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Abstract:

Two clinical cases of treatment of spontaneous hematomas in elderly patients with COVID-19 using endovascular diagnostic and treatment methods are presented.

Aim: was to show the effectiveness of endovascular hemostasis and, in some cases, there is no alternative to the use of other techniques.

Material and methods: we presented two clinical cases and analyzed the work of domestic and foreign authors on the prevention of venous thrombosis in patients with COVID-19 and endovascular treatment of spontaneous hematomas in patients with COVID-19.

Results: article describes two case reports of catheter embolization in patients with spontaneous hematoma during treatment of severe COVID-19. Elderly patients underwent prevention of thromboembolic complications with low-molecular-weight anticoagulants in prophylactic dosages; during therapy, soft tissue hematomas were revealed in one case in abdominal wall, in the other in chest. In both cases, conservative treatment was ineffective; bleeding required transfusion of blood components. In both cases, embolization was effective, and patients' condition stabilized. In one case, the progression of respiratory failure led to death, the second patient was discharged for out-patient treatment.

Conclusion: catheter embolization for arterial bleeding can be used as monotherapy or as a stage of stabilizing the patient before open surgical treatment.

 

Abstract:

Background: mortality in polytrauma with pelvic injuries and intrapelvic bleeding remains high and can be reduced through a multidisciplinary approach to hemostasis.

Aim: was to determine possibilities and tactics of using endovascular interventions to stop intrapelvic bleeding in polytrauma with pelvic injuries.

Material and methods: a search was made for scientific articles in the PubMed database and the Scientific Electronic Library (eLIBRARY.ru), published from 2017 to 2021. Transcatheter embolization of pelvic arteries is an effective method for stopping intrapelvic bleeding and is indicated for detecting extravasation of contrast in computed tomography and angiography. In patients with unstable hemodynamics, embolization can be used if it is possible to perform it no later than 30-60 minutes after the detection of intrapelvic bleeding. Resuscitation endovascular balloon occlusion of the aorta can serve as an important component of the damage control strategy and a bridge to the application of methods for the final control of abdominal and intrapelvic bleeding in patients with unstable hemodynamics and systolic blood pressure less than 70 mm hg.

Conclusion: methods of endovascular surgery do not oppose and do not exclude the use of extraperitoneal pelvic packing and/or external fixation of the pelvis to stop intrapelvic bleeding in case of polytrauma. The choice of methods of hemostasis and the algorithm for their application are determined by the degree of hemodynamic disturbances, the presence of combined injuries, the data of radiation diagnostics, and the technical and logistical resources of the trauma center.

 

Abstract:

Background: coronavirus disease is characterized by hypercoagulation and requires treatment with anticoagulants. At the background of anticoagulant therapy, life-threatening soft tissue bleeding may occur.

Aim: was to evaluate the efficacy of transcatheter arterial embolization in patients with severe COVID-19 complicated by soft tissue bleeding.

Materials and methods: within the period from January 30, 2021 to February 18, 2022, transcatheter arterial embolization of soft tissue bleeding was performed in 25 patients with COVID-19-associated pneumonia.

Results: transcatheter arterial embolization was performed in 19 of 25 patients (76%). Postoperative mortality was 42%, and overall mortality was 40%. Fifteen patients (60%) were discharged in satisfactory condition.

Conclusions: severe soft tissue bleeding may occur in patients with coronavirus disease while treated with anticoagulants. The method of choice for treatment of these hemorrhages is transcatheter arterial embolization.

 

 

Abstract:

In interventional radiology department of clinical hospital № 27 (Moscow) since 2002 till 2009 TIPS was performed in 62 patients for hepatic cirrhosis with portal hypertension. One of the patients underwent orthotopic liver transplantation in Germany.
Material and methods. Mean age in the group was 5f ,6 y. o., 17 women, 45 men. Three types of stents were used: matrix stents, self-expanding and stent-grapfts. Patients were divided in 2 groups. In Group 1 (17 pts) we performed TIPS with stent-grafts (Gore Viatorr TIPS Endoprosthesis); in Group 2 (47 pts) bare metal stents were used (matrix stents Perico, Genesis, JoMed and self-expanding stents Za-stent, Zilver, Wallstent, sinus-SuperFlex Visual-Stent, SMART-control).
Results. During 18 months follow-up there were no thrombosis, significant stenosis in patients of Group 1, and primary patency rate was 100%. In Group 2 primary and secondary patency rates were 69,3% and 85,6% correspondingly. Freedom from recurr­ ent esophageal varices hemorrhage was 82,8% in Group 1 and 69,3% in Group 2, ascitis and hydrothorax regression - 93,9% and 80,0%, absence of hepatic cerebropathy progression - 93,9% and 80,0%, overall survival - 87,8% и 76,0% correspondingly.
Conclusions. Therefore use of stent-graft in TIPS procedure improve patency of intrahepatic shunt (p < 0,01), significantly reduce risk of recurrent variceal hemorrhage (0,1 < p < 0,5), and reduce volume of ascitis (0,1 < p < 0,5). It worth saying that cerebropathy progression was caused by non-compliance to diet, and was corrected with medicamental treatment. In long-term follow-up stent­ graft «Viatorr» deployment improves survival of patients (0,1 < p < 0,5). Introduction of stent-grafts marked a new stage of TIPS pro­ cedure improvement.


 

Abstract:

Introduction: the main indicator that determines the prognosis of cancer is the degree of prevalence of tumor process at the time of detection. In terms of the growth of primary morbidity among urological cancers, bladder cancer ranks third, and prostate cancer is second. Treatment of patients in advanced stages is palliative and aimed at improving the quality of life and increasing its duration.

Bleeding from the bladder or prostate in such cases is a life-threatening complication and one of the most common causes of death in advanced cancer.

Aim: was to evaluate the effectiveness of embolization of arteries of the bladder and prostate in cancer patients with bleeding from the lower urinary tract as a preparatory stage for the subsequent specialized therapy of the oncological process.

Materials and methods: from 2019 to August 2021, 38 embolizing interventions were performed in 36 patients with recurrent bleeding from the bladder with ineffective conservative hemostatic therapy. Of these, there were 30 men and 6 women. The average age was 63 ± 2,6 years. All patients at the prehospital stage were diagnosed with pelvic cancer with invasion of the bladder wall without the possibility of radical treatment. Particles with a size of 300-500 µm, embolization coils and fragmentated hemostatic sponge were used for embolization.

Results: immediate angiographic success in the form of stagnation of blood flow through the target arteries was achieved in 100% of operations. In most cases, the relief of macrohematuria was achieved at day 4 (average values of erythrocytes in urine are 3,66 in p/sp). 2 patients (5,6%) underwent a second endovascular intervention during hospitalization due to the many small afferents suppluying the bladder tumor from the a. pudenta interna. Bleeding stopped in these patients by the 8th day of hospital stay. The early postoperative period in 100% of patients was accompanied by mild postembolization syndrome, which was stopped by symptomatic therapy within 24 hours.

Conclusions: endovascular embolization in patients with oncopathology using the superselective technique has shown efficacy in stopping urological oncological bleeding, allows to achieve stable hemostasis in a short time and to continue specific treatment of cancer in patients of the 2nd clinical group.

  

References

1.     Kaprin AD, Starinskiy VV, Shakhzadova AO. The state of cancer care for the population of Russia in 2019. - M.: MNIOI them. P.A. Herzen - branch of the Federal State Budgetary Institution "National Medical Research Center of Radiology" of the Ministry of Health of Russia. 2020. - ill. – 239 [In Russ].

2.     Schuhrke TD, Barr JW. Intractable bladder hemorrhage: therapeutic angiographic embolization of the hypogastric arteries. J Urol. 1976; 116(4): 523-525.

https://doi.org/10.1016/s0022-5347(17)58892-8

3.     Granov AM, Karelin MI, Tarazov PG. X-ray endovascular surgery in oncourology. Bulletin of roentgenology and radiology. 1996; 1: 35-37 [In Russ].

4.     Taha DE, Shokeir AA, Aboumarzouk OA. Selective embolisation for intractable bladder haemorrhages: A systematic review of the literature. Arab J Urol. 2018; 16(2): 197-205.

https://doi.org/10.1016/j.aju.2018.01.004

5.     Mohan S, Kumar S, Dubey D, et al. Superselective vesical artery embolization in the management of intractable hematuria secondary to hemorrhagic cystitis. World J Urol. 2019; 37(10): 2175 - 2182.

https://doi.org/10.1007/s00345-018-2604-0

6.     Tibilov AM, Baymatov MS, Kulchiev AA, et al. Arterial embolization in the treatment of inoperable bladder tumors complicated by bleeding. Materials of the V Russian Congress of Interventional Cardioangiologists. 2013; 35: 79 [In Russ].

