[The clinico-angiographic manifestations of vascular spasm in the acute period of an aneurysm rupture]. / Kliniko-angiograficheskie proiavleniia sosudistogo spazma v ostrom periode razryva anevrizm.

The clinical picture was compared to angiographic findings on the spasm in 85 patients in acute period of an aneurysmal rupture in the absence of the intracranial hematoma. Spasm-induced ischemia was responsible for cerebral dysfunction and neurological symptoms. Days 5-13 since the aneurysmal rupture can be viewed as a functionally significant spasm interval. To prevent repeat hemorrhages and brain ischemia, aneurysmal intervention should be conducted on early hours and days of the disease, before or during a less severe vascular spasm.

[Method for angiographic identification of the labyrinth artery]. / Metod angiograficheskoi identifikatsii labirintnoi arterii.

Digital subtraction angiography in Stenvers standard setting performed atraimatically has been tried in 106 emergency cases admitted to N. V. Sklifosovsky Research Institute of Critical Care. This new method of identification (in 75% of the cases) and verification of the labyrinthine artery intravitally proved safe and reliable. The patients were exposed to cerebral angiography by various methods for diagnosis of the underlying disease. Standard methods of vertebral angiography were found unsatisfactory.

[Radiologic anatomy of the labyrinth artery]. / Rentrenoanatomiia labirintnoi arterii.

Carotid and vertebral angiographic investigations were performed to study x-ray anatomy of the artery of the labyrinth (AL) in 96 inpatients admitted to the N. F. Sklifosovsky emergency care clinic. According to the angiograms, AL originated from the distal parts of the inferior anterior cerebellar artery in 66.3% of the patients. In this case it has a straight form. When initiating from the proximal parts of the basilar artery (33.7% of the patients), AL was shorter (0.8 +/- 0.3 against 2.5 +/- 0.8 cm) and curved. In any case AL was situated along the upper edge of the pyramid before it entered the internal acoustic meatus. By the meatus or inside it AL forms a characteristic loop or semiloop. A complete AL left-right symmetry was observed in 61.8% of the cases.

[Interrelations between obstructive changes in the coronary arteries and clinical manifestations of heart failure in patients after myocardial infarction]. / Vzaimozavisimost' obstruktivnykh izmenenii koronarnykh arterii i klinicheskikh proiavlenii serdechnoi nedostatochnosti u bol'nykh, perenesshikh infarkt miokarda.

The study was undertaken to examine clinical and angiographic signs in 154 patients with prior myocardial infarction. There was a relationship between the left ventricular performance and heart failure stages and the number of diseased left ventricular segments and heart failure stages. With an increase in the number of diseased left ventricular segments, cardiac contractility decreased. Severe stages of heart failure were observed in the diseased channel of the infarct-related anterior interventricular branch and in its occlusion. The stages of heart failure were unassociated with the number of diseased coronary arteries, and the presence or absence of collaterals. There were more frequently eccentric stenoses of type II and/or irregular shape in severe heart failure groups.

[Clinical manifestations of ischemic heart disease in the subacute period of myocardial infarction and post-infarct cardiosclerosis depending on the status of coronary arteries]. / Osobennosti klinicheskikh proiavlenii ishemicheskoi bolezni serdtsa v podostroi stadii infarkta miokarda i postinfarktnogo kardioskleroza v zavisimosti ot sostoianiia koronarnykh arterii.

Multifactor discriminant analysis was used on a computer to examine 100 patients with myocardial infarction in the subacute period (at week 4 of the disease onset) and 76 in the postinfarction period (at months 2-120 of postinfarction). A complex of clinical and coronary signs was defined, which differentiated patients with subacute myocardial infarction and postinfarct cardiosclerosis, as well as those with postinfarct stable and progressive angina pectoris.

[Coronary thrombosis, mechanisms of thrombolysis and the tactics in radiographically guided endovascular treatment of patients with acute myocardial infarction]. / O koronarnom tromboze, mekhanizmakh trombolizisa i taktike rentgenoéndovaskuliarnogo lecheniia bol'nykh ostrym infarktom miokarda.

