nmpЖурнал им. Н.В. Склифосовского «Неотложная медицинская помощь»Russian Sklifosovsky Journal "Emergency Medical Care"2223-90222541-8017“N.V. Sklifosovsky Research Institute for Emergency Medicine”nmp-83Research ArticleОБЗОРЫ ЛИТЕРАТУРЫREVIEWS OF LITERATUREСОВРЕМЕННЫЕ ПОДХОДЫ К ПРОФИЛАКТИКЕ, ОЦЕНКЕ И ЛЕЧЕНИЮ ОСЛОЖНЕНИЙ ЭНДОВАСКУЛЯРНЫХ ВМЕШАТЕЛЬСТВ НА КОРОНАРНЫХ АРТЕРИЯХ. ЧАСТЬ II. ДИССЕКЦИЯ СТВОЛА ЛЕВОЙ КОРОНАРНОЙ АРТЕРИИ, ПРАВОЙ КОРОНАРНОЙ АРТЕРИИ С ПЕРЕХОДОМ ДИССЕКЦИИ НА АОРТУCURRENT APPROACHES TO THE PREVENTION, EVALUATION AND TREATMENT OF COMPLICATIONS DURING ENDOVASCULAR CORONARY ARTERY INTERVENTIONS. PART II. DISSECTION OF THE LEFT MAIN CORONARY ARTERY AND THE RIGHT CORONARY ARTERY, INVOLVING THE AORTAПрозоровС. А.ProzorovS. A.

д.м.н., ведущий научный сотрудник отделения рентгенохирургических методов диагностики и лечения

surgeonserge@mail.ruНИИ скорой помощи им. Н.В. Склифосовского ДЗ г. Москвы, МоскваРоссияSklifosovsky research Institute for Emergency Medicine, MoscowRussian Federation201426032016031621Copyright © Прозоров С.А., 20162016Прозоров С.А.Prozorov S.A.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.jnmp.ru/jour/article/view/83ЦЕЛЬ ИССЛЕДОВАНИЯ

ЦЕЛЬ ИССЛЕДОВАНИЯ. Анализ частоты и причин диссекции ствола левой коронарной артерии, правой коронарной артерии с переходом диссекции на аорту при диагностических и эндоваскулярных вмешательствах; современные подходы к лечению таких осложнений.

МАТЕРИАЛ И МЕТОДЫ

МАТЕРИАЛ И МЕТОДЫ. Проанализированы результаты эндоваскулярных вмешательств у 2317 больных. Диссекция ствола левой коронарной артерии возникла у 3 больных (0,13%), в одном случае с распространением на аорту.

РЕЗУЛЬТАТЫ

РЕЗУЛЬТАТЫ. Cтентирование ствола левой коронарной артерии с закрытием расслоения оказалось эффективным в 2 случаях, в одном наблюдении диссекция сразу не была выявлена.

ВЫВОДЫ

ВЫВОДЫ. Стентирование для закрытия начала диссекции («входных ворот») является основным методом для ликвидации осложнения; при относительно ограниченных по протяженности диссекциях без тенденции к распространению возможно консервативное ведение больных. 

AIM OF THE STUDY

AIM OF THE STUDY. The aim of the study is to analyze frequency and causes of dissection of the left main coronary artery and the right coronary artery dissection involving the aorta related to diagnostic and endovascular interventions as well as to describe modern approaches to treatment for these complications.

MATERIAL AND METHODS

MATERIAL AND METHODS. The results of endovascular interventions in 2,317 patients were studied. Dissection of the left main coronary artery developed in 3 patients (0.13%), spreading to the aorta in 1 case.

RESULTS

RESULTS. coronary stent implantation closing the dissection of the left main coronary artery has been effective in 2 patients, and in 1 patient the dissection has not been immediately revealed.

CONCLUSIONS

CONCLUSIONS. A stent implanted to close the beginning of the dissection (“the entrance gate”) is the primary method for elimination of complications. conservative management of patients is possible if relatively limited dissection has no tendency to spread. 

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