Method for cerebral hyperperfusion syndrome prevention during carotid arteries stenting
SUBSTANCE: after transfemoral access to the internal carotid artery, first, a proximal MoMa protection system is installed, then the coronary guide is directed behind the stenosis. A balloon with a diameter of 1.5×20 mm is directed along the guide, and predilation is performed at a pressure of 8 atm. Then the balloon and the guide are removed. Active aspiration is performed through the lumen of the MoMa system. A distal protection system - FilterWire filter is directed behind the stenosis and installed in the angle of mandible projection, in the internal carotid artery projection on the neck, an ultrasonic sensor is installed, and duplex ultrasound (US) of blood flow controlled by the linear blood flow velocity (BFV) value is performed. Under the US control, the proximal balloon of the MoMa protection system is gradually depleted so that the BFV scores do not exceed Vps<70 cm/sec. Then, the balloon is re-inflated and repeated predilation is performed in the stenosis area with a balloon of a larger diameter 3.0×20 mm under the rated pressure for 30 s. After balloon removal, repeated aspiration is performed through the MoMa system. Then under the US control, the procedure for proximal balloon depletion is repeated with balloon angioplasty of the MoMa system to achieve residual stenosis of not more than 15% and BFV of not more than Vps<70 cm/sec, then the stent is implanted.
EFFECT: method improvement.
SUBSTANCE: method involves antibacterial, antimycotic, antiviral therapy taking into account sensitivity and recovered pathogenic flora and/or immune-enhancing therapy. From the 3rd day of the above therapy, local treatment involving the intrauterine insertion of a device for administering a complex of preparations and the prescribed hormone therapy is conducted. The device for administering the complex of preparations is presented by the Foley catheter, which is used to administer Miramistin 5 ml daily, Cefazoline or Ceftriaxone 4-6 minutes later, then Derinate 5 ml 4-6 minutes on even days, Longidaza 3 thousand units on odd days; the procedure is immediately followed by inserting a Miramistin tampon vaginally for 1-2 hours; one capsule of Polygynax is inserted vaginally for the night, whereas the hormone therapy is prescribed after the treatment.
EFFECT: effective treatment of chronic endometritis and prevention of the tubal and peritoneal infertility.
SUBSTANCE: group of inventions relates to medicine, namely to cardiology and cardiac surgery, and can be used in the treatment of patients with congestive heart failure. Claimed is a catheter device for the dynamic regulation of the venous return, including a bidirectional catheter, which has a proximal end, an inflatable balloon, which is installed on the catheter. The said balloon is made of a flexible material, extending to increase the balloon volume. The catheter has an external surface, which includes slots, directed parallel to its longitudinal axis, and a distal screw, fixing the catheter on the inferior vena cava wall. Also claimed is a method of installing the catheter device, which includes the introduction of the bidirectional catheter with the inflatable balloon through the subclavicular vein. The catheter is fixed on the cava vena wall by means of the distal screw. The balloon is fixed near the vena cava outlet with its further pumping with physiological solution or glucose solution.
EFFECT: group of inventions provides the mechanical regulation of an increased venous return flow in the patients with simultaneous simplicity of the catheter device application.
9 cl, 4 dwg, 2 ex
SUBSTANCE: invention refers to medical equipment, namely to devices for the small intestinal drainage in acute abdominal surgical pathology. A device for the small intestinal intubation in the technically complex environment consists of an outer elastic tube of 12 mm in diameter, 280-300 cm long and having holes at a caudal end. A supplementary tube of 3 mm in diameter is inserted into a lumen of the outer tube along the entire length; a longitudinal rubber bag is attached to the caudal end of the supplementary tube brought out through the caudal end of the outer tube; at the end of the caudal end, there is an olive movable in relation to the outer tube. Progressive motion of the olive in the intestinal lumen is ensured by the inflation and elongation of the bag. The device is movable by fixing the olive in the intestinal lumen by the elastic contraction of the bag after de-aeration.
EFFECT: invention provides reducing injuries that might accompany the intestinal intubation manipulations in the technically complex environment.
