Method for local thrombolysis in case of obstructing thrombus

FIELD: medicine.

SUBSTANCE: invention is related to medicine, namely to angiologia and may be used for local lysis of obstructing thrombus inside any vessel. Catheter is used with balloon, which is blown to complete obturation of vessel, and fibrinolytic agent is introduced under pressure into produced space, isolated from one side with catheter balloon and thrombus on the other side, until complete lysis of thrombus.

EFFECT: method makes it possible to increase efficiency of treatment due to creation of high concentration of fibrinolytic agent in the area of thrombus and action of pressure at thrombus, and also to achieve reduction in number of complications.

1 dwg, 1 tbl, 1 ex

 

The invention relates to medicine, namely to angiology, and can be used for local lysis alterimage clot inside any vessel.

Thrombosis is the most common pathology of the vascular system. The result of thrombosis are such terrible diseases such as ischemic stroke, myocardial infarction, pulmonary embolism. The number of these diseases is growing every year. Despite the level of development of surgery, more than 60% of thrombosis of arteries or veins cannot be cured by surgery, but almost all of the blood clots can lyse. So now is the actual creation of new methods of conservative treatment of patients.

There is a method to systemic thrombolysis, which consists in the introduction of the drug for thrombolysis in peripheral or subclavian vein. Circulating in the bloodstream, the drug gets into the area of thrombosis and causes lysis of the clot, after which the blood flow is restored (Epogen, Iketubosin "Selected lectures on angiology". Second edition, revised and expanded. MOSCOW SCIENCE 2006 ISBN 5-02-033969-5, str).

The disadvantage of this method is low efficiency, because it does create a high concentration of drug for thrombolysis in the area of the clot, because the preparation for thrombolysis falls mainly not to the diamond, and in the systemic circulation, which leads to a significant number of complications during and after the execution of the method; in addition, it is impossible to influence the clot physical methods - changes in pressure gradients.

The closest in technical essence and the achieved result is a method of selective thrombolysis, namely that directly to the clot down the catheter through which serves preparation for thrombolysis (Epogen, Iketubosin "Selected lectures on angiology". Second edition, revised and expanded. Moscow, Nauka, 2006, ISBN 5-02-033969-5, str).

The disadvantage of this method is low efficiency, because it slightly increases the concentration of the drug for thrombolysis in the field of thrombus compared with the competing product for thrombolysis falls mainly not to clot, and into the systemic circulation, which leads to a significant number of complications during and after the execution of the method; ensures the effectiveness of thrombolysis only within 24 hours after embolism; in addition, it is impossible to influence the clot physical methods (pressure gradients).

The authors offer a highly effective method of local thrombolysis for obtenerse the blood clot, which blocks the thrombosed artery segment with stopping it is robotica and the ability to maximize it to the concentration of the drug for thrombolysis, to change the pressure to reduce the flow of drug into the systemic circulation.

The technical result of the proposed method is to increase efficiency and reduce complications.

The technical result is achieved by using a catheter with a balloon which is inflated to its full obturation of the vessel, and formed isolated, on the one hand the balloon catheter with the other hand by a blood clot, space, enter fibrinolytic agent until complete lysis of the thrombus.

The method is as follows.

The method is carried out by means of the device illustrated in the drawing. The drawing shows: a catheter with a balloon 1, obtenerse thrombus 2 and an isolated space 3 in the pulmonary artery.

In terms of the x-ray operation room after radiographic verification of a blood clot, instead of the usual catheter in the vessel, under the control of angiotensinogen install a catheter with a balloon 1 (for example, the catheter Swan-Gans), the distal end of which is led to the blood clot 2. The cylinder 1 of the catheter to inflate the complete obturation of the vessel, and formed in an isolated space 3 enter the radiopaque agent (e.g., omnipaque, Ireland). No leaching of the radiopaque means indicates the absence of blood flow in the isolated space 3 of the vessel and blocks the implement. Further thrombolysis spend a fibrinolytic agent (e.g., Actilyse, Germany) at a dose of 100 mg for 2 hours, to consistently inflated balloon 1 of the catheter under the control of the pressure in the isolated space 3 of the pulmonary artery. When obtenerse the thrombus cylinder 1 of the catheter allows you to raise the pressure in the isolated space 3 of the vessel, which promotes more rapid penetration of fibrinolytic funds into blood 2 and explains its early lysis of the thrombus. Increasing the concentration of fibrinolytic funds only in the isolated space of the vessel causes a reduction in its exposure and reduction of complications in carrying out the proposed method.