7.     Bilhim T, Pisco JM, Tinto HR, et al. Prostatic arterial supply: anatomic and imaging findings relevant for selective arterial embolization. J. Vasc. Interv. Radiol. 2012; 23 (11): 1403-1415.

https://doi.org/10.1016/j.jvir.2012.07.028

8.     Bilhim T, Pereira JA, Tinto HR, et al. Middle rectal artery: myth or reality? Retrospective study with CT angiography and digital subtraction angiography. Surg Radiol Anat. 2013; 35(6): 517-522.

https://doi.org/10.1007/s00276-012-1068-y

9.     Korkmaz M, Sanal B, Aras B, et al. The short- and long-term effectiveness of transcatheter arterial embolization in patients with intractable hematuria. Diagn Interv Imaging. 2016; 97: 197-201.

https://doi.org/10.1016/j.diii.2015.06.020

10.   Liguori G, Amodeo A, Mucelli FP, et al. Intractable haematuria: long-term results after selective embolization of the internal iliac arteries. BJU Int. 2010; 106: 500-503.

https://doi.org/10.1111/j.1464-410X.2009.09192.x

 

11.   Karpov VK, Kapranov SA, Shaparov BM, Kamalov AA. Superselective embolization of urinary bladder arteries in the treatment of recurrent gross hematuria in bladder tumors. Urology. 2020; 5: 133-138 [In Russ].

https://doi.org/10.18565/urology.2020.5.133-138

 

Abstract:

Article presents a case report of a 38-year-old patient who was admitted to our hospital with symptoms of acute appendicitis, she was examined and then urgently operated.

Postoperative period was complicated by clinical picture of colonic bleeding. During 1 st day of postoperative period, patient underwent a diagnostic search of bleeding source, conservative hemostatic therapy, transfusion of blood components, however, taking into consideration negative dynamics of patient's condition, laboratory test indicators, the next day, she was urgently operated: lower midline laparotomy, suturing of cecum hematoma, drainage of the abdominal cavity. Eight hours after repeated surgical treatment, against the background of transfusion of blood components, further negative dynamics of patient's condition, laboratory test indicators also worsened, medical concilium decided to perform angiography, followed by a decision on the amount of treatment intraoperatively. Selective angiography of branches of the mesenteric artery was performed, the source of bleeding was diagnosed, and a successful temporary pharmacologic endovascular hemostasis of the branch of the superior mesenteric artery was performed. Post-hemorrhagic anemia in the patient was corrected on the 3rd day after endovascular intervention, 10 days after, patient was discharged in a satisfactory condition.

The choice of the method of endovascular intervention was carried out taking into consideration the ineffective of reoperation, patient's condition, as well as peculiarities of the blood supply to the area of the alleged source of bleeding.

The study also discusses indications and methods of endovascular treatment of colonic bleeding.

 

 

References

1.     Avdos'ev JuV, Belozerov IV, Kudrevich AN. Endovascular methods for the diagnosis and treatment of acute bleeding into the lumen of the gastrointestinal tract. Novostihirurgii. 2018; 26 (2): 169-178 [In Russ].

2.     Soh B, Chan S. The use of super-selective mesenteric embolisation as a first-line management of acute lower gastrointestinal bleeding. Annals of Medicine and Sur­gery. 2017; 17: 27-32.

3.     Avdos'ev JuV, Bojko W. Angiography and endovascular abdominal bleeding. Ukraina: Savchuk. 2011; 648. [In Russ].

4.     Tan К К, Wong D, Sim R. Superselective Embolization for Lower Gastrointestinal Hemorrhage: An Institutional Review Over 7 Years. World J Surg. 2008; 32:2707-2715.

http://doi.org/10.1007/s00268-008-9759-6

5.     Annamalai G, Masson N, Robertson I. Acute gastrointestinal haemorrhage: investigation and treatment. Imaging. 2009; 21(2): 142-151.

6.     Urbano J, Manuel Cabrera J, Franco A, Alonso-Burgos A. Selective arterial embolization with ethylenevinyl alcohol copolymer for control of massive lower gastrointestinal bleeding: feasibility and initial experience. J Vase I nterv Radiol. 2014; 25: 839-846.

7.     Walker TG, Salazar GM, Waltman AC. Angiographic evaluation and management of acute gastrointestinal hemorrhage. World J Gastroenterol. 2012;18 (11): 1191-1201.

http://doi.org/10.3748/wjg.v18.i11.1191

8.     Jang Bl. Lower gastrointestinal bleeding: is urgent colonoscopy necessary for all hematochezia? Clinical Endosc. 2013; 46: 476-479.

9.     Green ВТ, Rockey DC, Portwood G et al. Urgent colonoscopy for evaluation and management of acute lower gastrointestinal hemorrhage: a randomized controlled trial. Am J Gastroenterol. 2005; 100: 2395-2402.

10.   Loffroy R, Falvo N, Nakai M et al. When all else fails - radiological management of severe gastrointestinal bleeding. Best Practice & Research Clinical Gastroenterology. 2019; 1-9.

http://doi.org/10.1016/j.bpg.2019.04.005

11.   Shi Z X, Yang J, Liang H W et al. Emergency transcatheter arterial embolization for massive gastrointestinal arterial hemorrhage. Medicine. 2017; 96(52): 9437.

http://doi.org/10.1097/md.0000000000009437

12.   Nanavati S M. What if endoscopic hemostasis fails? Alternative treatment strategies: interventional radiology. Gastroenterol Clin North Am. 2014;43(4): 739-752.

http://doi.org/10.1016/i.gtc.2014.08.013

 

Abstract

Background: ongoing abdominal and pelvic bleeding is one of main causes of deaths among patients with penetrating and blunt trauma. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a method for temporary patient's stabilization and reducing blood loss.

Aim: was to present result of work of 1st-level trauma-center: to describe experience of application of methodics of REBOA in center, to estimate its efficacy on the base of retrospective analysis of hospital charts of injured and heavy damaged patients.

Materials and methods: during the period between April 2013 and November 2017, 14 REBOA procedures to patients with abdominal (thoracic aorta occlusion) and pelvic (occlusion of the aortic bifurcation) bleeding were performed at the War Surgery Department of the «KirovMilitaryMedicalAcademy». A decision to do REBOA was made upon admission according to significant hypotension (systolic blood pressure [sBP] less than 70 mm Hg.) or cardiac arrest, abdominal free fluid and/or mechanically unstable pelvic fractures.

Results: mean time from admission to REBOA was 27,5 [10,0-52,5] minutes. The procedure took 10 [5-13] minutes. Average BP elevation after balloon inflation was 43±16 mm Hg. Survival in acute phase of trauma (first 12 hours) was 57.1%, while total survival rate was only 14.3% (2/14 patients). One REBOA-associated major complication was registered - development of irreversible ischemia due to long sheath dwell time in the femoral artery.

Conclusion: REBOA is effective for temporary hemodynamic stabilization and internal hemorrhage control, it allows increasing early survival in severe trauma. Factors to improve short- and long-term outcome, total survival warrant to be additionally investigated, especially in terms of intensive care improvement.

 

References

1.     Stannard A., Eliason J.L., Rasmussen T.E. Resuscitative endovascular balloon occlusion of the aorta (REBOA) as an adjunct for hemorrhagic shock. J. Trauma. 2011; 71(6): 1869-1872.

2.     Barnard E.B.G., Morrison J.J., Madureira R.M. et al. Resuscitative endovascular balloon occlusion of the aorta (REBOA): a population based gap analysis of trauma patients in England and Wales. Emerg. Med. J. 2015; 32 (12): 926-932.

3.     Brenner M.L., Moore L.J., DuBose J.J. et al. A clinical series of resuscitative endovascular balloon occlusion of the aorta for hemorrhage control and resuscitation. J. Trauma Acute Care Surg. 2013; 75 (3): 506-511.

4.     Moore L.J., Brenner M., Kozar R.A. et al. Implementation of resuscitative endovascular balloon occlusion of the aorta as an alternative to resuscitative thoracotomy for resuscitative balloon occlusion of the aorta (REBOA). J. Trauma Acute Care Surg. 2016; 81 (3): 409-419.

5.     Zavrazhnov A.A. Damage of large vessels of the abdomen: ways to improve diagnosis and treatment: Diss. kand. med. Nauk. St.Petersburg. 1996; 201 [In Russ].

6.     Sadeghi M., Nilsson K.F., Larzon T. et al. The use of aortic balloon occlusion in traumatic shock: first report from the ABO trauma registry. Eur. J. Trauma Emerg. Surg. 2018; 44 (4): 491-501.