SUBSTANCE: foley catheter is re-laparotomically inserted through a suture line defect of the duodenal stump. The catheter cylinder is inflated until blocking the intestinal lumen completely. The defect is closed with a non-absorbable suture in a non-traumatic needle around the catheter. The suture is reinforced with a mobilised round ligament of the liver. The catheter is delivered outside through a separate incision. A dehiscence region is drained with laterally perforated tubes 10 mm in diameter. The method prevents the suture cutting out of the duodenal suture and the onset of peritonitis.
EFFECT: method enables forming the controlled duodenal anastomosis for preventing the duodenal suture dehiscence, when the reliable closure of the duodenal stump turns to be impossible.
1 ex, 1 dwg
SUBSTANCE: invention relates to medical equipment, namely to systems for extending narrowed part of patient's respiratory ways. System contains catheter tube with total length from 35 to 70 cm, lumen for probe and lumen for blowing, blowing balloon, located along distal part of catheter tube and connected with lumen for blowing; and probe, projecting beyond distal end of catheter tube, when probe is placed inside lumen for probe. Proximal part of probe is less flexible than distal part, with distal part being bendable and capable of preserving curved configuration when placed inside lumen for probe. Distal part of probe has higher level of rigidity than distal part of catheter tube, so when distal part of probe is bent, said bent distal part makes distal part of catheter tube bend when probe is placed inside it.
EFFECT: application of invention makes it possible to increase convenience of system introduction and holding in case of extension of narrowed parts of respiratory ways.
24 cl, 10 dwg
SUBSTANCE: invention refers to medical equipment, namely to cylinder angioplasty devices for passage dilation in the venous system. A cutting cylinder configuration for dissection of solid stenotic regions of the blood vessel comprises a delivery catheter, an expandable cylinder, as well as a dissecting mesh. The delivery catheter has a proximal end, a distal end and at least one lumen extended between the proximal and distal ends of the catheter. The expandable cylinder has a proximal end and a distal end and mounted on the distal end of the catheter. The dissecting mesh surrounds the expandable cylinder and is configured so that to be no bar to cylinder inflation and to return to an initial position after the cylinder blow-off. The dissecting mesh comprises intersecting filaments which interlaces between the proximal end of the mesh and the distal end of the mesh and form at least distal loops on the distal end of the mesh. The distal loops are configured so that to enable the binding of the distal loops of the dissecting mesh on the distal end of the mesh. At least, a portion of the filament of the crossed filaments interlace with adjoining filaments, forming a single permanent bond thereby presenting a dissecting element formed by bends of the twisted filaments, thereby forming at least one permanent binding on the distal end of the mesh. A method for making the cutting cylinder configuration for dissecting solid stenotic regions of the blood vessel provides the stages below. Preparing a certain number of the filaments with specific properties, diameter and length. Making the dissecting mesh of the filaments, including: preparing a plaiting pattern having a cylindrical structure comprising a number of pins along a circular surface of the configuration in lines and projecting therefrom outwards; arranging the filaments between the pins and crossing the filaments so that to form the dissecting mesh; crossing the filaments provides filament plaiting between the proximal end of the mesh and its distal end and twisting at least a portion of the filament to form at least one permanent bond to the adjoining filaments, forming the dissecting element formed by bends of the twisted filaments, thereby forming at least one permanent bond on the distal end of the mesh; forming at least distal loops on the distal end of the mesh; annealing the dissecting mesh. Preparing the feed catheter. Preparing the expandable cylinder. The above expandable cylinder is mounted on the distal end of the catheter. Mounting the dissecting mesh on the expandable cylinder.
EFFECT: invention is more flexible, safe and provides the improved dilation and treatment of fibrous damages.
26 cl, 5 dwg
SUBSTANCE: for treatment and prevention of recurrences of the intrauterine synechiae within the range of pre-implantation preparation of the endometrium, heteroscopy with further installation of the child's Foley catheter into the uterine cavity is performed. The catheter balloon is filled with 2 ml of the physiological solution. The catheter is installed for 7 days, on which instillagel in a dose of 2.5 ml is introduced into the uterine cavity through holes in the distal end of the catheter on 1, 3, 5, 7 day alternating it with introduction of filgrastim in a dose of 100 mcg on 2, 4, 6 days. Instillation is realised at the background of performed hormonal therapy.