Clinical example.

Patient Bukina Natalia Ilyinichna, 45 years, history No. 7073, arrived in Noosa heads the Bureau at the station Barnaul June 5, 2007 at 14:43 with clinical signs of pulmonary embolism - complaints of shortness of breath, weakness, ECG signs of overload of the right departments of heart.

In the x-ray operation room conditions were pulmonary. In the right pulmonary artery verified obtenerse thrombus. To prevent recurrence of thrombosis in the inferior Vena cava installed cava filter.

For local thrombolysis, through Introducer installed in the subclavian vein, directly to oboreru what he clot summed catheter Swan-Gans. For better x-ray contrast balloon catheter is inflated radiopaque agent. In the distal canal catheter introduced contrast omnipak. Formed area of the artery that is blocked on one side obtenerse thrombus, on the other hand the balloon catheter. According to x-ray images shows no leaching of a radiopaque contrast agent of the blocked area. For making local thrombolysis patient transferred to the intensive care unit.

Initial hemodynamic parameters before carrying out the methods of thrombolysis: the heart rate is 72 beats per minute, blood pressure - 167/90 mm RT. century, the oxygen saturation in the peripheral blood of 82%. The original pressure in the pulmonary artery 61/21 (34) mm RT. Art.

When an inflated balloon catheter initiated the introduction of a test dose of actilyse through the distal channel in the blocked area, where the pressure was 49 mm RT. Art. After administration of the test dose of actilyse started introduction the primary dose. After 10 min after the start of introduction of the basic dose determined a sharp decrease in the pressure in the blocked area up to 15 mm RT. century, testified to recanalization of the thrombus and the early restoration of blood flow. Introduction actilyse continued up to 2 hours for a more complete thrombolysis with an inflated balloon catheter. At the end of thrombolysis balloon catheter is deflated. ISM is Reny hemodynamic parameters and pressure in the pulmonary artery. Hemodynamics after conducting technique: HR - 66 beats per minute, blood pressure is 140/80 mm RT. century, the oxygen saturation in the peripheral blood is 98%. The pressure in the pulmonary artery - 17/12 (14) mm RT. Art., which corresponds to normal hemodynamics. The decrease in pulmonary artery pressure to normal values indirectly testified to complete lysis of the thrombus.

The inventive method was applied in 10 patients in 2007 and showed high efficiency in the treatment of pulmonary embolism, as well as reducing complications in carrying out the proposed method.

Comparative table of the effectiveness of the proposed method with analogue and prototype.

The table shows that the inventive method has a high efficiency through the creation of high concentrations of fibrinolytic tools in the area of the clot, holding thrombolysis without systemic effects of fibrinolytic means causes fewer complications.

Table
The way local thrombolysis for obtenerse the blood clot
No.IndexSystemic thrombolysis (similar) Selective thrombolysis (prototype)Local thrombolysis (invention)
1System action fibrinolyticFully systemSignificantMinor
2The concentration of fibrinolytic in the field of blood clotVery lowAverageVery high
3Effects on blood pressureNoNoYes
4An assessment of the effectiveness of the methodology (the time of recanalization of the thrombus)NoNoYes
5Time to recanalization of the thrombusWatchWatchMinutes
6The number of complications of the methodVery highHigh Very low

The way local thrombolysis for obtenerse the thrombus by introducing fibrinolytic means by means of a catheter, characterized in that use a catheter with a balloon which is inflated to its full obturation of the vessel and formed isolated on one side of the balloon catheter and on the other hand thrombus space is injected under pressure fibrinolytic agent until complete lysis of the thrombus.



 

Same patents:

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to surgery and combustiology, and can be used in treating the patients with burn wounds. That is ensured by toilet. Then 1-2 days after trauma, the wound surface is covered with a bandage bottom of which is made of hydrophobic perforated silicone film "Carbosyl-P" coated with a layer of human collagen type I and human allogenic fibroblasts. As allogenic fibroblasts, characterised cells of human diploid fibroblast line M-22 at passage level №15-25 are used.

EFFECT: invention enables fast adequate epithelium repair over the wound at good functional and cosmetic result including in burns of II-IIIA degree, and also prevents development of local purulo-necrotic complications.