7.     Hughes C.W. Use of an intra-aortic balloon catheter tamponade for controlling intra-abdominal hemorrhage in man. Surgery. 1954; 36 (1): 65-68.

8.     DuBose J.J., Scalea T.M., Brenner M. et al. The AAST prospective Aortic Occlusion for Resuscitation in Trauma and Acute Care Surgery (AORTA) registry: Data on contemporary utilization and outcomes of aortic occlusion and resuscitative balloon occlusion of the aorta (REBOA). J. Trauma Acute Care Surg. 2016; 81 (3): 409-419.

9.     Martinelli T., Thoni F., Declety P. et al. Intra-aortic balloon occlusion to salvage patients with life-threatening hemorrhagic shocks from pelvic fractures. J. Trauma. 2010; 68 (4): 942-948.

10.   Brenner M., Hoehn M., Pasley J. et al. Basic endovascular skills for trauma course: bridging the gap between endovascular techniques and the acute care surgeon. J. Trauma Acute Care Surg. 2014; 77 (2): 286-291.

11.   DuBose J., Fabian T., Bee T. et al. Contemporary utilization of resuscitative thoracotomy: results from the AAST aortic occlusion for resuscitation in trauma and acute care surgery (AORTA) multicenter registry. Shock. 2018; 50 (4): 414-420.

12.   Gumanenko E.K. An objective assessment of the severity of injuries. Voenno-medicinskij zhurnal. 1996; 317 (10): 25-34 [In Russ].

13.   Samokhvalov I.M., Reva V.A., Pronchenko A.A., Agliulin V.F. Comparison of the effectiveness of emergency thoracotomy in wounded and injured. Zdorov'e. Medicinskaja jekologija. Nauka. 2012; 1-2 (47-48): 43 [In Russ].

14.   White J.M., Cannon J.W., Stannard A. et al. Endovascular balloon occlusion of the aorta is superior to resuscitative thoracotomy with aortic clamping in a porcine model of hemorrhagic shock. Surgery. 2011; 150 (3): 400-409.

15.     Ogura T., Lefor A.T., Nakano M. et al. Nonoperative management of hemodynamically unstable abdominal trauma patients with angioembolization and resuscitative endovascular balloon occlusion of the aorta. J. Trauma Acute Care Surg. 2015; 78 (1): 132-135

 

Abstract

Background: pancreatic cancer (PC) - oncologic disease with nonsignificant clinics on early stages and tendention of spreadind in population, as a result - late diagnosis and low rate of radical treatment (10-25%). Carried radical treatment, such as pancreaticoduodenectomy (PDE) - has a high risk of postoperative complications (30-70%) due to its difficulty Most often and dangerous complications are: bleeding, anastomotic leakage, postoperative pancreatitis, purulent complications. Bleeding occurs in 5-10% of cases, mortality varries between 30,7% and 58,5% according to moderd literature. "Sentinel bleeding" - term that meand non-fatal bleeding through drainage or gastrointestinal bleeding (GIB) that follows PDE, and is a predictor of further massive fatal bleeding. Material and methods: article presents data of patient (male, 64y) who underwent gastropancreaticoduodenectomy (GPDE) through bilateral hypochondriacal access as treatment of moderate differentiated (MD) ductal adenocarcinoma of pancreatic head. On 21st day after surgery - massive GIB with source of bleeding as pseudoaneurysm of right hepatic artery Taking into consideration "adverse anatomy", impossibility of stent-graft implantation and failure of primary embolization with "front-to-back-door" technique - against the background of reccurent bleeding, patient undewent coiling of pseudoaneurysm and subseqent coil implantation into right hepatic artery anc common hepatic artery Against the background of second reccurency of GIB - patient underwent successful "front-to-back-door" embolization with combinaton of coils and Onyx.

Results: technique of «front-to-back-door» embolization led to stable hemostasis and patient's discharge in satisfactory condition without recurrence of bleeding.

Conclusions: surgical hospital, carrying on resections of pancreas as a routine, should have a CathLab unit, equipped with wide specter of angiografic instruments and 24/7 surgical team with experience of hemostatic interventions. Bleeding after PDE should be considered as «sentinel bleeding». In case of side-injury of large vessels - stent-graft implantation is preferable, if it is impossible - "front-to-back-door" embolization should be used. 

 

References

1.      Barannikov AYU, Sahno VD. Actual problems of the surgical treatment of diseases of organs of the biliopancreatoduodenal region. Kubanskij nauchnyj medicinskij vestnik. 2018; 25(1): 143-154. DOI: 10.25207/1608-62282018-25-1-143-154. [In Russ.]

2.      Kubyshkin VA, Vishnevskij VA. Pancreatic cancer. M.: ID Medpraktika-M; 2003. 386 s. [In Russ.]

3.      Egorov VI. Treatment of pancreatic cancer. V kn.: Gal'perin E.I., Dyuzheva T.G., redaktory. Lekcii po gepatopankreatobiliarnoj hirurgii. M.: Vidar-M; 2011. 449478. [In Russ.]

4.      Putov NV, Artem'eva NN, Kohanenko NYU. Pancreatic cancer.SPb.: Piter; 2005, 416 s. [In Russ.]

5.      Rasulov RI, Hamatov RK, Songolov GI, Zemko MV. Complex treatment of patients with locally spread cancer of pancreatic head. Annaly hirurgicheskoj gepatologii. 2013; 18(2): 75-89. [In Russ.]

6.      Malignant neoplasms in Russia in 2013 (incidence and mortality) pod red. A.D. Kaprina, V.V. Starinskogo, G.V. Petrovoj M., 2015. p. 36. [In Russ.]

7.      Malignant neoplasms in Russia in 2014 (incidence and mortality) pod red. A.D. Kaprina, V.V. Starinskogo, G.V. Petrovoj M., 2016. p. 36. [In Russ.]

8.      Malignant neoplasms in Russia in 2015 (incidence and mortality) pod red. A.D. Kaprina, V.V. Starinskogo, G.V. Petrovoj M., 2017. p. 36. [In Russ.]

9.      Malignant neoplasms in Russia in 2016 (incidence and mortality) pod red. A.D. Kaprina, V.V. Starinskogo, G.V. Petrovoj M., 2018. p. 36. [In Russ.]

10.    Malignant neoplasms in Russia in 2017 (incidence and mortality) pod red. A.D. Kaprina, V.V. Starinskogo, G.V. Petrovoj M., 2018. p. 36. [In Russ.]

11.    Onopriev VI, Korot'ko GF, Rogal' ML, Voskanyan SE. Pancreatoduodenal resection. Aspects of surgical technique, functional implications. Krasnodar: OOO «Kachestvo»; 2005. 135 s. [In Russ.]

12.    Patyutko YUI, Kotel'nikov AG. Surgery for cancer of organs of biliopancreatoduodenal zone. M.: Medicina; 2007. 448 c. [In Russ.]

13.    Patyutko YUI, Kudashkin NE, Kotel'nikov AG. Various types of pancreatodigestive anastomoses in pancreatoduodenal resection. Annaly hirurgicheskoj gepatologii. 2013; 18 (3): 9-14. [In Russ.]

14.    Propp AR. Diagnosis and surgical treatment of chronic pancreatitis with damage to the head of the pancreas. Annaly hirurgicheskoj gepatologii. 2013; 18(1): 103-151.

15.    Winter JM, Cameron JL, Campbell KA, et al. 1423 pancreaticoduodenectomies for pancreatic cancer: A single-institution experience. J. Gastrointest. Surg. 2006; 10(9): 1199-1210. DOI: 10.1016/j.gassur. 2006.08.018.

16.    Veligockij NN, Veligockij AN, Arutyunov SE. Experience of 200 pancreatoduodenectomy - assessment of various options for anastomoses. Annaly hirurgicheskoj gepatologii. 2015; 20(1): 100-105. [In Russ.]

17.    Egorov VI, Vishnevskij VA, Kozlov IA, et al Results of standard and expanded pancreatoduodenal resection with ductal adenocarcinoma of the pancreas. Annaly hirurgicheskoj gepatologii. 2008; 13(4): 19-32. [In Russ.]

18.    Rogal' ML, YArcev PA, Vodyasov AV. Distal loop pancreatoenteroanastomosis in pancreatoduodenal resection.2014; 19(2): 14-18. [In Russ.]

19.    Lai ECH, Lau SHY, Lau WY. Measures to prevent pancreatic fistula after pancreatoduodenectomy: a comprehensive review. Arch. Surg. 2009; 144(11): 1074-1080. DOI: 10.1001/archsurg.2009.193. 70.