EFFECT: effective treatment and prevention of recurrences of the intrauterine synechiae due to activisation of regenerative processes of the endometrium and performing an immunomodulating impact on it with taking into account the terms of ending of a risk of possible adhesion formation.
1 dwg, 1 ex
SUBSTANCE: invention relates to medical equipment. A coaxial infusion catheter system comprises a component of an infusion catheter having an infusion section for infusion of a thrombolytic agent into a vascular occlusion or a transplant; as well as a component of an occlusion catheter having an elongated body wherein an expandable occlusion element is attached to a distal end of the elongated body. The expandable occlusion element is made in the form of an unloadable hood comprising two overlapping components and having moveable curtains or overlapping slots. The above components are relatively rotatable and provide depending on a rotation angle either the blood flow in the expanded and closed positions or occlusion of a vessel or the transplant lumen in the expanded and open positions.
EFFECT: providing effective vessel or transplant occlusion in the distal and/or proximal direction in relation to a zone of treatment.
4 cl, 8 dwg
SUBSTANCE: invention relates to medicine, namely to urology. The Foley type catheter is introduced into the urinary bladder through the urethra. Inside the urinary bladder a balloon is filled with a solution or gas with a volume not less than 200 ml. A puncture of the anterior abdominal wall, the urinary bladder and the balloon is performed with a trocar in the suprapubic area.
EFFECT: method makes it possible to carry out safe trocar epicystomy in case of extraperitoneal breached integrity of the urinary bladder walls.
2 ex, 6 dwg
SUBSTANCE: invention relates to the field of medicine, in particular to vascular surgery, and is intended for transfer of medications onto an internal surface of a vessel wall. A device for transfer of medications onto the internal surface of the vessel wall contains a matrix, made in the form of a polymer film, covered with medication and placed on a flexible framework. The matrix and the framework have specified standard sizes. They are made with a possibility of placement in them of a cellular knitted metal temporary stent and with a possibility to be inside the temporary stent of an inflatable balloon with a fixed diameter and length and a cylindrical or conic shape when blowing under high pressure or a latex balloon with a possibility of filling the entire internal space of the temporary stent when blowing under low pressure.
EFFECT: invention makes it possible to simultaneously perform long-term efficient transfer of medication into the vessel wall with preservation of blood flow and efficient diameter of the affected vessel.
4 cl, 1 dwg
SUBSTANCE: technique involves foetus's middle cerebral artery Doppler ultrasonography prior to and after a pregnant woman holds her breath as much as possible at a depth of inhale. Diagnostically significant indices of blood velocity curves resistance in the foetus's middle cerebral artery that are a systolic/diastolic ratio, a resistance, a pulsation index are measured with a breath-holding test conducted and taking into account foetus's daily rhythmostasis. If the Doppler ultrasound measures are: the systolic/diastolic ratio at 12.00 prior to breath-holding 3.71±0.05, after breath-holding 4.56±0.08 and at 20.00 prior to breath-holding 3.92±0.06, after breath-holding 4.74±0.09; the resistance at 12.00 prior to breath-holding 0.69±0.03, after breath-holding 0.87±0.04 and at 20.00 prior to breath-holding 0.80±0.03, after breath-holding 0.91±0.04; the pulsation index at 12.00 prior to breath-holding 1.78±0.04, after breath-holding 1.92±0.03 and at 20.00 prior to breath-holding 1.84±0.04, after breath-holding 1.97±0.04, changes in the foetus's functional status are detected and chronic foetal hypoxia is diagnosed.
EFFECT: technique enables increasing the diagnostic accuracy in chronic foetal hypoxia by measuring the functional parameters taking into account the time variations of daily rhythmostasis.
