activity of cardiomyocytes, insufficient glucose transport into cells, endothelial dysfunction, diabetic macro­ and microangiopathy, myocardial fibrosis leading to disruption of left ventricle filling and development of ALVF. Modern pharmacological agents and interventions for MI increase the life span and improve the quality of life of T2DM patients. However, MI is complicated with ALVF 3 times as frequently and mortality related to acute MI is 2 times higher in T2DM patients compared to non­T2DM patients.

Key words:  type 2 diabetes mellitus, acute myocardial infarction, acute left ventricular failure.

 

* Address for corespondence:

Dr. Serguey Kakorin

Moscow city Clinical hospital N4

25, Pavlovskaya ul., Moscow, 115093.

E-mail : kakorin­s@yandex.ru

 

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Complications After Stenting of the Aortic Arch Arteries (Review)

 

Yu.L. Shevchenko, N.V. Bolomatov*, A.G. Viller

Federal State Budgetary Institution N.I. Pirogov National Medical Surgical Center
(FGBU N.I. Pirogov NMHC) of the Minzdrav of
Russia

 

Stenting of the aortic arch arteries is an effective option for primary prevention of ischemic stroke. However, the complications may develop during intervention or after it as for any other surgical intervention. The article reviews various complications related to stenting of the aortic arch arteries, methods of their prevention, diagnosis, and treatment.

Key words: complications of stenting of the aortic arch arteries; hypotension, bradycardia; cerebral arterial spasm; subarachnoid hemorrhage; brain hyperperfusion syndrome; distal embolism; contrast­induced encephalopathy, carotid artery rupture.

 

* Address for correspondence:

Dr. Nikolay Bolomatov

N.I. Pirogov National Medical Surgical Center

70, Nizhnyaya Pervomayskaya, Moscow, 105203

Tel.: +7­499­464­49­54, +7­495­465­33­55

Fax: +7­495­465­09­52

E-mail : info@pirogov­center.ru

 

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