Vol 21, No 2 (2017)

Articles
PATENT DUCTUS ARTERIOSUS - GOOD AND EVIL IN ONE VESSEL
Bokerya E.L., Degtyareva E.A.
Abstract

Literature review discusses questions of hemodynamic significance of Patent Ductus Arte-riosus, methods of its surgical and drug (non-surgical) treatment and features in premature newborns.

RUDN Journal of Medicine. 2017;21(2):163-170
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ENDOVASCULAR INTERVENTION OF CORONARY ARTERY BYPASS GRAFT
Bazanov I.S., Ivanov V.A., Zharikov S.B., Polyakov I.I., Tsymbal E.V., Musoev T.Y., Sitko I.G., Lokshina M.V.
Abstract

In the first year occlusion occurs 10-15% of coronary artery bypass graft in 10 years - 50%, which causes the resumption of anginal patients after CABG. One of the most effective and safe methods of treatment of these patients is recognized endovascular intervention artery bypass graft failure or inter-vention of native coronary artery. In contrast classical percutaneous coronary reconstructions, for which there exist algorithms endovascular treatment for minimizing intraoperative risk and achieving the best long term results, treatment of saphenous vein grafts (SVG) still remains a challenging clinical problem. This article is a summary review of the literature dedicated to endovascular interventions for myocardial revascularization on the coronary artery bypass graft in patient after CABG. Analysis of the research allowed us to draw conclusions about the tactics of endovascular treatment of patients with return of angina after CABG, as well as about the defeat of the saphenous vein grafts lesions for endovascular interventions, and to identify the technical features of the SVG stenting.

RUDN Journal of Medicine. 2017;21(2):171-183
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MODERN CONCEPTS OF SYSTEMIC ARTERIAL HYPERTENSION AS COMPLICATION OF BRONCHOPULMONARY DYSPLASIA
Ovsyannikov D.Y., Strutynskaya A.D., Kantemirova M.G., Karnaushkina M.A.
Abstract

Arterial hypertension (AH) is highlighted as a complication of bronchopulmonary dys-plasia (BPD) in children. The review provides information on the incidence, pathophysiology, diagnosis and treatment of AH in children with BPD. After analyzing the studies, were identified risk factors for hypertension in children with BPD, the role of endothelial dysfunction in raising systemic blood pressure, analyzed therapy and consequences of AH in children with BPD.

RUDN Journal of Medicine. 2017;21(2):184-193
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THE BASICS OF CHEMOEMBOLIZATION
Gitelson D.G., Rogov D.A., Vasiliev A.E., Gitelson E.A.
Abstract

Chemoembolization has advantages over systemic chemotherapy as increase in drug concentration, time of exposition and decrease in systemic adverse effects.

RUDN Journal of Medicine. 2017;21(2):194-204
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ENDOVASCULAR SURGERY IN PHLEBOLOGY
Volkov S.V., Korobkov A.O., Lutsenko M.M.
Abstract

The article gives an overview of modern methods of endovascular treatment of acute and chronic venous pathology. And also the experience of using rheolytic thrombectomy (RT) as a method of treatment of flotation thromboses in the system of the inferior vena cava. The influence of the timing of the manifestation of flotation thrombosis on the efficacy of RT was assessed. The high efficiency of RT in patients with thrombosis up to 7 days from the moment of manifestation was demonstrated. The necessity of preliminary implantation of a temporary cava filter during RT is shown.

RUDN Journal of Medicine. 2017;21(2):205-211
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CAROTID ARTERY STENTING - NEW HORIZONS
Volkov S.V., Korobkov A.O.
Abstract

The article presents the main current trends of endovascular carotid surgery. The experi-ence of using the last generation carotid stents - two-layer self-expanding stents of 2 types - CGuard and Casper Rx. Demonstrated convincing results in the immediate and early post-operative period, including using optical coherence tomography.

RUDN Journal of Medicine. 2017;21(2):212-218
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PREDICTORS OF ADVERSE LEFT VENTRICULAR REMODELING IN PATIENTS AFTER MYOCARDIAL INFARCTION
Zharikova E.S., Villevalde S.V., Kobalava Z.D.
Abstract

Functional recovery or irreversible negative remodeling of injured myocardial segments has different prognostic implication in patients with myocardial infarction (MI) undergoing coronary percutaneous intervention (PCI). Increased pulse wave velocity (PWV), a non-invasive index of arterial stiffness, is one of the important risk factors of cardiovascular events in different clinical conditions. The aim of the study was to assess the relationship between PWV and changes of left ventricular (LV) systolic function in patients with acute MI. Adverse cardiac remodeling was revealed in 72% of patients and they more often had non-recovery of left ventricular longitudinal function. Higher baseline PWV is associated with less effective recovery of LV function.