SUBSTANCE: common carotid artery (CCA) is scanned. A peak systolic blood flow velocity in the CCA and the beginning of the systolic peak to peak time, a final diastolic blood flow velocity in the CCA, systolic and diastolic CCA diameters are determined. The value K is determined by formula K=(Vs-Vd)·Dd2:[AT·(Dd2-Ds2)], wherein Vs, Vd is the peak systolic and final diastolic blood flow velocities in the CCA respectively, cm/s; Ds, Dd are systolic and diastolic CCA diameters, cm; AT is the time from the beginning of the systolic peak blood flow to its peak, s. If the value K is more than 8,500, the humoral transplanted heart rejection is diagnosed.
EFFECT: method enables increasing the early diagnostic accuracy of the humoral heart rejection by assessing the reliable diagnostic value that is a hardness of the vascular wall of the common carotid artery, and avoiding the invasive diagnostic intervention.
SUBSTANCE: technique involves transabdominal ultrasonography of jejumum and colon in longitudinal and transversal projections. The transabdominal ultrasonography is native with the patient positioned on his/her back. Visualising all the jejuneal segment involves taking intestinal loops without haustra as reference points. haustra are used as reference points for visualising the colon. pulsed Doppler velocimetry is conducted to determine a blood flow velocity in mesenterial arterial branches. A transperineal examination of the anorectal area is performed in the patient placed on his/her left side with bended knees. A sensor is placed into an anal pit directly and displaced from pubic to sacrum while scanning in two projections - longitudinal and longitudinal-oblique. The reference points are sacrum, symphysis, and anal canal. The state of a distal portion of rectal ampulla is assessed. The derived values are compared to the normal criteria. If observing any changes in the jejunum: wall thickening more than 2 mm, higher echogenicity, intestinal lumen narrowing; if observing any changes in the colon: haustra flatness, contour roughness, wall thickening more than 2.5 mm, mucosal thickness more than 1 mm, submucosal thickness more than 0.5 mm, the absence of clear layer differentiation, higher submucosal echogenicity, intestinal lumen narrowing, higher blood flow velocity in the mesenterial arterial branches more than 7.0 cm/sec; changes in adjoining organs: higher echogenicity of the greater omentum, envelopment of the jejuneal and colonic loops involved into the inflammatory process with the omentum, lengthening of the mesenterial, para-aortic lymph nodes more than 10 mm, free abdominal fluid, the changes in the anorectal area: rectal ampulla wall thickening more than 2.5 mm, higher echogenicity of perineal subcutaneous fat, anorectal fistulas and paraproctitis testify to the presence of colonic and jejuneal wall hyperplasia in the involved portions, mesenterial, para-aortic lymph node hyperplasia, reactive changes of the greater omentum, as well as the presence of a perineal inflammation, and Crohn's disease is diagnosed. The changes in the colon only: haustra flatness, smooth contours, wall thickening more than 2.5 mm, mucosal thickness more than 1 mm, submucosal thickness more than 0.5 mm, reduced clear differentiation, lower submucosal echogenicity, no intestinal lumen narrowing, higher blood flow velocity in the mesenterial arterial branches more than 7.0 cm/sec; changes in the adjoining organs: lengthened mesenterial and para-aortic lymph nodes more than 10 mm, no reactive changes of omentum, rectal ampulla wall thickening more than 2.5 mm without involving the perineal region testifies to colonic wall hyperplasia and mesenterial, para-aortic lymph nodes and enables diagnosing non-specific ulcerative colitis.
EFFECT: technique enables performing the early differential diagnosis of chronic inflammatory intestinal diseases by using the accurate qualitative and quantitative ultrasonic criteria.
