TY - JOUR

T1 - Гемоперикард после стентирования коронарных артерий: клинические наблюдения и обзор литературы

AU - Семиголовский, Никита Юрьевич

AU - Симутис, Ионас Стасио

AU - Мазуренко, Сергей Олегович

AU - Никольская, Елена Михайловна

AU - Мазуренко, Мария Сергеевна

PY - 2023/10/21

Y1 - 2023/10/21

N2 - Currently, at least 5,000,000 patients with coronary artery disease undergo percutaneous coronary interventions with stent implantation every year in the world, and more than 200,000 in Russia. Dissection and perforation of the coronary artery are quite rare, but they are very dangerous complications leading to the development of hemopericardium with cardiac tamponade, cardiogenic shock, myocardial infarction, various arrhythmias and death. The frequency of cardiac tamponade in interventional cardiology, according to various authors, ranges from 0.1 to 3.0% of all interventions. The frequency of deaths cited in the literature also varies greatly (0–20–40%). At the same time, there are no special registers that accumulate data on coronary artery perforations in concrete countries and in the world as a whole. Unfortunately, today, there is still no clear algorithm for identifying high-risk patients, the necessary timing of their intensive follow-up is not clear, and the criteria for choosing between conservative, angiosurgical and operative treatment tactics are not defined. In addition to a literary review of recent sources on this topic, the article presents 3 clinical cases of hemopericardium development in elderly patients at different times after percutaneous interventions, with different symptoms and with different outcomes. The observations illustrate the variability of symptoms, the complexity of diagnosis and treatment, and also touch upon the issues of a multidisciplinary approach with the participation of specialists of different profiles (X-ray angiosurgeons, cardiac surgeons, intensive care specialists, cardiologists and doctors of functional diagnostics).

AB - Currently, at least 5,000,000 patients with coronary artery disease undergo percutaneous coronary interventions with stent implantation every year in the world, and more than 200,000 in Russia. Dissection and perforation of the coronary artery are quite rare, but they are very dangerous complications leading to the development of hemopericardium with cardiac tamponade, cardiogenic shock, myocardial infarction, various arrhythmias and death. The frequency of cardiac tamponade in interventional cardiology, according to various authors, ranges from 0.1 to 3.0% of all interventions. The frequency of deaths cited in the literature also varies greatly (0–20–40%). At the same time, there are no special registers that accumulate data on coronary artery perforations in concrete countries and in the world as a whole. Unfortunately, today, there is still no clear algorithm for identifying high-risk patients, the necessary timing of their intensive follow-up is not clear, and the criteria for choosing between conservative, angiosurgical and operative treatment tactics are not defined. In addition to a literary review of recent sources on this topic, the article presents 3 clinical cases of hemopericardium development in elderly patients at different times after percutaneous interventions, with different symptoms and with different outcomes. The observations illustrate the variability of symptoms, the complexity of diagnosis and treatment, and also touch upon the issues of a multidisciplinary approach with the participation of specialists of different profiles (X-ray angiosurgeons, cardiac surgeons, intensive care specialists, cardiologists and doctors of functional diagnostics).

KW - cardiogenic shock

KW - coronary artery dissections

KW - coronary artery perforations

KW - elderly age

KW - hemopericardium

KW - percutaneous coronary intervention

KW - pericardial tamponade

UR - https://www.med-sovet.pro/jour/article/view/7808

UR - https://www.mendeley.com/catalogue/41471781-b1f1-3e02-b118-7b99d11c75df/

U2 - 10.21518/ms2023-349

DO - 10.21518/ms2023-349

M3 - статья

VL - 17

SP - 117

EP - 127

JO - МЕДИЦИНСКИЙ СОВЕТ

JF - МЕДИЦИНСКИЙ СОВЕТ

SN - 2079-7028

IS - 16

ER -