rentradВестник рентгенологии и радиологииJournal of radiology and nuclear medicine0042-46762619-0478Limited Liability Company "LUCHEVAYA DIAGNOSTIKA", Russian Association of Radiologists10.20862/0042-4676-2015-0-1-34-39rentrad-5Research ArticleКЛИНИЧЕСКИЕ НАБЛЮДЕНИЯПрименение мануальной тромбоэкстракции при чрескожном коронарном вмешательстве у больного с инфарктом миокарда с подъемом сегмента ST типа 2Clinical case of using manual thrombus aspiration during percutaneous coronary intervention in a patient with ST-segment elevation myocardial infarction type 2МироновВ. М.MironovV. M.

кардиолог

Cardiologist;

ТерещенкоА. С.TereshchenkoA. S.

кардиолог

Cardiologist

МеркуловЕ. М.MerkulovE. V.

д. м. н., ст. науч. сотр. отдела рентгеноэндоваскулярных методов диагностики и лечения

MD, PhD, DSc, Senior Research Associate of Department of Endovascular Diagnosis and Treatment

СамкоА. Н.SamkoA. N.

д. м. н., профессор, руководитель отдела рентгеноэндоваскулярных методов диагностики и лечения

MD, PhD, DSc, Professor, Head of Department of Endovascular Diagnosis and Treatment

Институт клинической кардиологии им. А.Л. Мясникова ФГБУ «Российский кардиологический научно-производственный комплекс» Министерства здравоохранения РФРоссияInstitute of Clinical Cardiology, Russian Cardiology Research-and-Production Complex, Ministry of Health of the RFRussian Federation201527022016013439Copyright © Миронов В.М., Терещенко А.С., Меркулов Е.М., Самко А.Н., 20162016Миронов В.М., Терещенко А.С., Меркулов Е.М., Самко А.Н.Mironov V.M., Tereshchenko A.S., Merkulov E.V., Samko A.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.russianradiology.ru/jour/article/view/5

Представлен клинический случай лечения больного, поступившего в Институт клинической кардиологии им. А.Л. Мясникова с диагнозом «острый коронарный синд-ром с подъемом сегмента ST». На догоспитальном этапе больному выполнялась тромболитическая терапия, без эффекта, в отделе рентгеноэндоваскулярных методов диагностики и лечения ИКК им. А.Л. Мясникова через 3,5 ч от начала заболевания проведено чреcкожное коронарное вмешательство. Неоднократно выполнялась тромбоэкстракция из инфарктсвязанной артерии, что позволило добиться хорошегоангиографического результата. Из анамнеза известно, что больной длительное время страдает постоянной формой мерцательной аритмии. В 2010 и 2011 гг. имели место преходящие нарушения мозгового кровообращения. Отсутствие стенозов в коронарных артериях после удаления тромба, характер аспирированного тромба позволили заподозрить тромбоэмболический генез развития инфаркта миокарда.

The paper describes a patient admitted to the Emergency Cardiology Department, A.L. Myasnikov Institute of Clinical Cardiology, for diagnosed ST-segment elevation acute coronary syndrome. At the prehospital stage, the patient received ineffective thrombolytic therapy; percutaneous coronary intervention was made at the Department of X-ray  Endovascular Diagnostic and Treatment Methods of the Institute 3.5 hours after disease onset. Repeated thrombus aspirations from the infarction-related artery were carried out, which could have a good angiographic pattern. His medical record shows that thepatient has been suffering from persistent atrial fibrillation for a long time. There is also evidence for transient ischemic attacks in 2010 and 2011. The fact that there are no coronary artery stenoses after thrombus removal could suspect the thromboembolicgenesis of myocardial infarction.

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