SUBSTANCE: in case of unilateral cryptorchidism measured is a linear rate index of the blood flow in the medium segment of the recurrent artery of the healthy testicle Vmax1 and testicle in the cryptorchidism condition Vmax2. In case of bilateral cryptorchidism measured is the linear rate index of the blood flow in the medium segment of the recurrent artery of the right and left testicle. As Vmax2 taken is the lower index from the two measurements of the testicle blood flow. As the index of blood flow Vmax1 taken is the lower index of the age norm, constituting for children from 0 to 12 months - 1.2 cm/sec; from 1 to 3 years - 1.5 cm/sec; from 3 to 7 years - 1.8/sec, and for children above 7 years - 2.0 cm/sec. If the difference between Vmax1 and Vmax2 is larger than 25% of Vmax1 index, impairment of haemodynamics, requiring operative treatment, is diagnosed. If the difference is in the range from 15 to 25%, dynamic US-monitoring after 3, 6 and 9 months is required.
EFFECT: method makes it possible to objectify results of USE due to the clear determination of parameters of a threshold value of the blood flow index in the testicle arteries.
2 cl, 3 ex
SUBSTANCE: patient's epicardial fat thickness is measured by transthoracic echocardiography by means of a sector transducer at a frequency of 2,500 MHz on a free anterior wall of the right ventricle. Pulse Doppler imaging is performed to determine the diastolic function of the left ventricle - the E/A ratio measured as a transmitral blood flow velocity in the early diastolic filling of the left ventricle (E peak) to a transmitral blood flow velocity in a left auricular systole (A peak). If the epicardial fat thickness is from 2.7 to 4.5 mm, whereas the E/A diastolic function is less than 0.80, insulin resistance is diagnosed.
EFFECT: higher diagnostic accuracy, as well as wider number of individuals, who had the insulin resistance diagnosis.
1 tbl, 2 ex
SUBSTANCE: invention refers to medicine, namely to oncology and can be used for the prevention and early diagnosis of postmastectomy complications. The m. pectorales major et minor changes are ultrasonically assessed from the left and right in the 2-3 intercostal spaces along the midclavicular line. The muscle thickness and a degree of atrophy are determined. Phlebohaemodynamic disorders are detected by measuring a diameter and a blood flow rate with the use of thick gel pads; in v. subclavia dexter et sinister - along the clavicle between its middle and external one-thirds; in v. basilica dexter et sinister - at the border of the superior and middle one-thirds of the shoulder along the internal surface; in v. cephalica dexter et sinister - at the border of superior and middle one-thirds of the shoulder along the external surface; in v. radialis dexter et sinister - in the inferior one-third of the forearm 1.5-2 cm above the hand along the lateral surface; in v. ulnaris dexter et sinister - in the inferior one-third of the forearm 1.5-2 cm above the hand along the medial surface. An intensity of lymphostasis of the upper extremity is assessed by measuring the thickness of subcutaneous fat within the maximum intensity of oedema and phlebohaemodynamics in the vessels involved into the oedema, and of a symmetrical region of the counterlateral arm prior to and after treatment. The derived data are used to assess the functional disorders of the postmastectomy area.
EFFECT: method enables assessing the degree of structural changes of the postmastectomy area in relation to the healthy side, which makes it possible to predict technical difficulties in surgical repairs, to determine the presence of subclinical phlebohaemodynamic disorders, specifying the level of the maximum blood flow block, and evaluating the effectiveness of corrective actions at lymphostasis.
9 dwg, 2 ex
SUBSTANCE: invention relates to medical equipment, namely to means for performing cardio-pulmonary resuscitation of people. Device for control of cardio-pulmonary resuscitation contains ultrasound converter, unit of electrodes, connected via interface to processor, connected with display, memory unit, sound signaller, unit of light-diode signallers, unit of connection with central control panel unit of operation mode selection, unit of connection with the internet and, via USB interface, with unit of top level software. Device also contains colour television microcamera, connected via successively installed block of signal amplification and filtration and unit of processing and imposing alignment of images to additional processor input/output, illumination unit, pulse measurement unit, gas analyser, unit of microphones with matching unit, connected with processor and power supply unit. Pulse measurement unit and unit of electrodes are made with possibility of fixation on patient by means of fixation unit, with unit of microphones, controlled illumination unit and gas analyser being fixed on patient by means of additional fixation unit. Method of control contains stages of obtaining ultrasound echo signals and electrosignals, characterising blood flow in blood vessel, determination of blood flow characteristic by impedance of neck tissues in the process of performing cardio-pulmonary resuscitation, presentation of sound and visual information about patient/s condition. After that, current information about patient's condition is formed by television images and geometrical and colour characteristics of eye pupil and eye iris are determined, with estimation of colour and geometrical characteristics of blood vessels. Sound laryngeal signals, exhaled gas and patient's pulse are also read and analysed, light signals are used to signal about patient/s condition and patients condition is estimated basing on data of comparison of standard and current information.