20.    McEvoy SH, Lavelle LP, Hoare SM, et al. Pancreaticoduodenectomy: expected post-operative anatomy and complications. Br. J. Radiol. 2014. Vol. 87. P. 1-8.

21.    Kabanov MYU, Semencov KV, YAkovleva DM, Alekseev VV. The state of the development of pancreatic fistula in patients who underwent pancreatoduodenal resection. VestnikNMHC im. Pirogova N.I. 2017 T. 12 № 2. S. 112-116. [In Russ.]

22.    Darnis B, Lebeau R, Chopin-Laly X, Adham M. Postpancreatectomy hemorrhage (PPH): predictors and management from a prospective database. Langenbecks Arch. Surg. 2013. Vol. 398. P. 441-448.

23.    Kabanov MYU, Semencov KV, YAkovleva DM, Alekseev VV. Bleeding after pancreatoduodenal resections. Vestnik Nacional'nogo mediko-hirurgicheskogo Centra im. N.I. Pirogova 2018, t. 13, № 2. C138-140. [In Russ.]

24.    Rogal' ML, Ivanov PA, YArcev PA, et al. Results of pancreatoduodenal resection in a specialized department of a multidisciplinary hospital. Zhurnal im. N.V. Sklifosovskogo Neotlozhnaya medicinskaya pomoshch'. 2016. №1. S. 54-58. [In Russ.]

25.    Wente, M.N., Veit, J.A., Bassi, C . et al. Postpancreatectomy hemorrhage (PPH)-An International Study Group of Pancreatic Surgery (ISGPS) definition. Surgery. 2007. Vol. 142. P. 20-25.

26.    Ramacciato, G., Mercantini, P., N. Petrucciani, G.R., Nigri, A., Kazemi, M., Muroni, M., Del Gaudio, A,. Balesh, M., Cescon, A., Cucchetti, and M. Ravaioli (2011). Risk factors of pancreatic fistula after pancreaticoduodenectomy: a collective review. The American surgeon 77, 257-69.

27.    Brodsky JT, Turnbull AD. Arterial hemorrhage after pancreatoduodenectomy. The ‘sentinel bleed’. Arch Surg 1991;126 (8):1037-1040.

28.    Treckmann J1, Paul A, Sotiropoulos GC, et al. Sentinel bleeding after pancreaticoduodenectomy: a disregarded sign. J Gastrointest Surg. 2008 Feb;12(2):313-8. Epub 2007 Oct 20.

29.    Kriger AG, Kubyshkin VA, Karmazanovskij GG, et al. Postoperative pancreatitis during surgical interventions on the pancreas. Hirurgiya 2012; 4: 14-19.2. [In Russ.]

30.    Kubyshkin VA, Kriger AG, Vishnevskij VA, et al. Pancreatectomy for pancreatic tumors. Hirurgiya. 2013. №3.   S. 11-16. [In Russ.]

31.    Lai EC, Lau SH, Lau WY Measures to prevent pancreatic fistula after pancreatoduodenectomy: a comprehensive review. Arch Surg 2009; 144: 11: 1074-1180.

32.    de Castro S, Kuhlmann KFD, Busch ORC, et al. (2005) Delayed massive hemorrhage after pancreatic and biliary surgery: embolization or surgery? Ann Surg 241: 85-91.

33.    Iatrogenic and non-iatrogenic trauma. Casebased discussion. Marie Cerna. Cirse 2015.

  

Abstract:

Background: we present a literary review of foreign articles on the strategy of treating of patients with blunt abdominal trauma and/or pelvic fractures, without laparotomic access using endovascular diagnosis and treatment.

Aim: was to analyze the modern approach in the diagnosis and treatment of arterial bleeding Г patients with blunt abdominal trauma and/or pelvic fractures according to literary sources. Materials and methods: article reviewed 3 studies, 1 literary review of articles by foreign authors and guidelines of the Eastern Association of Traumatology

Results: computed tomography with contrast enhancement was the method of choice for diagnosing blunt abdominal trauma and pelvic fractures, endovascular treatment of arterial hemorrhage has proven its effectiveness and is increasingly included in routine practice in both hemodynamically stable patients and patients with unstable hemodynamics.

Conclusion: catheter embolization for arterial bleeding can be used as monotherapy or as a stage of stabilizing the patient before open surgical treatment.

 

References

1.      Hrupkin VI, Hanevich MD, Zubrickij VF i dr. Urgent endovascular surgery in gastroduodenal bleeding. Petrozavodsk: Izd-vo «IntelTek», 2002 [In Russ].

2.      Health Topics: Injuries, World Health Organization. 2015. ISBN 978 92 4 156506 6.

3.      Upadhyaya P. Splenic trauma in children J. Surg. Gynecol. Obsted. 1968; 126(8): 781 - 790. PMID:5643159.

4.      Stylianos S. Evidence-based guidelines for resource utilization in childrenwith isolated spleen or liver injury. The APS A Trauma J. Pediatr. Surg. 2000; 35 (2): 164-167. PMID:10693659

5.      Stylianos S. Compliance with evidence-based guidelines in children with isolated spleen or liver injury: a prospective study J. of Pediatr. Surg. 2002; 37(3): 453 - 456. PMID:11877665.

6.      Mohamed A.Z., Morsi H.A., Ziada A.M., et al. Management of major blunt pediatric renal trauma: single-center experience. J. Pediatr. Urol. 2010; 6(3): 301-305. PMID:19854105. D0I:10.1016/j.jpurol.2009.09.009

7.      Cogbill T.H., Moore E.E., Jurkovich G.J., et al. Nonoperative management of blunt splenic trauma: a multicenter experience. J. Trauma. 1989; 29(10): 1312-1317. PMID:2681805.

8.      Croce M.A., T.C. Fabian, PG. Menke, et al. Nonoperative management of blunt hepatic trauma is the treatment of choice for hemodynamically stable patients. Results of a prospective trial. Ann. Surg. 1995; 221(6): 744-753. PMID: 7794078

9.      Stassen N.A., BhullarI., Cheng J.D., et al. Nonoperative management of blunt hepatic injury: an Eastern association for the surgery of trauma practice management guideline. J. Trauma Acute Care Surg. 2012; 73(5): PP 288-293. D0I10.1097/TA.0b013e318270160d.

10.    Stassen N.A., Bhullar I., Cheng J.D., et al. Selective nonoperative management of blunt splenic injury: an Eastern association for the surgery of trauma practice management guideline J. Trauma Acute Care Surg. 2012; 73(5): 294-300. PMID:23114484.

11.    Van der Vlies C.H., OlthofD.C., van Delden O.M., et al. Management of blunt renal injury in a level 1 trauma centre in view of the European guidelines Injury. 2012;43(10): 1816-1820. PMID: 21742328.

12.    Karmazanovskij GG, Kokov LS, Stepanova YUA, i dr. Aneurysms of visceral vessels and arrosive bleeding into postnecrotic cysts of pancreas. Annaly hirurgicheskoj gepatologii. 2007; 12(2): 85-95 [In Russ].

13.    Sclafani S.J., Shaftan G.W., Scalea T.M., et al. Nonoperative salvage of computed tomography-diagnosed splenic injuries: utilization of angiography for triage and embolization for hemostasis J. Trauma. 1995; 39(5): 818825. PMID:7473996.

14.    Velmahos G.C., Toutouzas K., Radin R., et al. High success with non-operative management of blunt hepatic trauma: the liver is a sturdy organ. Arch Surg. 2003; 138: 475-480. PMID: 12742948 D0I:10.1001/archsurg. 138.5.475.

15.    Hellins T.E., Morse G., McNabney W.K., et al. Treatment of liver injuries at Level I and II centers in a multi-institutional metropolitan trauma system. J Trauma. 1997; 42: 1091-1096. PMID:9210547

16.    Carrillo E.H., Platz A., Miller FB., et al. Non-operative management of blunt hepatic trauma. Br J Surg. 1998; 85: 461-468. PMID: 9607525 D0I:10.1046/j.1365- 2168.1998.00721.x

17.    Brasel K.J., DeLisle C.M., Olson C.J., et al. Trends in the management of hepatic injury. Am J Surg. 1997; 174: PP 674-677. PMID:9409595.

18.    Coimbra R., Hoyt D.B., Engelhart S., et al. Nonoperative management reduces the overall mortality of Grades 3 and 4 blunt liver injuries. Int Surg. 2006; 91: 251-257. DOI: 10.11648/j.js.20170506.16.

19.    Velmahos G.C., Toutouzas K., Radin R., et al. Nonoperative treatment of blunt injury to solid abdominal organs: a prospective study. Arch Surg. 2003; 138: 844-851. PMID: 12912742 DOI:10.1001/archsurg. 138.8.844.