7 dwg, 3 tbl, 1 ex

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to combustiology, and can be used in treatment of deep burn of skin including of III-B degrees. That is ensured by application on wound surface of a biodegradable material containing allogenic cultivated fibroblasts of animal's fetal allografts and a sponge composition prepared of 2% collagen acetate and 2% chitosan acetate of molecular weight 100-700 kDa and deacetylation degree over 95%. Herewith 2% chitosan acetate contains: ascorbic acid 1.8 g, chondroitin sulphuric acid 5-100 mg, D-glucuronic acid 10-100 mg, heparin 2.5-5 mg and cattle's serum growth factor "adgelon" 11-220 mkg.

EFFECT: method ensured accelerated healing of burn wound with high-grade recovery of dermal skin layer owing to application of the highly biocompatible material containing components that ensure optimal microenvironment for wound recovery.

6 tbl

FIELD: medicine.

SUBSTANCE: invention concerns medicine, particularly traumatology and orthopedics, and can be applied as preventive measure against purulent inflammatory complications for orthopedic trauma cases. It involves whole blood take from any central or peripheral vein of patient on the day before surgical intervention in amount of 10 ml by syringe flushed by heparin in advance. Obtained whole blood is settled for 100-140 minutes, lymphocyte fraction is separated in amount of 0.5-1.5 ml with further adding 5 ml of RPMI-1640 cultural medium and 5 ml of the patient's own serum to the fraction. Obtained cell suspension is poured by 2 ml into sterile vessels, and 5 ml of RPMI-1640 cultural medium and 0.01 ml of 10% phytohemoagglutinin solution in RPMI-1640 cultural medium is added to each vessel. Vessels with lymphocyte culture are placed in thermostat and kept at 37°C for 72 hours. Then autologic lymphocyte culture obtained in each vessel is centrifuged for 3-5 times for 10 minutes at 800-1200 rpm rotation rate. After each centrifugation, supernatant fluid is discharged, and 5 ml of saline solution is added to each vessel for repeated centrifugation. When centrifugation is over, cell bulk of autologic lymphocytes is gathered from all vessels by a syringe with added 10 ml of saline solution, and obtained bulk is further injected intravenously to any central or peripheral vein for 30-70 seconds. Cell bulk obtained by the method is injected before surgical intervention, or during it, or over 2-3 days after surgical intervention. Cell bulk of autologic lymphocytes can also be performed again over 7-14 days after initial injection.

EFFECT: enhanced immune organism reactivity in post-operation period due to increased lymphocyte number in blood.

2 cl, 3 ex

FIELD: medicine.

SUBSTANCE: invention concerns medicine, particularly surgery. Method involves sanitisation of pathology locus by drainage. Forced exercises are performed before each sanitisation by body leaning to the left, to the right, forward and backward, combined by respiratory exercises. For sanitisation 50 ml of dioxydine per 800 ml of nitrofurazone solution is used, the procedure is performed each 4 hours. Afterwards classical manual massage of upper and lower extremities with transition to waist area is performed in combination with alcohol solution rubbing. Vobenzym is administered orally at the ratio of 7 pills per 1 l of water, by 200 ml 5 times a day for 2 weeks. Mix of 800 mg of Abaktal in 400 ml of 5% glucose solution is injected intravenously twice a day till leukocyte rate in blood is 7.0×109 or less. 200 ml of blood is exposed to UV radiation for 15-20 minutes in 10 sessions.

EFFECT: enhanced efficiency of treatment due to complication prevention.

1 ex

FIELD: medicine.

SUBSTANCE: invention refers to medicine and can be used for post cosmetic surgery rehabilitation that is ensured by introduction of mixed medicinal preparations in lymphoid region of orbit, namely within pterygopalatine fossa and parotid. The mixed preparations introduced in pterygopalatine fossa are lidocaine 50-100 mg, dexamethasone 4-8 mg, glucose 400-800 mg, dalargin 1-2 mg and Lydasa 16-32 UN. And parotid injection contains lidocaine 50-100 mg, aminophylline 24-28 mg, hystochrom 10-20 mg and Lydasa 16-32 UN. Introduction of the mixed preparations is carried out on right or left side of face alternately every 4-5 hours daily within the course 6-8 procedures. Then 3-5 procedures of discrete plasmapheresis follow with using no more than 20-25% of total blood volume for exfusion. The prepared cell mass is incubated with 250-350 cm3 of ozone-oxygen mixture of ozone concentration 3000-3200 mkg/l.