The radio-angiographic features of coronary blood flow were studied in 119 patients in the first 24 hours of a macrofocal myocardial infarction. In 100 (84%) patients with recognized occlusion of the coronary artery responsible for the infarction the semeiotics of the occluding coronary thrombosis is described, and the characteristics of the residual stenoses after intracoronary thrombolysis were studied. In more than 60% of cases the radiographic features of these stenoses were found to be similar to those of primarily revealed stenoses responsible for infarction of the coronary arteries in degree, form, and the presence of mural thrombus. The mechanism of the formation of these stenoses was of a common character--lysis of the occluding thrombus, which was medicinal in the first case and spontaneous in the second. Medicinal thrombolysis is an analogue of the natural physiological mechanism--spontaneous coronary thrombolysis. It was established that the process of medicinal lysis of the coronary thrombus, a mural thrombus among others, is fully completed by the end of the second day of myocardial infarction. The obtained information makes it possible to formulate some principles of radiologically-guided intravascular treatment of patients with myocardial infarction.

[X-ray endovascular dilatation using an axillary access]. / Rentgenoéndovaskuliarnaia dilatatsiia aksilliarnym dostupom.

Based on the analysis of 39 observed cases, the authors consider various aspects of the use of roentgenovascular dilatation by an axillary access: problems of methods, indications and contraindications; they also assess the advantages and shortcomings of the access.

[Axillary approach for radiologic endovascular dilatation]. / Rentgenoéndovasculiarnaia dilatatsiia aksilliarnym dostupom.

Basing on the analysis of 39 observed cases, the authors consider various aspects of the use of roentgenovascular dilatation by an axillary access : problems of methods, indications and contraindications; they also assess the advantages and shortcomings of the access.

[Features of clinical manifestations of intermediate coronary syndrome in relation to the status of the coronary bed]. / Osobennosti klinicheskikh proiavlenii promezhutochnogo koronarnogo sindroma v zavisimosti ot sostoianiia koronarnogo rusla.

Uni- and multifactorial analyses of clinical and angiographic findings were made in 32 patients with coronary heart disease concurrent with the intermediate coronary syndrome and 34 patients with progressive angina pectoris. A complex of clinical and angiographic signs was defined, which enabled these groups of patients to be differentiated. Exercise tolerance was the same in the two groups and related to the severity of coronary artery lesions. The efficacy of the antianginal therapy depended on the angiographic morphology of occlusive changes in the coronary bed and it was less in patients with Type II eccentric stenosis.

[Relation between the duration of cardiac pain and the state of the coronary vessels in patients with acute myocardial infarction]. / Sopostavlenie prodolzhitel'nosti bolevogo serdechnogo sindroma s sostoianiem koronarnogo rusla u bol'nykh ostrym infarktom miokarda.

The study compared specific characteristics of cardiac pain syndrome with coronary arteriography findings for 100 patients in acute period of myocardial infarction. The evidence obtained suggests that duration of cardiac pain does not depend on the type of obstruction in the infarction-related coronary artery. Long-standing radiating pain occurred in affected anterior interventricular branch. The pain seems related to total asynergia severity and the lesion of coronary bed. Neuroleptanalgesia induced more continuous anesthesia in patients with infarction-related circumflex branch and anterior coronary artery while its effect reduced in ++multi-vascular affection of the coronary bed. No relapses of pain syndrome were recorded in responders to intracoronary thrombolytic therapy.

[Development of left-ventricular aneurysm in relation to the status of the coronary bed in patients with a history of myocardial infarction]. / Razvitie anevrizmy levogo zheludochka serdtsa v zavisimosti ot sostoianiia koronarnogo rusla u bol'nykh, perenesshikh infarkt miokarda.

The study was undertaken to examine 270 patients with a history of myocardial infarction. Its purpose was to reveal a relationship between the ischemic signs of cardiac aneurysm and the status of coronary arteries. The findings suggested that left ventricular aneurysm was greatly due to severe obstruction of the infarct-related right intraventricular branch of a coronary artery.

[Characteristics of the clinical manifestations of stenocardia in patients with ischemic heart disease, without myocardial infarct, in relation to the state of the coronary bed]. / Osobennosti klinicheskikh proiavlenii stenokardii u bol'nykh ishemicheskoi bolezn'iu serdtsa, ne perenesshikh infarkt miokarda, v zavisimosti ot sostoianiia koronarnogo rusla.

Mono- and multifactorial discriminant analyses aided by computer were used in 106 patients with coronary disease to compare the clinical and angiographic findings common to different manifestations of angina pectoris. The relationship was discovered between the clinical form of angina pectoris and the gravity of lesions of the coronary artery. Intracardiac hemodynamics and left ventricular contractility at rest did not differ whatever the patients' group. According to the bicycle ergometry test, the physical exercise tolerance was lower in patients with progressive angina pectoris and depended on the gravity of coronary artery lesions. The outcome of the clinical manifestations of angina pectoris during observation at hospital was mainly influenced by the natural course of coronary disease, primarily stipulated by obstruction in the coronary arteries. Using the multifactorial discriminant analysis aided by computer, the classifying signs were outlined, making it possible to differentiate between the groups of angina pectoris patients depending on the duration of angina pectoris attacks (in minutes), irradiation of pain to the shoulder or to both arms, T wave inversion on the ECG, and the gravity of coronary artery obstruction. The given signs enable one to recognize patients with destabilization of the clinical course of angina pectoris.