20.    Mohseni S., et al. The diagnostic accuracy of 64-slice computed tomography in detecting clinically significant arterial bleeding after pelvic fractures. Am Surg. 2011; 77(9): 1176-1182. PMID:21944627.

21.    Stephen D.J., et al. Early detection of arterial bleeding in acute pelvic trauma. J Trauma. 1999; 47(4): 638-642. PMID:10528596.

22.    Brasel K.J., et al. Significance of contrast extravasation in patients with pelvic fracture. J Trauma. 2007; 62(5): 1149-152. PMID: 17495715 DOI:10.1097/ TA.0b013e3180479827 .

23.    Pereira S.J., et al. Dynamic helical computed tomography scan accurately detects hemorrhage in patients with pelvic fracture. Surgery. 2000; 128 (4): 678-685. PMID: 11015102 DOI:10.1067/msy.2000. 108219

24.    Brun J., et al. Detecting active pelvic arterial haemorrhage on admission following serious pelvic fracture in multiple trauma patients. Injury. 2014; 45(1): 101-106. PMID: 23845571 DOI: 10.1016/j.injury 2013.06.011.

25.    Verbeek D.O., et al. Management of pelvic ring fracture patients with a pelvic «blush» on early computed tomography. J Trauma Acute Care Surg. 2014; 76(2): 374-379. PMID:24458044 DOI:10.1097/TA. 0000000000000094

26.    Brown C.V., Kasotakis G., Wilcox A. et al. Does pelvic hematoma on admission computed tomography predict active bleeding at angiography for pelvic fracture? Am Surg. 2005; 71(9): PP 759-762. PMID:16468513.

27.    Fu C.Y, Wang YC., Wu S.C., et al. Angioembolization provides benefits in patients with concomitant unstable pelvic fracture and unstable hemodynamics. Am J Emerg Med. 2012; 30(1): 207-213. PMID:21159470 DOI: 10.1016/j.ajem.2010.11.005

28.    Sarin E.L., Moore J.B., Moore E.E., et al. Pelvic fracture pattern does not always predict the need for urgent embolization. J Trauma: Inj Infect Crit Care. 2005; 58(5): 973-977. PMID:15920411

29.    Salim A., Teixeira P.G., DuBose J., et al. Predictors of positive angiography in pelvic fractures: a prospective study. J Am Coll Surg. 2008; 207(5): 656-662. PMID:18954776 D0I:10.1016/j.jamcollsurg.2008.05.025

30.    Hallinan J.T., Tan C.H., Pua U. et al. Emergency computed tomography for acute pelvic trauma: where is the bleeder? Clin Radiol. 2014; 69(5): 529-537. PMID:24581961 D0I:10.1016/j.crad.2013.12.016.

31.    Cerva Jr D.S., Mirvis S.E., Shanmuganathan K., et al. Detection of bleeding in patients with major pelvic fractures: value of contrast-enhanced CT. AJR Am J Roentgenol. 1996; 166( 1): 131-135. PMID:8571861 D0I:10.2214/ajr. 166.1.8571861.

32.    Dormagen J.B., Totterman A., Roise O., et al. Efficacy of plain radiography and computer tomography in localizing the site of pelvic arterial bleeding in trauma patients. Acta Radiol. 2010; 51(1): 107-116. PMID: 20001476 DOI:10.3109/02841850903286703.

33.    Fu C.Y, Hsieh C.H., WuS.C., et al. Anterior-posterior compression pelvic fracture increases the probability of requirement of bilateral embolization. Am J Emerg Med. 2013; 31(1): 42-49. PMID:22944536 DOI: 10.1016/ j.ajem.2012.05.026

34.    Hagiwara A., Murata A., Matsuda T., et al. The usefulness of transcatheter arterial embolization for patients with blunt polytrauma showing transient response to fluid resuscitation. J Trauma. 2004; 57: PP. 271-276. PMID:15345972

35.    Froberg L., Helgstrand F., Clausen C., et al. Mortality in trauma patients with active arterial bleeding managed by embolization or surgical packing: An observational cohort study of 66 patients. J Emerg Trauma Shock. 2016; 9(3): 107-114. PMID:27512332 DOI:10.4103/0974-2700.185274.

36.    Salcedo E.S., Brown I.E., Corwin M.T., et al. Angioembolization for solid organ injury: A brief review. Int J Surg. 2016; 33: 225-230.

37.    Fu C.Y, Hsieh C.H., Shih C.H., et al. Selective computed tomography and angioembolization provide benefits in the management of patients with concomitant unstable hemodynamics and negative sonography results.World J. Surg. 2012;36(4): PP. 819-825. PMID:22350476 DOI:10.1007/s00268-012-1457-8.

38.    Olthof D.C., van der Vlies C.H., Joosse P., et al. Consensus strategies for the nonoperative management of patients with blunt splenic injury: a Delphi study J. Trauma Acute Care Surg. 2013; 74(6): 1567- 1574.PMID:23694889 DOI:10.1097/TA. 0b013e3182921 627.

39.    Li M., Yu W.K., Wang X.B., et al. Non-operative management of isolated liver trauma. Hepatobiliary Pancreat. Dis. Int. HBPD INT. 2014; 13(5): 545-550. PMID:25308366.

40.    Lin H.L., Lee K.T., Chen C.W., et al. Management of motorcycle accident-related blunt hepatic injury-a different strateg. Am. J. Emerg. Med. 2010; 28(2): 177-182. PMID:20159387 DOI:10.1016/j.ajem.2008.11.001.

41.    Gamanagatti S., Rangarajan K., Kumar A., et al. Blunt abdominal trauma: imaging and intervention. Curr. Problems Diagnostic Radiol. 2015; 44(4): 321-336. PMID:25801463 DOI:10.1067/j.cpradiol.2015.02.005.

42.    Stassen N.A., BhullarI., Cheng, J.D., et al. Nonoperative management of blunt hepatic injury: An Eastern Association for the Surgery of Trauma practice management guideline. Journal of Trauma and Acute Care Surgery. 2015; 73(5): 288-293.

43.    Katsura M., Yamazaki S., Fukuma S., et al. Comparison between laparotomy first versus angiographic embolization first in patients with pelvic fracture and hemoperitoneum: a nationwide observational study from the Japan Trauma Data Bank. Scand J Trauma Resusc Emerg Med. 2013; 21: 82-84. PMID:24299060 DOI: 10.1186/ 1757-7241-21-82.

 

Abstract:

122 cases of gastroesophageal bleeding due to portal hypertension are analyzed in the article. It is shown that transcatheter interventions, as a part of the complex hemostasis strategy, can significantly improve the results. Keeping to algorithms and acting in accordance with protocols developed for any diagnostic procedure or intervention are declared to be crucial to success. The complex approach to profuse bleeding management, that included transcatheter procedures, decreased mortality rate from 72,2% to 22,1% and reduced rebleeding rate from 47,2% to 31,4%. 

 

 

Reference

 

 

1.     Хрупкин В.И., Ханевич М.Д., Зубрицкий В.Ф., Теканадзе А.Н. Неотложная эндоваскулярная хирургия гастродуоденальных кровотечений. Петрозаводск, 2002; 90.

2.     Бабенков Г.Д., Усов С.Н., Глазунов В.К. и др.Результаты лечения больных циррозом печени, осложненного кровотечением. Анналыхирургической гепатологии. 2000; 5 (2): 210-211.

3.     Ерамишанцев А.К., Щерцингер А.Г., Китенко Е.А. и др. Консервативная терапия острых пищеводно-желудочных кровотеченийу больных портальной гипертензией. Клиническая медицина. 1998; 7: 33—37.

4.     Оноприев В.И., Дурлештер В.М., УсоваО.А., Ключников О.Ю. Хирургическое лечение кровотечений из варикозно-расширенных вен пищевода и желудка. Хирургия. 2005; 1: 38-42.

5.     Прокубовский В.И., Черкасов В.А. Результаты эндоваскулярной эмболизации венжелудка у больных с портальной гипертензией. Вестник хирургии. 1993; 712: 16-19.

6.     Акилов Х.А., Хашимов Ш.Х., Девятов А.В.Роль отдельных факторов в патогенезе ВРВП и кровотечений из них у больных циррозом печени. Анналы хирургической гепатологии. 1998; 3 (3): 130.

7.     Пациора М.Д. Хирургия портальной гипертензии. Ташкент. Медицина. 1984; 319.

8.     Петров В.П., Ерюхин И.А., Шемякин И.С. Кровотечения при заболеваниях пищеварительного тракта. М.: Медицина. 1987; 256.

9.     Шалімов О.О., Каліта М.Я., Буланов К.І. таінші. Лікування хворих з ускладненнями цирозу печінки в стадії декомпенсації. Клінічна хірургія. 1997; 3 (4): 4-8.