EFFECT: application of invention makes it possible to extend functional possibilities, increase operation speed, immediacy and accuracy in performing cardiopulmonary resuscitation.
16 cl, 10 dwg
SUBSTANCE: method for detecting the burn wound granulation readiness for autografting involves the granulation microcirculation by laser Doppler flowmetry to calculate an average microcirculation (M, p.u.). That is combined with combining a granulation microcirculation effectiveness index (MEI). If the MEI is more than 1.6, and M is more than 3 p.u. the reparative ability of the burn wound granulation is considered to be preserved, and the granulation appears to be ready for autodermoplasty. If MEI is less than 1.6 regardless of the value M, the reparative ability of the burn wound granulation is considered to be diminished, the wound requires additional wound cleansing and granulation incision.
EFFECT: method enables providing the higher diagnostic effectiveness of the reparative ability of the tissues, selecting the autodermoplasty time, reducing the rate of transplant rejections and cutting the treatment costs and reducing the length of staying in hospital.
SUBSTANCE: microcirculation is assessed by laser Doppler flowmetry using combined functional tests - thermal postural leg test and thermal postural arm test. Both tests involve recording a microcirculation index. The derived data are saved. An average basic microcirculation from the 10th to 110th seconds is evaluated for the leg and arm tests according to the provided formulas. That is followed by calculating an average relative microcirculation Irel1 and Irel2 during the functional leg exposure according to the presented formulas. If any of the two values Irel1, Irel2 is below standard - Irel1<3.7; Irel2<3.5, the presence of microcirculatory disorders is stated in the person being tested.
EFFECT: method is accurate, simple, enables immediately detecting systemic microcirculatory disorders in the patients suffering carbohydrate metabolism disorders on the basis of available diagnostic tests and measured microcirculation parameters; using the combined functional tests involves most regulatory mechanisms that provides obtaining the reliable microcirculation information from the patients of this category.
2 cl, 2 dwg, 2 ex
SUBSTANCE: triplex scanning of the interlobular artery of the upper kidney pole is performed in clinostasis, and then within the first minute in orthostasis. The acceleration time (Ta), the total time of the blood flow during one cardiac cycle (Tt) are measured, their ratio Ta/Tt in clinostasis and orthostasis is calculated. After that the acceleration time index (ATI) is calculated by the mathematical formula. If Ta/Tt is less than 0.09 and ATI is less than 0, early affection of the kidneys, accompanied by arteriovenous shunting, is diagnosed.
EFFECT: method makes it possible to identify the group of patients requiring prophylaxis or treatment and in this way prevent the development of complications, disability retirement and mortality.
1 dwg, 3 tbl, 4 ex
SUBSTANCE: method involves carrying out ultrasonic scanning examination of subclavian artery over its whole extent in physiological arm position with arterial blood pressure being measured in the middle one third of the arm. Next, when applying compression tests, blood circulation parameters variations are recorded in distal segment of the subclavian artery with arterial blood pressure being concurrently measured. Three degrees of superior thorax aperture syndrome severity are diagnosed depending on reduction of linear blood circulation velocity and arterial blood pressure compared to their initial values. Mild one takes place when linear blood circulation velocity reduction reaches 40% and arterial blood pressure 20% of initial level, moderate one when linear blood circulation velocity reduction reaches 70% and arterial blood pressure 50% and heavy one when linear blood circulation velocity reduction is greater than 70% of initial level and arterial blood pressure is greater than 50% to the extent of no blood circulation manifestation being observed in the subclavian artery.
EFFECT: high accuracy of diagnosis.