The use of endovascular hemostasis in the treatment of coronary artery perforation as a complication during recanalization of chronic occlusion

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Recanalization of chronic occlusions of the coronary arteries is a complex and difficult procedure, associated with a high incidence of intraoperative complications. One of the most serious complications is the perforation of the artery wall with a metal conductor. The article presents the experience of using endovascular balloon hemostasis to treat perforations, on the basis of which it is concluded that achieving endovascular hemostasis through long-term inflation of a balloon in perforation of the coronary artery, which arose in the process of recanalization of chronic occlusion of the coronary bed, is a relatively safe and effective method of stopping bleeding and treatment of this complication. It is important to note that this method requires a highly skilled operator and must be accompanied by continuous monitoring of vital signs.

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作者简介

I. Borisov

The P.V.Mandryka Central Military Clinical Hospital of the Ministry of Defense of the Russian Federation

编辑信件的主要联系方式.
Email: borisov@sokolniki-cardio.ru
俄罗斯联邦, Moscow

D. Shilin

The P.V.Mandryka Central Military Clinical Hospital of the Ministry of Defense of the Russian Federation

Email: borisov@sokolniki-cardio.ru
俄罗斯联邦, Moscow

R. Grigoryan

The P.V.Mandryka Central Military Clinical Hospital of the Ministry of Defense of the Russian Federation

Email: borisov@sokolniki-cardio.ru
俄罗斯联邦, Moscow

E. Zyubin

The P.V.Mandryka Central Military Clinical Hospital of the Ministry of Defense of the Russian Federation

Email: borisov@sokolniki-cardio.ru
俄罗斯联邦, Moscow

参考

  1. Бадоян А.Г., Хелимский Д.А., Шермук А.А. и др. Хронические окклюзии коронарных артерий: когда польза превышает риск? // Рос. кардиол. журн. – 2019. – № 8. – С. 116–123.
  2. Есипов А.В., Лищук А.Н., Колтунов А.Н., Есион Г.А., Карпенко И.Г. Диагностика и лечение хронической сердечной недостаточности в условиях специализированного стационара // Воен.-мед. журн. – 2017. – Т. 338, № 1. – С. 28–33.
  3. Есипов А.В., Шкловский Б.Л., Иванов В.А. и др. Результаты эндоваскулярного лечения больных с острым коронарным синдромом // Междунар. журн. интервенц. кардиоангиол. – 2017. – № 48–49. – С. 42.
  4. Brilakis E.S., Banerjee S., Karmpaliotis D. et al. Procedural outcomes of chronic total occlusion percutaneous coronary intervention: a report from the NCDR (National Cardiovascular Data Registry) // JACC Cardiovasc. Interv. – 2015. – N 8. – P. 245–253. doi: 10.1016/j.jcin.2014.08.014
  5. Maeremans J., Walsh S., Knaapen P. et al. The hybrid algorithm for treating chronic total occlusions in Europe: the RECHARGE Registry // J. Am. Coll. Cardiol. – 2016. – Vol. 68. – P. 1958–1970. doi: 10.1016/j.jacc. 2016.08.034
  6. Sapontis J., Salisbury A.C., Yeh R.W. et al. Early procedural and health status outcomes after chronic total occlusion angioplasty: a report from the OPENЃ]CTO Registry (Outcomes, Patient Health Status, and Efficiency in Chronic Total Occlusion Hybrid Procedures) // JACC Cardiovasc. Interv. – 2017. – N 10. – P. 1523–1534. doi: 10.1016/j.jcin.2017.05.065

补充文件

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1. JATS XML
2. Angiograms (freeze frame). A: the white arrow indicates the accumulation of extravasal contrast agent in the area of perforation of the coronary artery, the black arrow indicates the metal conductor in the lumen of the proximal stump of RCA occlusion; B: the black arrow indicates the area of the inflated balloon for hemostasis, the white arrow indicates the absence of extravasation of the contrast agent; B: the instrument is removed, the accumulation of contrast agent outside the vessel has completely stopped and hemostasis has been achieved

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版权所有 © Borisov I.A., Shilin D.A., Grigoryan R.F., Zyubin E.A., 2023



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