10.   Ерамишанцев А.К. Развитие проблемы хирургического лечения кровотечений из варикозно-расширенных вен пищевода и желудка. Анналы хирургической гепатологии. 2007; 12 (2): 8-15.

11.   Любинский В.Л., Андреев Г.Н., Оспанов А., Турмаханов СТ. Агрегатное состояние крови и значение его нарушений при кровотечениях портального генеза. Вестник хирургии. 2005; 164 (3): 65-69.

12.   Бойко В.В., Васильев Д.В. Профилактика рецидивов кровотечения из варикозно-расширенных вен пищевода и желудка при циррозе печени. Хірургія України. 2007; 2: 108-113.

13.   Горбузенко Д.В. Лечебная тактика при кровотечениях из варикозно-расширенных вен желудка. Анналы хирургической гепатологии. 2007; 12 (1): 96-101.

 

14.   Щеголев А.А., Шиповский В.Н., Аль-Самбунчи О.А., Шагинян А.К. Эндоскопический и эндоваскулярный гемостаз при кровотечениях из варикозно-расширенных вен пищевода. М.: РГМУ. 2003; 238.

 

15.   Stiegmann G. Update of endoscopic band lig ation therapy for treatment of esophageal varices. Endoscopy. 2003; 35: 5-8.

 

16.   Каримов Ш.И., Ким В.Ф., Ахтаев А.Р. Эндоваскулярная диагностика и катетерная хирургия профузных пищеводных кровотечений у больных с портальной гипертензией. Ташкент. Изд-во Ибн Сина. 1992; 124.

 

 

17.   Kiyosue H., Matsumoto S., Yamada Y. et al.Transportal intravariceal sclerotherapy withN-Butyl-2-Cyanoacrylate for Gastric Varices. J. Vasc. Interv. Radiol. 2004; 15 (5): 505-509.

 

 

18.   Ninoi T., Nakamura K., Kaminou T. et al.TIPS versus transcatheter sclerotherapy forgastric varices. AJR. 2004; 183: 3693-3776.

 

 

19.   Tripathi D., Therapondos G., Jackson E., 29.Redhead D.N., Hayes P.C. The role of thetransjugular intrahepatic portosystemic stent shunt (TIPSS) in the management of bleeding gastric varices: clinical and haemodynamic correlations. Gut. 2002; 51: 270-274.

 

 

20.   Vidal V., Joly L., Perreault P. et al. Usefulnessof transjugular portosystemic shunt in themanagement of bleeding ectopic varices in cirrhotic patients. Cardiovasc. Intervent. Radiol. 2006; 29: 216-219.

 

 

21.   Haciyali M., Genc H., Halici H. et al. Resultsof modifickend sugiura operation in varicealbleeding in cirrhotic and noncirrhotic patients. Hepatogastroenterology. 2003; 50 (51):748-788.

 

 

22.   Wolff M., Hirner A. Current state of portosystemic shunt surgery. Langenbecks. Arch. Surg. 2003; 388 (3): 141-149.

 

 

23.   Hert C., Fisher L., Broering D. et al. Livertransplantation in patients with liver cirrhosisand esophageal bleeding. Langenbecks. Arch. Surg. 2003; 388 (3): 150-154.

 

 

24.   Li M.K., Sunf J.J., Woo K.S. et al. Somatostatinreduces gastric mucosal blood flow in patientswith portal hypertensive gastropathy: a randomized, doubl-blind crossover study. Dig.Dis. Sci. 1996; 41: 2440-2446.

 

25.   Калита Н.Я., Буланов К.И., Весненко А.И.Прогнозирование исхода полостной операции у больных с декомпенсированным пиррозом печени. Клінічна хірургія. 1995; 1: 4—6.

26.   Зубарев П.Н., Котив Б.Н., Хохлов А.В. и др.Выбор способа портокавального шунтирования. Анналы хирургической гепатологии..2000; 3 (3): 23-27.

27.   Борисов А.Е., Рыжков В.К., Кащенко В.А. идр. Малоинвазивные операции в лечениипищеводно-желудочных кровотечений портального генеза. Анналы хирургической гепатологии. 2006; 5 (2): 214.

28.   Зубрицкий В.Ф. Регионарная внутриартериальная перфузия и малоинвазивная рентгенохирургия локальных патологических процессов. Автореф. дис. д-ра мед. наук. С.-Пб., 2000; 43.

29.   Ханевич М.Д., Зубрицкий В.Ф., Овчинников А.А. Эндоваскулярные вмешательства при кровотечениях из варикозно-расширенных вен пищевода и кардиального отдела желудка у больных портальной гипертензией. В кн.: Актуальные вопросы малоинвазивной хирургии. Владимир, 2004; 49-55.

30.   Овчинников А.А. Эндоваскулярный гемостаз при кровотечениях из варикозно-расширенных вен пищевода и желудка у больных портальной гипертензией. Автореф. дис. канд. мед. наук. М., 2004; 25.

31.   Шерцингер А.Г., Жигалова С.Б., Мусин РА. и др. Осложнения после эндоскопических вмешательств у больных с портальной гипертензией. Анналы хирургической гепатологии. 2007; 12 (2): 16-21.

32.   Братусь В.Д. Дифференциальная диагностика и лечение острых желудочно-кишечных кровотечений. Киев: Здоровье. 1991; 272.

33.   Авдосьев Ю.В., Бойко В.В., Лазирский В.А. Рентгенэндоваскулярные методы гемостаза в комплексе хирургического лечения кровотечений из флебэктазий пищевода и кардии, развившиеся на фоне внутрипеченочной и допеченочной портальной гипертензии. Врачебная практика. 2006; 6: 21-30.

 

34.   Ninoi Т., Nishida N., Kaminou Т. et al. Balloon-occluded retrograde transvenous obliteration of gastric varices with gastrorenal shunt: long-term follow-up in 78 patients. AJR. 2005; 184:1340-1346.

 

 

35.   Sugimori K., Morimoto M., Shirato K. et al. Retrograde transvenous obliteration of gastric varices associated with large collateral veins or a large gastrorenal shunt.J. Vasc. Interv. Radiol. 2005; 16: 113-118.

 

 

 

Abstract:

One of the most significant problems in interventional cardiology is a correct drug-support after held procedure. First of all it is the prevention of stent thrombosis - application of anticoagulants and antiaggregants. The variety of these drugs on sale constantly grows - that leads to have clear ideas of their properties.

Article presents the review of clinical researches devoted to the recently appeared and early not used in Russia, drug Angioks (Bivalirudin), which has the same efficiency as well-known drugs, but is more safe.

 

References

1.     Maraganore J.M., Bourdon P., Jablonski J., Ramachandran K.L., Fenton J.W. 2nd. Design and characterization of hirulogs: a novel class of bivalent peptide inhibitors of thrombin. Biochemistry. 1990; 29(30): 7095-101.

2.     Bates S.M., Weitz J.I. Direct thrombin inhibitors for treatment of arterial thrombosis: potential differences between bivalirudin and hirudin. Am. J. Cardiol. 1998; 82(8B): 12P-18P. Review.

3.     Sciulli T.M., Mauro V.F. Pharmacology and clinical use of bivalirudin. Ann. Pharmacother. 2002; 36(6): 1028-41. Review.

4.     Topol E.J., Bonan R., Jewitt D., Sigwart U., Kakkar V.V., Rothman M., de Bono D., Ferguson J., Willerson J.T., Strony J., et al. Use of a direct antithrombin, hirulog, in place of heparin during coronary angioplasty. Circulation. 1993; 87(5): 1622-1629.

5.     Bates E.R. Bivalirudin: an anticoagulant option for percutaneous coronary intervention. Expert. Rev. Cardiovasc. Ther. 2004; 2(2): 153-62. Review.

6.     Bittl J.A., Strony J., Brinker J.A., Ahmed W.H., Meckel C.R., Chaitman B.R., Maraganore J., Deutsch E., Adelman B. Treatment with bivalirudin (Hirulog) as compared with heparin during coronary angioplasty for unstable or postinfarction angina. Hirulog Angioplasty Study Investigators. N. Engl. J. Med. 1995; 333(12): 764-9.

7.     Bittl J.A., Chaitman B.R., Feit F., Kimball W., Topol E.J. Bivalirudin versus heparin during coronary angioplasty for unstable or postinfarction angina: Final report reanalysis of the Bivalirudin Angioplasty Study. Am. Heart. J.2001;142(6): 952-9.

