avkАрхивъ внутренней медициныThe Russian Archives of Internal Medicine2226-67042411-6564“SINAPS” LLC10.20514/2226-6704-2018-0-5-346-360avk-836Research ArticleОБЗОРНЫЕ СТАТЬИREVIEW ARTICLESРОЛЬ ИНТЕРВЕНЦИОННЫХ МЕТОДОВ В ЛЕЧЕНИИ ОСТРОЙ ЛЕГОЧНОЙ ЭМБОЛИИTHE ROLE OF INTERVENTIONAL METHODS IN TREATMENT OF PULMONARY EMBOLISMВатутинН. Т.VatutinN. T.

Донецк.

Donetsk.

ТарадинГ. Г.TaradinG. G.

Донецк.

Donetsk.

taradin@inbox.ruКанишеваИ. В.KanishevaI. V.

Донецк.

Donetsk.

БортД. В.BortD. V.

Донецк.

Donetsk.

ЗагоруйкоА. Н.ZagorujkoA. N.

Донецк.

Donetsk.

ГОО ВПО «Донецкий национальный медицинский университет им. М. Горького»; ГУ «Институт неотложной и восстановительной хирургии им. В.К. Гусака».РоссияState Educational Organization of Higher Professional Education «M. Gorky Donetsk National Medical University»; State Institution «V.K. Gusak Institute of Urgent and Recovery Surgery».Russian FederationГОО ВПО «Донецкий национальный медицинский университет им. М. Горького».РоссияState Educational Organization of Higher Professional Education «M. Gorky Donetsk National Medical University».Russian Federation20180910201885346360Copyright © Ватутин Н.Т., Тарадин Г.Г., Канишева И.В., Борт Д.В., Загоруйко А.Н., 20182018Ватутин Н.Т., Тарадин Г.Г., Канишева И.В., Борт Д.В., Загоруйко А.Н.Vatutin N.T., Taradin G.G., Kanisheva I.V., Bort D.V., Zagorujko A.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.medarhive.ru/jour/article/view/836

Представленный обзор посвящен современным интервенционным методам лечения острой легочной эмболии. В статье даётся обоснование применения катетерных методик, подробно изложены п ринципы отбора пациентов, и стратификация риска с учётом оценки массивности тромбоэмболического события, степени риска острой легочной эмболии, оценки риска кровотечений и индивидуальных особенностей пациентов. Обзор содержит современную классификацию легочной эмболии на основе оценки риска 30-дневной смертности и расчет прогноза заболевания по традиционной и упрощенной шкале Pulmonary Embolism Severity Index. Особое внимание уделено собственно интервенционным методикам, в частности катетер-управляемому тромболизису, реолитической тромбэктомии, фрагментации и аспирации тромбов. Приводятся результаты исследований, посвященных оценке эффективности и безопасности использования эндоваскулярных методов у больных легочной эмболией. Подчёркивается важность дальнейшего изучения различных клинических аспектов при использовании указанных методов для получения всесторонней информации при лечении этого грозного заболевания, ассоциирующегося с существенной инвалидизацией и смертности больных.

The presented review concerns to current interventional methods of acute pulmonary embolism treatment. The article provides a rationale for catheter approaches, detailed description of patient selection and risk stratification including an estimation of thromboembolic burden, risk degree of acute pulmonary embolism, bleeding risk assessment, and patient-specific considerations. The review contains the up-to-date classification of pulmonary embolism on the basis of 30-day mortality assessment and estimation of disease outcome according to the conventional and simplified Pulmonary Embolism Severity Index. A special attention is paid to interventional methods peculiarly, in particular to catheter directed thrombolysis, rheolytic thrombectomy, thrombus fragmentation and aspiration. The results of studies concerning efficiency and safety of endovascular methods in treatment of pulmonary embolism patients are reported. It was emphasized importance of further investigation of various clinical aspects using these methods for obtaining of comprehensive information about treatment of the dangerous disease associated with significant morbidity and mortality.

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The authors declare that there are no conflicts of interest present.