ENDOVASCULAR BOUGIENAGE IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION WITH ST SEGMENT ELEVATION

Sazanov Grigoriy V., Aydemirov Artur Nasirovich, Sapelnikov Oleg V.

Objective: To present a demonstrative clinical case of endovascular treatment of patients with acute occlusion of an infarct-related coronary artery. Case report: Patient G.N.A., male, 42 years old, city resident, was hospitalized in the regional vascular center of the State Budgetary Healthcare Institution of the Stavropol Territory «Stavropol State Clinical Hospital» (RVC) with a diagnosis of acute transmural infarction of the inferior wall of the myocardium, with complaints of burning pain in the heart area, radiating under the scapula. History of the disease: the above complaints arose 40 minutes before the puncture of the radial artery, an ambulance team delivered him to the RVC, bypassing the admission department, and delivered him to the operating room. At the prehospital stage, the patient received the following treatment: aspirin 500 mg orally, a loading dose of ticagrelor 180 mg orally, unfractionated heparin 5000 IU intravenously, morphine 10 mg intravenously. During coronary angiography, acute occlusion of the right coronary artery is visualized. A decision was made to perform bougienage of the infarct-related coronary artery (IRCA), after which the distal stent landing zone was satisfactorily visualized. A drug-eluting stent was implanted with a satisfactory angiographic result. No complications were registered during PCI and the hospitalization period. The phenomenon of unrecovered coronary artery blood flow or distal embolism were absent. Conclusion: The clinical case demonstrates the technical feasibility and ease of implementation of the technique of endovascular bougienage of the IRCA in a patient with acute myocardial infarction with ST segment elevation. The absence of thrombotic complications when performing this technique allows to reduce mortality and improve the functional indicators of the pumping function of the heart muscle.

Keywords:no-reflow phenomenon, infarction-related coronary artery, acute myocardial infarction with ST-segment elevation, bougienage