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International Journal of Interventional Cardioangiology #45

  

Method for the Determination of the Consecution of Coronary Blood Flow Restoration in Patients with Acute Coronary Syndrome and Multivessel Coronary Disease

E.B. Shakhov1*, B.E. Shakhov2, E.B. Petrova2, E.G. Sharabrin2

1 City Clinical Hospital #5, Nizhniy Novgorod, Russia

2 Nizhniy Novgorod State Medical Academy, Nizhniy Novgorod, Russia

Correct assessment of the priority of coronary blood flow restoration during PCI plays an important role in modern X-ray surgery. The treatment results from 38 patients with ST-segment elevation and non-ST-segment elevation ACS and multivessel coronary disease were analyzed. The scores based on which the completeness and sequence of coronary blood flow restoration were determined, were programmatically assigned to each affected coronary artery using specialized software. The software recommendation was compared with the treatment tactics proposed by three independent experts and “opinion” of the operating surgeon. The proportion of complete concordance between software recommendations and operating surgeon’ suggestions in relation to priority of blood flow restoration for all three coronary arteries was 66.7%. The proportion of complete concordance in stenting tactics offered by the software and independent experts was 100%.

Keywords: acute coronary syndrome, multivessel disease, staged revascularization, priority of coronary blood flow restoration, interventional tactics. 


 Clinical Presentation of a Successful Transcatheter Aortic Valve Replacement Via the Right Subclavian Artery

R.S. Akchurin, T.E. Imaev, A.E. Komlev , D.V. Salichkin, M.E. Nikonova, M.A. Saidova, P.M. Lepilin, A.S. Kolegaev

Russian Cardiology Research and Production Complex, Ministry of Health of the Russian Federation, Moscow, Russia

Recently, transcatheter aortic valve implantation has become a method of choice in patients at high surgical risk. Transfemoral approach is considered to be preferable for this intervention. However, with the increased number of transcatheter interventions in the clinical practice, we have been faced with the increased proportion of patients who are not eligible for the femoral access. Various alternative methods of delivering the aortic valve endograft can be used in such cases. This article describes a clinical presentation of a successful implantation of a self-expanding aortic valve bioprosthesis via the right subclavian artery.

Keywords: aortic stenosis, transcatheter aortic valve replacement, subclavian access. 


Diagnosis and Endovascular Treatment of a Splenic Artery Aneurysm

M.B. Patsenko*, V.A. Ivanov, A.V. Obraztsov, D.A. Mironenko, S.N. Kryzhov, N.V. Obraztsova, V.L. Smirnov

Vishnevsky 3rd Central Military Clinical Hospital, Krasnogorsk, Russia

High resolution capacities of modern non-invasive imaging techniques have significantly simplified the diagnostics of visceral aneurysms. Splenic artery aneurysms are potentially life-threatening in case of rupture. This fact requires timely preventative surgical treatment which should be offered if the aneurysm exceeds 20 mm in diameter. Currently, the endovascular treatment options are increasingly used for treatment of splenic artery aneurysms. The authors present a clinical case of successful endovascular embolization of a splenic artery aneurysm.

Keywords: aneurysm, splenic artery embolization, endovascular treatment. 


Coronary Artery Bypass Grafting (CABG) Combined with Endarterectomy and Stent Retrieval in Patients after Percutaneous Coronary Interventions

R.S. Akchurin, A.A. Shiryaev , D.M. Galyautdinov, V.P. Vasilev, D.V. Salichkin , A.S. Kolegaev, A.V. Emelianov

Russian Cardiology Research and Production Complex, Moscow, Russia

Despite the increasing number of patients undergoing percutaneous coronary interventions (PCIs), in-stent restenosis remains the major limiting factor for this procedure. In this situation, interventional techniques are often ineffective and long-term results remain unsatisfactory. Therefore, the interest in surgical treatment methods for patients with a history of PCI is increasing. The experience of coronary artery bypass grafting with endarterectomy and stent retrieval from the coronary arteries is presented.

Key words: percutaneous coronary intervention, endarterectomy, diffuse coronary artery disease, coronary artery bypass grafting. 


Endovascular Correction of Pelvic Arterial Injury

S.. Prozorov*, G.. Belozerov, P.. Ivanov, S.. Bocharov

Sklifosovsky Emergency Care Research Institute, Moscow, Russia

Endovascular surgery methods were used in 14 patients (13 men and 1 woman aged from 15 to 57 y.o.) with pelvic arterial injuries. Selective embolization was performed in 12 patients using PVA particles (9 cases) and embolic coils (3 cases). Embolization was effective and no recurrent bleeding was observed in all cases. Stent-grafts were implanted in 2 patients with developing false aneurysm with complete exclusion of the aneurysm from the blood flow. Endovascular treatment options are minimally invasive alternatives to reconstructive vascular surgeries.

Keywords: arterial injury, pelvic fractures, endovascular surgery, embolization, stent-graft. 


Complications During and at Various Follow-up After Inferior Vena Cava Filters Implantation. Indications for inferior Vena Cava Filters Retrieval (Literature Review)

S.. Prozorov*

Sklifosovsky Emergency Care Research Institute, Moscow, Russia

Inferior vena cava filters are widely used for prevention of pulmonary embolism, their high efficacy has been demonstrated worldwide. Many types of inferior vena cava filters have been developed, and all types of them cause complications. Complications can vary: local complications at the puncture site, malposition of the inferior vena cava filter, failed deployment, dislocation, perforation of the inferior vena cava wall and adjacent organs, fracture of the inferior vena cava filter and its parts, inclination of the filter by more than 15° to the long axis of the inferior vena cava, invasion of the filter parts into the inferior vena cava wall, thrombosis of the filter and inferior vena cava, recurrent thromboembolism, microbial colonization of the inferior vena cava filter.

The objective of this review was to demonstrate the current status of the issue: the desire to use this highly effective method and to avoid related complications. In the recent years, the inferior vena cava filters which can then be removed from the inferior vena cava have become widely used. Literature data show that the removal of inferior vena cava filters as soon as they are no longer needed is optimal.

Keywords: inferior vena cava filter, complications, inferior vena cava filter retrieval.


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