METHOD FOR ENDOVASCULAR CORRECTION OF NO-REFLOW PHENOMENON IN PATIENTS WITH ACUTE CORONARY SYNDROME WITH ST-SEGMENT ELEVATION DURING PRIMARY PERCUTANEOUS CORONARY INTERVENTION OF CULPRIT ARTERY

摘要

FIELD: medicine.;SUBSTANCE: method involves performing coronary angiography, detecting an acute thrombotic occlusion or stenosis, measuring the artery diameter and distal blood flow by grading a degree of restoration of a coronary blood flow and myocardial perfusion. A 0.014-inch coronary guide wire is inserted into the distal culprit artery, which is followed by thromboaspiration from the culprit artery through the guide wire by means of a thrombus aspiration device. An aspiration catheter is attached to a Y-connector and delivered along the first coronary guide wire to the culprit artery thrombus; the second coronary guide wire is inserted through the main trunk; the second coronary guide is used to deliver a coronary balloon having the diameter and length of no more than 1.5×10 mm and a delivery length of not less than 1,500 mm behind the thrombotic occlusion; the balloon is inflated at a nominal pressure in the distal culprit artery. The thrombus is aspirated through the secondary passage of the Y-connector. The coronary guide wire is taken out of the main trunk of the coronary balloon; a vasodilator solution is administered through the main trunk; that is combined with intravenous bolus dosing of an eptifibatide solution 180 mcg/kg. After the blood flow and myocardial perfusion restore, the culprit artery is stented.;EFFECT: method makes it possible to increase the therapeutic effect of the surgery, provide distal branches protection against migration of residual thrombotic masses, as well as enable the single-step balloon angioplasty of a destabilised atheromatosis plaque or parietal small thrombotic masses.;7 dwg, 1 ex