patient in the operating room.
Indications for surgery - clinical picture of unstable angina, entered the Krasnogorsk Vascular Center, after the next attack of chest pain.
Surgeon - Andrey Larin, head of endovascular methods of diagnostics and treatment.
first phase of the intervention - coronary angiography, a detailed examination of the problem of vessels with a special X-ray machine.
Andrei Larin commented:
«The patient previously stented, about a year ago in a Moscow clinic.We have identified certain coronary lesions and chronic occlusion (overlapping) of one medium-sized arteries.It is now essential, because blood flow has found workarounds, myocardium supplied with blood by the so-called collaterals.
main and crucial issue elsew
stent - a fine mesh tube composed of wire cells.
special balloon is inserted into it.A stent with a balloon inside in a compressed state is entered in place of the vessel narrowing (this is a moment positioning the stent).The balloon is then inflated with a special syringe-inflator.
Expanding, he presses the stent in the vessel wall, increasing its clearance.At the final stage of the operation the balloon is removed, and the stent remains.
blood supply is restored virtually in its entirety.
After deciding on the tactics of surgery, the surgeon puts a guiding catheter.Through his vessel is introduced a tool that Andrei Larin affectionately calls "coronary provodnichok".
According to him directly mounted stent into the artery.This is the so-called direct stenting without predilatation, ie without pre-expansion vessel.
Special mention should tell you about the place through which the vessels entered in the tools (everything that is entered into, are collectively referred to - introducers).
So, in the Krasnogorsk center of most of the operations is so-called "radial access", that is, through the radial artery hands.
This method, compared to the classical, through the femoral artery, is considered to be gentle, gives an opportunity to significantly reduce the rehabilitation period.During surgery, the patient is conscious, talking with the surgeon for his team makes the breaths, holds his breath.
«All our operations are performed under local anesthesia, - says Andrey Larin - anesthetized directly puncture site and the place of the introducer, ie, the patient does not feel any pain.Inside the vessels have no pain receptors, because if they were, people would feel every heartbeat, every moment of ejection of blood.Since no pain receptors within, respectively, the inner anesthesia is not necessary. "
The operating surgeon sounds loud command: "All done!" The patient gets the recommendation for the first time.They are simple - try not to strain the punctured arm.At the same time, in the role of head of the department, Andrey shares important information:
«These operations are complex, but we do often, we can say that now they are on stream.In our center in the year they performed 700-800.In general, in the Moscow region, of course, it does not cover all in need of such transactions, not all.At present, we plan to expand the flow of patients, we will operate more. "
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