RUDN Journal of Medicine. 2017;21(2):219-226
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SURGICAL PROCEDURES IN PATIENTS WITH IMPLANTED PACEMAKERS
Safonov N.V., Baranovich V.Y., Maximkin D.A., Faibushevich A.G.
Abstract

The article presents preventive measures aimed at surgical treatment of patients with artificial rhythm drivers. The relationship between the regime and the duration of electrocoagulation and the disturbances in the work of the ECS was revealed.

RUDN Journal of Medicine. 2017;21(2):227-233
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EVALUATION OF THE EFFECTIVENESS OF ENDOVASCULAR TREATMENT OF PATIENTS WITH OBLITERATING ATHEROSCLEROSIS OF LOWER LIMB ARTERIES WITH LONG OCCLUSIONS OF THE SUPERFICIAL FEMORAL ARTERY
Goloshchapov-Aksenov R.S., Shugushev Z.K., Matveev D.V., Maximkin D.A., Lakunin K.Y.
Abstract

The article presents 2-year results of endovascular treatment of 68 patients with peripheral arterial disease, chronical limb ischemia stage 2B-4 (by Fontain-Pokrovsky), with the vascular lesions of type D according to TASC II classification, which is characterized by long, over 20 cm occlusion of the superficial femoral artery, popliteal artery involvement and/or arteries of the lower leg. The rationale to perform endovascular recanalization and stenting of extended occluding lesions of the arteries infrainguinal segment in our study were the results of the analysis of the literature data on the treatment of patients with occlusions of the femoro-popliteal segment, namely the development of postoperative complications after femoral-popliteal bypass surgery, such as lymphorrhea, primary thrombosis of the bypass, bleeding, acute renal failure and infection complications; occlusion of femoro-popliteal bypass grafts at 2 years after surgery reaching 60%, the need to perform repeated operations in 45% of patients; prolonged postopera-tive rehabilitation and therefore low quality patients. Analyzing treatment results testified the effectiveness and safety of endovascular method. Technical success of recanalization, angioplasty and stenting of arteries was successfully performed in all patients. Restenosis occurred in 13 patients (15%) at 1 year. After 2 years restenosis was revealed in another 4 patients. Primary patency during the first year of follow-up was 74.7 per cent, for 2 years - 72%. Secondary patency after 2-year follow-up after performing balloon angioplasty in patients with restenosis segment was 100%. Fatal complication of retroperitoneal bleeding developed in 1 patient. The overall incidence of complications was 6%. Most patients were discharged after 3 days. We continue to accumulate clinical observation and study long-term results of endovascular treatment of patients with peripheral arterial disease, with the vascular lesions of type D according to TASC II classification.

RUDN Journal of Medicine. 2017;21(2):234-245
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THE ROLE OF INTRAVASCULAR METHODS OF RESEARCH TO VERIFY THE DIAGNOSIS OF CORONARY HEART DISEASE IN WORKERS OF JSC “RUSSIAN RAILWAYS” RELATED TO THE SAFETY OF TRAIN TRAFFIC
Prishchep O.A., Maksimkin D.A., Shugushev Z.K.
Abstract

The purpose of the study was to determine the role of the complex use of FFR and IVUS to verify the diagnosis of coronary heart disease in the examination of the professional suitability of Russian Railways employees, related to safety of train traffic. The study showed that survival rates free of major adverse cardiac events, transient rhythm disturbances, syncopal conditions and repeated hospitalizations for the angina pectoris, in groups with “unchanged” coronary arteries and intermediate stenoses of the coro-nary arteries with FFR negative result were not significantly different in the long-term period and amounted to 100 and 95.2%, respectively (p > 0.05), which makes to consider them as professionally suitable workers and return to work. When comparing this indicator in the subgroups of patients with FFR positive result undergoing stenting under the control of IVUS and patients with FFR negative result receiving optimal medical therapy, there were also no significant differences (97.3 and 95.2%, respectively, p > 0.05), which makes it possible to swich workers who have undergone stenting to "light" work, not related to the safety of train traffic.

RUDN Journal of Medicine. 2017;21(2):246-258
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RISK FACTORS AND ECHOCARDIOGRAPHIC DIAGNOSIS OF PULMONARY HYPERTENSION IN CHILDREN WITH BRONCHOPULMONARY DYSPLASIA
Degtyareva E.A., Ovsyannikov D.Y., Zaitseva N.O., Shokin A.A.
Abstract

Pulmonary hypertension and pulmonary heart are severe complications of broncho-pulmonary dysplasia, accompanied by poor prognosis and high mortality. Based on Doppler echocardio-graphy in 100 children with bronchopulmonary dysplasia, the frequency of pulmonary hypertension de-velopment and pulmonary heart formation was determined. The risk factors for these complications and mortality outcomes have been defined. The quantitative evaluation of the informative value of electro-cardiographic, radiographic, computer tomographic signs of pulmonary hypertension in children with bronchopulmonary dysplasia was performed. The correspondence of the functional classes of pulmonary hypertension in the Panamanian classification of hypertensive vascular lung disease in children (2011) to the degree of increase in systolic pressure in the pulmonary artery and the severity of hypoxemia was defined.