8.     Lincoff A.M., KleimanN.S., Kottke-Marchant K., Maierson E.S., Maresh K., Wolski K.E., Topol E.J. Bivalirudin with planned or provisional abciximab versus low-dose heparin and abciximab during percutaneous coronary revascularization: results of the Comparison of Abciximab Complications with Hirulog for Ischemic Events Trial (CACHET). Am. Heart. J. 2002; 143(5): 847-53.

9.     Lincoff A.M., Bittl J.A., Harrington R.A., Feit F., Kleiman N.S., Jackman J.D., Sarembock I.J., Cohen D.J., Spriggs D., Ebrahimi R., Keren G., Carr J., Cohen E.A., Betriu A., Desmet W., Kereiakes D.J., Rutsch W., Wilcox R.G., de Feyter P.J., Vahanian A., Topol E.J. REPLACE-2 Investigators. Bivalirudin and provisional glycoprotein IIb/IIIa blockade compared with heparin and planned glycoprotein IIb/IIIa blockade during percutaneous coronary intervention: REPLACE-2 randomized trial. JAMA. 2003; 289(7):853-63. Erratum in: JAMA. 2003; 289(13):1638.

10.   Gibson C.M., Morrow D.A., Murphy S.A., Palabrica T.M., Jennings L.K., Stone PH., Lui H.H., Bulle T., Lakkis N., Kovach R., Cohen D.J., Fish P,  McCabe C.H., Braunwald E. TIMI Study Group. A randomized trial to evaluate the relative protection against post-percutaneous coronary intervention microvascular dysfunction, ischemia, and inflammation among antiplatelet and antithrombotic agents: the PROTECT-TIMI-30trial. J. Am. Coll. Cardiol. 2006; 47(12): 2364-73.

11.   Pinto D.S., Stone G.W., Shi C., et al. on behalf of the ACUITY Investigators. Economic evaluation of bivalirudin with or without glycoprotein IIb/IIIa inhibition versus heparin with routine glycoprotein IIb/IIIa inhibition for early invasive management of acute coronary syndromes. J. Am. Coll. Cardiol. 2008; 25: 1758-1768.

12.   Kastrati A., Neumann F.J., Schulz S., Massberg S. et al. Abciximab and heparin versus bivalirudin for non-ST-elevation myocardial infarction. N. Engl. J. Med. 2011; 365: 21: 1980-1989.

13.   Stone G.W., Witzenbichler B., Guagliumi G., Peruga J.Z., Brodie B.R., Dudek D., Kornowski R., Hartmann F., Gersh B.J., Pocock S.J., Dangas G., Wong S.C., Kirtane A.J., Parise H., Mehran R. HORIZONS-AMI Trial Investigators. Bivalirudin during primary PCI in acute myocardial infarction. N. Engl. J. Med. 2008; 358(21): 2218-30.

14.   Mahaffey K.W., Lewis B.E., Wildermann N.M., Berkowitz S.D., Oliverio R.M., Turco M.A., Shalev Y., Ver Lee P., Traverse J.H., Rodriguez A.R., Ohman E.M., Harrington R.A., Califf R.M. ATBAT Investigators. The anticoagulant therapy with bivalirudin to assist in the performance of percutaneous coronary intervention in patients with heparin-induced thrombocytopenia (ATBAT) study: main results. J. Invasiv. Cardiol. 2003; 15(11): 611-6.

15.   Waksman R., Wolfram R.M., Torguson R.L., Okubagzi P., Xue Z., Suddath W.O., Satler L.F., Kent K.M. Switching from Enoxaparin to Bivalirudin in Patients with Acute Coronary Syndromes without ST-segment Elevation who Undergo Percutaneous Coronary Intervention. Results from SWITCH- a multicenter clinical trial. J. Invasiv. Cardiol. 2006; 18(8): 370-5.

16.   Andreas Koster, Bruce Spiess, Michael Jurmann, MD, Cornelius M. Dyke, Nicholas G. Smedira, MD, Sol Aronson and Michael A. Lincoff. Bivalirudin Provides Rapid, Effective, and Reliable Anticoagulation During Off-Pump Coronary Revascularization: Results of the «EVOLUTION OFF» Trial. Anesth Analg. 2006; 103(3): 540-4. 

Abstract:

We present case report of patient, with recurrent pulmonary bleeding of malignant genesis and ineffective previous endoscopic hemostasis. During embolization of bronchial artery, to stop massive life-threatening pulmonary bleeding, transradial approach was used for the first time. Full bleeding control was reached after embolization of right bronchial artery with use of microspheres through microcatheter 2,8 Fr. During hospital stage, recurrence of bleeding was not notices; patient discharged on the 7th day in satisfactory condition.

Duration of procedure and radiation exposure at this patient were comparable with same parameters in case of transfemoral approach. Main advantages of this vascular access are increased comfort of the patient after the procedure and the possibility of early activization. Besides, use of transradial vascular approach provides decreased frequency of complications, that is very important among patients with signs of respiratory insufficiency, because of the inability of these patients to stay in bed within a day. 

 

References 

1.    Cowling M.G., Belli A.M. A potential pitfall in bronchial artery embolization. Clin. Radiol. 1995; 50: 105-107.

2.    Haponik E.F., Fein A., Chin R. Managing life-threatening hemoptysis: has anything really changed? Chest. 2000; 118: 1431-1435.

3.    Hirshberg B., Biran I., Glazer M. et al. Hemoptysis: etiology, evaluation, and outcome in a tertiary referral hospital. Chest. 1997; 112: 440-444.

4.    Saluja S., Henderson K.J., White R.I. Embolotherapy in the bronchial and pulmonary circulations. Radiol. Clin. North Am. 2000; 38: 425-448.

5.    Chandrasekar B., Doucet S., Bilodeau L. et al. Complications of cardiac catheterization in the current era: a single-center experience. Catheter Cardiovasc. Interv. 2001; 52(3): 289-295.

6.    Sherev D.A., Shaw R.E., Brent B.N. Angiographic predictors of femoral access site complications: implication for planned percutaneous coronary intervention. Catheter Cardiovasc. Interv. 2005; 65(2): 196-202.

7.    Tavris D.R., Gallauresi B.A., Lin B. et al. Risk of local adverse events following cardiac catheterisation by hemostasis device use and gender. J. Invasive Cardiol. 2004; 16(9): 459-464.

8.    Mc. Ivor J., Rhymer J.C. 245 transaxillary arteriograms in arteriopathic patients: success rate and complications. Gin. Radiol. 1992; 45: 390-394.

9.    Jolly S.S., Yusuf S., Cairns J. et al. Radial versus femoral access for coronary angiography and intervention in patients with acute coronary syndromes (RIVAL): a randomised, parallel group, multicentre trial. Lancet. 2011; 377(9775): 1409-1420.

10.  Kanei Y, Kwan T., Nakra N.C. et al. Transradial cardiac catheterization: A review of access site complications. Catheter Cardiovasc. Interv. 2011.

11.  Caputo R.P., Tremmel J.A., Rao S. et al. Transradial arterial access for coronary and peripheral procedures: Executive summary by the transradial committee of the SCAI. Catheter Cardiovasc. Interv. 2011.

 

 

Abstract:

Article describes a rare clinical case: a successful endovascular haemostasis of splenic artery arrosive bleeding into pancreatic enteroanastomosis in early postoperative period in patient with chronic postnecrotic pancreatitis.

 

References 

1.    Karmazanovskij G.G. i dr. Anevrizmy visceral'nyh sosudov i arrozionnye krovotechenija v polost’ postnekroticheskih kist podzheludochnoj zhelezy. Zh. Annaly hirurgicheskoj gepatologii [Aneurysms of visceral vessels and arrosive bleeding into postnecrotic cysts of pancreas. Journal «Annals ofsurgical hepatology»]. 2007; 12(2) 85-95[In Russ] .

2.    Alfredo F.T. Acute pancreatitis at the beginning of the 21st century: The state of the art. WorldJ. Gastroenterol. 2009; 28 (15(24)): 2945-2959.

3.    Gubergric N.B. i dr. Sosudistye zabolevanija podzheludochnoj zhelezy i sosudistye oslozhnenija pankreaticheskoj patologii: luchevye, sonograficheskie i morfologicheskie sopostavlenija (obzor literatury). Zh. Medicinskaja vizualizacija [Vascular diseases of pancreas and vascular complications of pancreatic patology: beam-diagnostics, sonographic and morphological comparison. Jornal «Medical Visualisation»]. 2005; 5: 11-21 [In Russ].

4.    Andersson E., D. Ansari, R. Andersson. Major haemorrhagic complications of acute pancreatitis. The British journal of surgery. 2005; 97(9): 1379-84.

5.    De Perrot M., T. Berney, L. Buchler Management of bleeding pseudoaneurysms with pancreatitis. Brit. J. Surg. 1999; 86: 29-32.