EFFECT: method allows reducing post cosmetic surgery rehabilitation time owing to stimulation of regional lymph flow ensured by high local concentration of medical preparations.

2 ex

FIELD: medicine; surgery.

SUBSTANCE: mini thoracotomic access with the subsequent aspiration of a transudate for treatment of patients with secondary recurring transudate pleuritis is made in the 6th intercostal space. Then pleurodesis is carried out under visual control, treating thus parietal and visceral leaves of a pleura by the drape moistened plentifully with the 70% ethyl alcohol solution. After that active drainages are placed in a pleural cavity and an operational wound is taken in.

EFFECT: full and proof obliteration of a pleural cavity, prevention of local liquid accumulations relapse occurrence in it at the expense of uniform total processing of a pleural cavity by an ethyl alcohol solution under visual control.

2 ex

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to surgery, and can be used for prevention and/or treatment of visceral and parietal peritoneum adhesions. It is ensured as follows. At the final stage of operation, 1-4 silicone male drainage tubes of internal diametre 4-8 mm are inserted in subhepatic space, and/or in left subphrenic space, and/or in right lateral sinus and/or in left lateral sinus. Besides, 1 to 3 silicone female drainage tubes of internal diametre 6-8 mm are installed in left and/or right lateral canals, and/or in small pelvis cavity. Provided the blood analysis showed lymphocyte content more than 19%, leukocytes at least 3.5×109/l and thrombocytes at least 180×109/l, in early postoperative period, epidural anaesthesia aided 5% glucose, dialysis or Ringer-Lock based solution containing 5-Fluorouracil 0.25-0.75 g/m2 of body surface in amount 800 - 2000 ml is introduced through the inserted male tubes. Solution exposition in abdominal cavity makes 4-23 hours. After that the solution is evacuated from abdominal cavity through the drainage tubes. Further all drainage tubes are removed. The procedure is carried out daily starting from the first to fifth days after operation.

EFFECT: method allows for high effectiveness of prevention and/or treatment of postoperative adhesions in abdominal cavity including recurrent adhesions owing to application of complex of the preparations that effect adhesive process in abdominal cavity without disturbing intestinal transit.

3 cl, 4 ex

FIELD: medicine.

SUBSTANCE: treatment of the patients with purulent wounds is ensured by bathing of a purulent wound that is being in alterative and exudative inflammation phase, with physiologic saline. It is followed with registering fluorescence of the purulent wound within its depth, centre and infiltrate. Thereafter a factor K1=Iav/If is calculated, where Iav is an average fluorescence index of the wound within depth, centre and infiltrate, If is a standard fluorescing reference of a comparison object which is the fluorescence of earlap. Then the wound is sponged with a probiotic in amount 5.0-50.0 ml and more considering the wound extent. It is drained and loosely filled with a probiotic-saturated tampon. Thereafter an aseptic dressing is applied, and conventional integrated therapy is administered. Probiotic re-management of the wound is carried out once a day and more often, with multiple bathing of the purulent wound and fluorescence registration. Provided K1>>K2, where K2 is the fluorescence measured again in combination with the integrated therapy, the same is continued. Otherwise, the integrated therapy is corrected by changing an antibacterial preparation and/or prescribing the other antibacterial preparations and/or additional oral introduction of probiotic Euflorin L and B dosed 1 tablespoon 1-3 times a day. The therapy is prolonged until granulations are observed in the wound, and until K1>>Kn is provided, where Kn is a value verging towards fluorescence powers specific for intact tissues or varies no more than by 5-20%.

EFFECT: higher effectiveness of purulent wounds repair combined with integrated therapy without local application of antibacterial preparations owing to local introduction of probiotics in this case acting as antagonists to pyogenous flora of the wound.

2 tbl

FIELD: medicine.

SUBSTANCE: invention concerns medicine. The device implanted into a human body or an animal is described, containing the bioblasted polymer including units of ethylene carbonate of the formula (A): -(-C(O)-CH2-CH2-O-)- (A), in number of 70-100 molar % which possesses internal viscosity 0.4-4.0 dl/g at determination in chloroform at 20°C in concentration of 1 g/dl and 5-50°C vitrification temperature, blasted at the expense of superficial erosion which is supervised on the mechanism of non-hydrolytic scission.