RUDN Journal of Medicine. 2017;21(2):259-269
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SHORT- AND LONG-TERM OUTCOMES OF SELECTIVE PROSTATIC ARTERY EMBOLIZATION IN PATIENT HIGH SURGICAL AND ANESTESILOGICAL RISK
Zharikov S.B., Roslik S.S., Tsymbal E.V., Ivanov V.A., Kochetov A.G., Esipov A.V., Karabach I.V., Khayrutdinov E.R.
Abstract

Prostate artery embolization has garnered much attention as a promising treatment for lower urinary tract symptoms secondary to benign prostatic hyperplasia. Current evidence suggests it is a safe and effective option for patients with medication-refractory urinary obstructive symptoms who are poor surgical candidates or refuse surgical therapy.

RUDN Journal of Medicine. 2017;21(2):270-280
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TRANSRADIAL ACCESS TO TREATMENT OF PATIENTS WITH ACS: STILL TRAINING OR ALREADY ROUTINE PRACTICE?
Majskov V.V., Meraj I.A., Mil'to A.S., Sharapova O.V., Kobalava Z.D., Moiseev V.S.
Abstract

The article is devoted to the study of a one-center experience of routine application of transradial access (TRD) by default in the treatment of patients with ACS in a short-term clinic, which has neither a vascular or cardiovascular surgery department. The experience of treatment of 3436 patients with acute coronary syndrome was analyzed, of which 72.64% were patients with acute myocardial infarc-tion. The use of TRD was considered successful in the case of completion of the procedure of stenting through the arm without the need for conversion of arterial access to the thigh. By default, right transradial access was used, except for cases of known anamnesis of mammarocoronary shunting. Time for puncture of the radial artery, installation of the introducer and catheterization of the arch of the aorta was 2.8 - 1.1 min. The average duration of fluoroscopy was 13.36 ± 8.86 minutes. The immediate success of the intervention, performed by transradial access, was 98%, of which the need for conversion to contralateral access was in 6.5% of patients. In total, two patients developed access point hematomas, which required the transfusion of blood components, managed to stop bleeding conservatively, in no case did vascular surgeons need help.

RUDN Journal of Medicine. 2017;21(2):281-288
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APPLICATION PRACTICE OF THE ORDER OF THE RUSSIAN MINISTRY OF HEALTH IN THE ORDER OF THE ORGANIZATION OF SANATORIUM TREATMENT (on the example of sanatorium for children)
Shipova V.M., Berseneva E.A., Gadzhieva S.M.
Abstract

The analysis of recommendations of the Russian Ministry of Health about regular provid-ing the sanatorium organizations is provided to publications, reducing standard number of average and associate health workers is shown.

RUDN Journal of Medicine. 2017;21(2):289-294
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METHODICAL APPROACHES TO THE IMPLEMENTATION OF PLANNING AND FORECASTING IN THE REFORM OF HEALTH
Zudin A.B.
Abstract

Article is devoted to analysis of models and methods for planning and forecasting in the reform of health care. Approaches to strategic planning and forecasting are shown by the example of the Federal program of the state guarantees of rendering to citizens of the Russian Federation of free medical aid.

RUDN Journal of Medicine. 2017;21(2):295-303
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STAGES OF MEDICAL AND SOCIAL SUPPORT OF RESERVE OFFICERS (RETIRED)
Popov A.V.
Abstract

The data obtained during the survey of 574 reserve officers (retired) indicates that about half of them need rehabilitation. At the same time, rehabilitation programs should be maximally adapted and personified depending on the adaptation potential. The developed three-stage system of medical and so-cial care to military reserve officers (retired) and the algorithm for its implementation including the rules for intra-departmental cooperation is described in the article.

RUDN Journal of Medicine. 2017;21(2):304-311
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INTERVENTIONAL STRATEGY FOR CLINICALLY SIGNIFICANT THROMBOSIS OF THE SUPERIOR VENA CAVA AND BRACHIOCEPHALIC VEIN
Vasiliev A.E., Margolin O.V., Karagyulyan S.R., Rogov D.A., Gitelzon D.G., Vasiliev M.A., Gitelzon E.A.
Abstract

Superior vena cava syndrome (SVCS) is a relatively common complication of malignant mediastinal tumors and can cause severe functional impairment. Over the past 20 years, in addition to the conventional management of the disease, interventional treatment of this syndrome has become a viable option for alleviating the symptoms of SVCS. Thus, multidisciplinary care can maximize the effectiveness of treatment for patients with SVCS.

RUDN Journal of Medicine. 2017;21(2):312-315
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