6.    Vimalraj V., D.G. Kannan, R. Sukumar. Haemosuccus pancreatitis: diagnostic and therapeutic challenges. HPB. 2009; 4: 345-350.

7.    Kriger A.G., Karmazanovskij G.G., Kokov L.S. Lozhnye anevrizmy arterij bassejna chrevnogo stvola u bol'nyh hronicheskim pankreatitom. Zh. Hirurgija [False aneurysms of truncus coeliacus in patients with crhonic pancreatitis. Journal «Surgery»]. 2008; 12: 85—95 [In Russ].

8.    Sahakian A.B., S. Krishnamoorthy, T.H. Taddei. Necrotizing pancreatitis complicated by fistula and upper gastrointestinal hemorrhage. Clin. Gastroenterol. Hepatol. 2011; 9(7): 66-67.

9.    Vishnjakova M.V. i dr. Diagnostika i jendovaskuljarnoe lechenie psevdoanevrizmy selezenochnoj arterii. Zh. Diagnosticheskaja i intervencionnaja radiologija [Diagnostics and endovascular treatment of splenic artery pseudoaneurysm. Journal «Diagnostic and interventional radiology»]. 2010; 4( 4) 97 - 99 [In Russ].

10.  Tarazov P.G. i dr. Uspeshnaja arterial'naja jembolizacija posttravmaticheskoj psevdoanevrizmy pechenochnoj arterii. Zh. Diagnosticheskaja i intervencionnaja radiologija [Succesful arterial embolization of posttraumatic hepatic artery pseudoaneurysm. Journal «Diagnostic and interventional radiology»]. 2011; 5(3): 93-98 [In Russ].

11.  Tibilov M.A., Bajmatov M.S. Jendovaskuljarnye vmeshatel'stva v lechenii zheludochno-kishechnyh krovotechenij pri zabolevanijah pankreatoduodenal'noj zony. Zh. Diagnosticheskaja i intervencionnaja radiologija [Endovascular treatment of gastrointestinal bleeding in patients with pancreatoduodenal zone diseases. «Diagnostic and interventional radiology»]. 2009; 3(3) 45 - 50 [In Russ].

12.  Kalva S.P., K.Yeddula, S. Wicky. Angiographic intervention in patients with a suspected visceral artery pseudoaneurysm complicating pancreatitis and pancreatic surgery. Arch Surg. 2011; 146(6): 647-652.

13.  Mansueto G. et al. Endovascular treatment of arterial bleeding in patients with pancreatitis. Pancreatology.- 2007; 7(4): 360-369.

14.  Sethi H., P. Peddu, A. Prachalias. Selective embolization for bleeding visceral artery pseudoaneurysms in patients with pancreatitis. Hepatobiliary and pancreatic diseases international. 2007; 9(6): 634-638

 

 

Abstract:

The presented research on studying the efficiency and safety of various anticoagulants used in patients with acute coronary syndrome during percutaneous coronary interventions (PCI). High efficiency of a Bivalirudin is shown, in comparison with Unfractionated Heparin and Monofram on the amount of bleeding arising in the postoperative period and main adverse coronary events (MACE). 

 

References

1.     Bolezni serdca: Rukovodstvo dlja vrachej [Heart diseases: Manual for doctors]. (Pod red. R.G. Oganova, I.G. Fominoj) M. Litera. 2006; 1328 [In Russ].

2.     Rukovodstvo po kardiologii. Pod red. V.N. Kovalenko [Manual on cardiology edited by V.N.Kovalenko]. K. MORION. 2008; 1424 [In Russ] .

3.     Volozh O.I., Deev A.D., Kal'juste T.I. Prognosticheskoe znachenie nekotoryh faktorov dlja smertnosti trudosposobnogo vozrasta (prospektivnoe jepidemiologicheskoe issledovanie) [Prognostic value of some factors for estimation of mortality of able-bodied age (prospective epidemiologic study)]. Kardiologija. 1997; 9: 43-48 [In Russ].

4.     Oganov R.G. Pervichnaja profilaktika ishemicheskoj bolezni serdca [Primary prophylaxis of ischemic heart disease]. M. Medicina. 1990; 160 [In Russ].

5.     Paolo G. Camici, Sanjay Kumak Prosad, Omela E. Rimoldi. Stunning, Hybernating and Assesment of Myocardial Viability. Circulation, 2008; 117: 103-114.

6.     Aasa M., Dellborg M., Herlitz J. et al. Risk reduction for cardiac events after primary coronary intervention compared with thrombolysis for acute ST elevation myocardial infarction (five year results of the Swedish early decision reperfusion strategy [SWEDES] trial). Am. J. Cardiol. 2010; 106 (12): 1685-1691.

7.     2011 ACCF/AHA Focused Update Incorporated Into the ACC/AHA 2007 - Guidelines for the Management of Patients With Unstable Angina/Non ST-Elevation Myocardial Infarction: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation, 2011; 123: e426-e579.

8.     The Direct Thrombin Inhibitor Trialists' Collaborative Group. Direct thrombin inhibitors in acute coronary syndromes: principal results of a meta-analysis based on individual patients' data. Lancet. 2002; 359: 294-302.

9.     Doyle B.J., Rihal C.S., Gastineau D.A., Holmes D.R. Jr. Bleeding, blood transfusion, and increased mortality after percutaneous coronary intervention: implications for contemporary practice. J Am. Coll. Cardiol. 2009; 53: 2019-2027.

10.   Kastrati A., Neumann F.J., Schulz S., Massberg S. et al. Abciximab and heparin versus bivalirudin for non-ST-elevation myocardial infarction. N. Engl. J.Med. 2011; 365(21): 1980-1989.

11.   Kessler D.P., Kroch E., Hlatky M.A. et al. The effect of bivalirudin on costs and outcomes of treatment of ST-segment elevation myocardial infarction. Am. Heart. J. 2011; 162: 494-500.

12.   Linkins L.A., Warkentin T.E. Heparin-induced thrombocytopenia: real-world issues. Semin Thromb Hemost 2011; 37(6): 653-663.

13.   Management of acute myocardial infarction in patients presenting with persistent ST-segment elevation. Eur. Hear. J. 2008; 29: 2909-2945.

14.   Budaj A., Eikelboom J.W., Mehta S.R. et al. Improving clinical outcomes by reducing bleeding in patients with non-ST-elevation acute coronary syndromes. Eur. Heart J. 2009; 30:655-661.

15.   Mehran R., Pocock S.J., Stone G.W. et al. Associations of major bleeding and myocardial infarction with the incidence and timing of mortality in patients presenting with non-ST-eleva- tion acute coronary syndromes: a risk model from the ACUITY trial. Eur Heart J. 2009; 30:1457-1466.

16.   Bittle J.A., Chaitman B.R., Feit F. et al. Bivalirudin versus heparin during coronary angioplasty for unstable or postinfarction angina: Final report reanalysis of the Bivalirudin Angioplasty Study. Am. Heart J. 2001; 142(6):952-959.

17.   Montalescot G., Baldit-Solier C., Chibedit D. et al. for the ARMADA investigators. ARMADA study: a randomized comparison of enoxaparin, dalteparin and unfractional heparin on markers off cell activation in patients with unstable angina. Am. J. Cardiol. 2003; 91: 925-930.

18.   Montalescot G., Collet G.P., Lison L. et al. Effects of various anticoagulant treatments on von Willebrand factor release in unstable angina. J. Am. Coll. Cardiol. 2000; 36:100-114.

19.   Kokov L.S., Lopotovsky P.Yu., Parkhomenko M.V., Larin A.G., Korobenin A.Yu. Experience with the Use of Angiox (Bivalirudin) in Acute Coronary Syndrome (ACS) Patients with Complications Caused by Percutaneous Coronary Intervention (PCI). International Journal of InterventionalCardioangiology, 2013; 34: 39-42.

20.   Manoukian S.V., Feit F., Mehran R. et al. Impact of major bleeding on 30-day mortality and clinical outcomes in patients with acute coronary syndromes: an analysis from the ACUITY Trial. J. Am. Coll. Cardiol. 2007; 49(12): 1362-1368.

21.   Stone G.W., Witzenbichler B., Guagliumi G. et al. Heparin plus a glycoprotein IIb/IIIa inhibitor versus bivalirudin monotherapy and paclitaxel-eluting stents versus bare-metal stents in acute myocardial infarction (HORIZONS-AMI): final 3-year results from a multicenter, randomized controlled trial. Lancet 2011; 377(9784): 2193-2204.

22.   Steg G., Stefan K. James, Atar D. et al. ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J. 2012; 33:2569-2619. 

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