EFFECT: restoration of normal blood flow and keeping an artery opened after installation of a balloon catheter.

13 cl, 1 dwg, 2 ex

FIELD: medicine.

SUBSTANCE: invention concerns medicine, namely, to abdominal surgery, and can be used for prevention of formation of postoperative adhesions of serous cavities. For this purpose deserosed and-or the inflamed sites of organs and a cavity wall are covered with an admixture of sterile gel "Lintexum-Mesogel" and derinate during an operative measure on organs of serous cavities. Derinate volume makes from 1% to 25% from all volume of the admixture. The way allows preventing development of adherent process in abdominal cavity in the postoperative period without additional administration of other medicinal preparations during this period at the expense of local prolonged immunopotentiation provision and consolidation prevention of deserosed surfaces.

EFFECT: prevention of development of adherent process in abdominal cavity in the postoperative period without additional administration of other medicinal preparations during this period at the expense of local prolonged immunopotentiation provision and consolidation prevention of deserosed surfaces.

2 tbl, 1 ex

FIELD: medicine.

SUBSTANCE: invention relates to medical equipment and urology. Permanent catheter for draining urea from urinary bladder into urinary sphincter location nearby external urinary sphincter comprises urinary channel passing from external urinary sphincter to outer hole. Catheter comprises main body allowing installing its distal end inside urinary bladder and its proximal end nearby and distally from sphincter inside urinary path. Aforesaid body features inner passage for draining urea. Cylinder is fastened onto distal end of the main body. Aforesaid cylinder can expand inside urinary bladder to hold distal end inside urinary bladder and prevent primal motion of the main body from location of its use. Catheter comprises also filling tune with its distal end connected with the main body and length sufficient to pass from the main body, via urinary channel and outer hole, when main bode is in location of use. Filling tube and body form filling passage running from proximal end of filling end into the cylinder thought which fluid is fed to fill the cylinder. Spiral section of filling tube is located at such point along filling tube whereat spiral section stays inside urinary channel, nearby and proximally from sphincter when main body is in location of use. Spiral section interacts with urinary path contraction via outer sphincter to prevent distal motion of main body inside urinary path from location of use. In draining, permanent catheter is arranged nearby and distally from sphincter. Catheter has filling cylinder and uses spiral section inside urinary path. Section prevents distal motion of catheter due to contact with urinary path contraction. Proximal motion of catheter is prevented by contact between filled cylinder with urinary bladder. In particular case, a tool may used to insert catheter using inner channel between tool ends. Here, inner channel of aforesaid tool and catheter are made communicating. Flushing fluid is fed via tool inner channel.

EFFECT: ruling out surgery intervention, reduced risks of infection.

10 cl, 16 dwg

FIELD: medicine.

SUBSTANCE: invention concerns medicine. The device includes a plastic catheter and restrictor. The catheter is executed in the form of the tube having two channels unconnected among themselves, one of them is intended for supply of a radiopaque liquid in a cavity of the uterus, and another - for inflating by means of a liquid entered into the cervical channel of the cuff, placed on the distal extremity of the catheter. The cuff is executed with possibility of acquisition of the cylindrical form after filling of its cavity with a liquid. And in inflated condition diametre of the cuff is not less than twice less than its length, and at a catheter introduction external diametre of the cuff coincides with the size of a two-channel tube. Thus the restrictor is established with possibility of free movement and bracing on a tube between the cuff and a catheter adapter. Application of the given device provides easy introduction and reliable bracing of a handpiece in the cervical channel, and also prevents leak of a contrast liquid from an examined organ.

EFFECT: easy introduction and reliable bracing of a handpiece in the cervical channel, and also prevention of leak of a contrast liquid from an examined organ.

1 dwg

Coronary catheter // 2355435

FIELD: medicine; cardiosurgery.