[Digital subtraction angiography in the diagnosis of emergency neurosurgical states]. / Digital'naia subtraktsionnaia angiografiia v diagnostike neotlozhnykh neirokhirurgicheskikh sostoianii.

Digital subtraction angiography (DSA) was used in the examination of 203 patients with various forms of acute diseases and injuries of the brain. The method of the examination is described and its advantages and shortcomings in each type of pathology are revealed. DSA meets the requirements placed upon angiographic examination of patients with acute diseases of the brain and craniocerebral injury and may be used successfully in the diagnosis of emergency neurosurgical conditions.

[Angiographic diagnosis of hemorrhagic myocardial infarct]. / O vozmozhnosti angiograficheskoi diagnostiki gemorragicheskogo infarkta miokarda.

Hemorrhagic myocardial infarction (HMI) has certain angiographic features that make it possible to diagnose it during the patient's life. HMI angiographic criteria are hypervascularization of an infarction zone in the late arterial phase, an intense contrast of an infarction zone in the parenchymal phase, extravasation of a contrast medium in an infarction zone in the venous phase of coronarography lasting for a long time, and slow discharge of a contrast medium from the distal vascular channel of an infarction zone. HMI characteristic features require thorough phase-by-phase angiographic investigation of the coronary arteries in all MI patients, especially in young ones and those after intracoronary thrombolytic therapy. The detected morphological spasm of microcirculatory vessels and veins disturbing the blood outflow from an infarction zone, noticeable hemorrhages in its interstice prove to be the morphological substantiation of HMI angiographic signs.

[Clinical significance of reciprocal changes in the ECG in acute myocardial infarction]. / Klinicheskoe znachenie retsirpoknykh izmenenii EKG pri ostrom infarkte miokarda.

A total of 206 patients with acute myocardial infarction marked by infarction localization in the anterior and inferior walls were examined. It is revealed that reciprocal changes, namely the depression of the ST segment are of prognostic significance in the assessment of the clinical course of the disease, with the ST depression being recorded for over one day. The patients demonstrated a reduction in left ventricle (LV) function, namely a decrease in the ejection fraction of the LV. Moreover, in this group of patients, a greater number of cases with multiple lesions of the coronary vessels were recorded. The reciprocal changes correlated well with the size of myocardial injury.

[Experience with using selective angiography of the mesenteric arteries in patients with cicatricial esophageal stenosis]. / Opyt primeneniia selektivnoi angiografii bryzheechnykh srterii u bol'nykh s rubtsovym suzheniem pishchevoda.

The authors have used selective angiography of the upper and lower mesenterial arteries in patients with scary constriction of the esophagus in order to obtain data of blood supply of the colon before operation of esophagus plasty and to give preliminary grounds for surgical tactics. The method was used in 37 patients operated upon. In ten of them angiography of the upper mesenterial arteries has shown contrasted veins. Coincidence of the pathway of arteries and veins was noted in 1 patient. Angiography of the lower mesenterial artery has shown coincidence of the pathway of arteries and veins in 16 cases, i.e. in all the cases where the venous phase was fulfilled.

[The possibility of spontaneous lysis of a coronary thrombus in patients with acute myocardial infarct]. / O vozmozhnosti spontannogo lizisa tromba koronarnoi arterii u bol'nykh ostrym infarktom miokarda.

The results of coronary angiography in 108 patients within the first 24 hours of myocardial infarction were compared to autopsy coronary arterial findings in 78 cases of myocardial infarction death within similar periods of time. The rate of occlusion of the coronary artery, responsible for infarction, dropped considerably within 12-24 hours of its onset, as compared to the data obtained within the first 6 hours: from 90.3% to 57.1% as evidenced by coronarography, or from 87.8% to 68.4% as evidenced by postmortem findings. Coronarography conducted within the first day of myocardial infarction demonstrated markedly activated fibrinolysis that coincided with the drop in the incidence of coronary-arterial thrombosis. Fibrinolysis activation is a prerequisite for spontaneous coronary thrombolysis.