SUBSTANCE: invention can be used in cardiosurgical practice for left heart revascularisation for treatment of ischemic heart disease. Coronary catheter consists of basic catheter with central opening, balloon segment, which has balloon, and shaft for balloon blowing. Basic catheter, whose frame is made of flexible but strong and heat-resistant polymer, is equipped with metal bush with guide pin at the end. Bush is made from metal possessing high resistance and low heat conductivity for restraining electric potential and protection against high temperature of basic catheter polymeric frame, with possibility of translational and rotary motion in central opening, which has narrowing at distal end. Basic catheter is also equipped with rod electrode, made of strong metal, possessing shape memory, with possibility of translational motion inside bush. Shaft is made with smaller opening than in standard two-opening catheters, and is connected with air pump, subjected to control system. Balloon segment has length not more than 3 times and diametre of balloon stretching not more than 2 times exceeding diametre of affected coronary artery. Proximal end of rod electrode is connected to operating phase of high-frequency electrosurgical unit and together with metal bush with guide pin - to driving elements of control system.

EFFECT: myocardium revascularisation with low traumatisation of coronary arteries, performing revascularisation from different sections of left coronary basin, renunciation of using coronary guide for passing coronary catheter, revascularisation of small vessels of distal coronary flow and diffusely changed coronary arteries.

5 dwg

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to vascular surgery. Conduction catheter is introduced into blood vessel. Fixation of conduction catheter in blood vessel is realised by means of inflatable balloon of cylindrical form and air duct, one end of which is located in balloon wall thickness, the other end has possibility of rigid fixation to proximal end of conduction catheter, air duct being located either inside conduction catheter gap, or in its wall thickness, or outside. Inflatable balloon and conduction catheter are placed with respect to each other in such way that it is possible to change distance between them.

EFFECT: eliminating possibility of catheter swinging and reducing possibility of traumatising vessel during operation, increasing its efficiency.

7 dwg

FIELD: medicine; gynaecology.

SUBSTANCE: hemostatics and uterotonic agents are parenterally introduced. Previously folded intrauterine rubber balloon catheter with delivery and support in the form of tubular element rounded at distal end with length that is comparable to but not less than total length of uterine cavity and vagina is introduced into cavity of birth canal. Irrigation and drain tubes from elastic shape-holding material are located on external surface of balloon. Length of tubes exceeds length of tubular element for delivery and support of balloon catheter with possibility of exit beyond the limits of birth canal - from vagina. Distal ends of tubes are rounded with openings on the surface for contents outlet and collection. One of tubes is arranged with the possibility of connection with syringe for introduction of hemostatic into uterine cavity, other tubes are connected with reservoir for collection of drained liquid. Tubular element for delivery and support of balloon catheter is connected with reservoir for filling of balloon catheter with sterile liquid, the second tube installed in reservoir above liquid level is connected to manometer, and pump for pressure charging is located at its end. This device is located from entry to vagina to uterus bottom, fixing proximal end of balloon catheter with tubes in entry to vagina. Then sterile physiological solution is pumped into catheter by means of pump until visually controlled bleeding is arrested. After bleeding has been stopped, pressure value is fixed, then pressure changes are registered in filled balloon catheter, at that pressure rise is treated as restoration of uterus contractive activity, afterwards pulled pressure is reduced in successive steps down to fixed value. If pressure value in catheter drops, it is increased up to fixed value. In both cases fixed pressure of bleeding arrest is maintained for at least 30 minutes, reduction is carried out in successive steps by 10 mm of mercury column every 5-10 minutes. Hemostatics are introduced into uterine cavity by irrigation tube in appropriate doses, then all tubes are isolated for the time sufficient for creation of blood clot. If no bleeding takes place through drain tubes in process of stepwise pressure reduction, pressure is dropped, liquid is removed from balloon catheter, and it is withdrawn outside.

EFFECT: fast and efficient arrest of metrorrhagia by coverage of the whole area of possible bleeding and simultaneous additional effect at local hemostasis by introduction of medicines into uterine cavity.

2 cl, 3 dwg, 2 ex

FIELD: medicine; gastroenterology.

SUBSTANCE: invention can be used at treatment of patients with gastroesophageal reflux disease caused by disturbance of pylorus patency in the form of a pylorospasm. Enter a probe-dilatator in the pylorus and a proximal part of a duodenum by means of the endoscopic apparatus. Fan a cylinder of a probe-dilatator under the pressure of 0.3-0.6 kg/cm for 4-7 seconds. Perform the procedure 2-3 times with an interval of 11-30 seconds. Repeat the treatment 3 times with a break in 2 days.

EFFECT: the method provides reliable treatment of the gastroesophageal reflux disease at the expense of normalisation of patency of the pylorus.

2 ex

Balloon catheter // 2327489

FIELD: medicine.

SUBSTANCE: given invention refers to balloon for medicinal equipment, specifically for catheter used within angioplasty containing polyamide copolymer material, characterised by the fact that specified polyamide copolymer material is presented with general formula (I), HO-(PF-OOC-PA-COO-PF-COO-PA)n-COOH, where PA is polyamide segment, PF is diol segment containing dimeric diol and/or corresponding diol polyester with end OH groups and n is number within 5 to 20.

EFFECT: improved plasticity performance.

25 cl, 1 dwg, 3 tbl, 2 ex

FIELD: medicine.

SUBSTANCE: method and device can be used for selective treatment of ill parts of tissue or organs of human bodies. Surface of medicinal devices being in contact with mentioned parts of body under pressure of medicinal devices are covered with lypophile, mainly water-insoluble medicinal aids being capable of connecting with any components of tissue, which medicinal preparations effect onto tissue immediately after contact and they effect for very short period of time without making dangerous effect onto adjacent healthy tissue. Device has balloon which surface is connected with lypophile, water-insoluble medicinal preparations being capable of binding with tissue. After contact with tissue is made, medicinal preparations are capable of instant release of biological active matters. Balloon is provided with preformed longitudinal folds. Biological active matter covers parts of balloon hidden by folds.

EFFECT: higher efficiency of treatment.

20 cl, 11 ex

FIELD: medicine, cardiosurgery.

SUBSTANCE: the present innovation deals with reconstructing permeability of occluded coronary arteries due to removing occlusion out of affected parts of arteries. So, a coronary guide with a soft tip should be applied to achieve the site of occlusion by not entering a lateral artery. As balloon catheters one should apply two-lumen ones, moreover, the first is designed to be shortened from its distal edge and ends with a balloon segment. The present balloon catheter should be applied up to the site of occlusion onset and simultaneously up to bifurcation region to install it, to be blown up to overlap the mouth of lateral artery. Then a rigid direct guide should be applied along the same balloon catheter - according to its conduit mine after preliminary removing a coronary guide with a soft tip. After directing this rigid guide through occlusion into distal part of occluded main artery and its recanalization with it is important to remove the first modeled balloon catheter and apply the second balloon catheter instead. It should be moved along occlusion to reach the center and dilate the artery. In particular case, one should remove a two-lumen tip by not interrupting the hermetic nature of a balloon catheter. The innovation enables to remove occlusion of the main artery in the site of branching, exclude "falling down" of coronary guide into lateral artery and, thus, provide the disposition of coronary guide especially in the stump in occluded artery and obtain its central position and movement strictly along the center of occlusion avoiding vascular wall traumatism due to subintimal application of coronary guide and, also, avoid arterial perforation in the site of occlusion.

EFFECT: higher efficiency.

1 cl, 7 dwg, 1 ex

FIELD: medicine, purulent and thoracic surgery.

SUBSTANCE: it is necessary to carry out draining and sanitation of restricted pleural empyema in a patient. Then the drainage should be substituted with a balloon catheter into the balloon of which under roentgenocontrol one should introduce isotonic NaCl solution with water-soluble contrast till complete filling the empyemic cavity and, correspondingly, occlusion of fistula-carrying bronchus. Filled up catheter should be kept for 7 d and then under roentgenocontrol gradually for 14-21 d one should remove the introduced solution. Te quantity of simultaneously removed solution should be determined according to the presence or absence of air drop out of empyemic cavity. After cavitary reduction the catheter should be removed. The innovation enables to provide reduction of pleural empyemic cavity along with occlusion of bronchopleural fistula and, also, prevent aerogenic contamination, stimulate granulation and subsequent cicatrisation of cavitary walls due to the pressure of balloon catheter upon them being filled by the cavitary volume.

EFFECT: higher efficiency of therapy.

3 dwg, 1 ex

FIELD: medicine.

SUBSTANCE: invention refers to ophthalmology and can be used in surgery of subretinal haemorrhages combined with age-specific macular dystrophy with subretinal neovascular membrane. The technique involves subtotal vitrectomy and removal of posterior hyaloid membrane. Bevacizumab and Ranibizumab are injected intravitreally. It is followed with intravitreal injection of tissue plasminogen activator and expanding gas while a patient is pronated.

EFFECT: method allows deploying blood from under retina, ensuring pathogenetic action on haemorrhage source, preventing proliferative processes in vitreal cavity.

2 ex

Up!