Роль фракционного резерва кровотока в определении тактики рентгенохирургического вмешательства при стентировании «ложных» бифуркационных стенозов коронарных артерий

Main vessel stenting in the «false» bifurcation coronary lesions compromises side branch vessel ostium often. Functional significance of the side vessel ostium narrowing after main vessel stenting was defined in 40 patients with II-III classes of stable angina pectoris with isolated «false» bifurcation coronary lesions by means of a fractional flow reserve (FFR). Average side branch vessel ostium narrowing was 69,8 ± 8,7%, average value of FFR was detected 0,83 ± 0,06. It was noted, that the visual estimation and the quantitative coronary angiography are unreliable methods in assessment of the severity of side branch vessel ostium narrowing. The results of our study demonstrate, that if FFR > 0,75 it is out of any benefit to conduct additional kissing balloon angioplasty of side brahch vessel ostium. Moreover, it was associated with high risk of side branch vessel dissection and ischemic myocardium injury.Стентирование магистральных артерий «ложных» бифуркационных стенозов коронарных артерий часто осложняется компрометацией устья боковой ветви. У 40 больных со стабильным течением стенокардии II-III ФК с изолированным «ложным» бифуркационным стенозом с помощью фракционного резерва кровотока (ФРК) была определена функциональная значимость сужения устья боковой ветви после стентирования магистальной артерии. При средней степени сужения устьев боковых ветвей на 69,8 ± 8,7%, средняя величина ФРК составила 0,83 ± 0,06. Установлено, что визуальная оценка и количественная коронарная ангиография являются ненадежными методами при оценке функциональной значимости компрометации устьев боковых ветвей. Полученные результаты свидетельствуют, что при величине ФРК > 0,75 проведение дополнительной баллонной ангиопластики в устьях скомпрометированных боковых ветвей не улучшает отдаленный прогноз, в то время как ассоциируется с увеличением риска диссекции интимы боковых ветвей и ишемическим повреждением миокарда

Использование устройств аспирации тромба при острых окклюзиях коронарных артерий

There were analyzed 38 patients with acute coronary syndrome with ST segment elevation. Every patient was revealed by coronary angiography to have an occlusion in one of the main coronary arteries. The patients were divided in two groups by the technique of percutaneous coronary intervention. In the first group (n = 18) after mechanical recanalisation with wire we used a catheter for thrombus aspiration. Furthermore according to results after coronary angiography these patients underwent either direct stenting or predilatation with further stenting. After mechanical recanalisation in the second group (n = 20) routine stenting with predilatation were performed. The reperfusion quality was evaluated by TIMI scale by the angiography and ST segment decrease during 30 minutes after the intervention. It was statistically proved that adequate reperfusion was achieved in the group with thrombus aspiration catheter.Проанализированы результаты обследования и лечения 38 пациентов с инфарктом миокарда с подъемом сегмента ST. По результатам коронарной ангиографии во всех наблюдениях определялась окклюзия одной из магистральных коронарных артерий. Пациенты были разделены на две группы в зависимости от тактики выполнения чрескожного коронарного вмешательства. В первой группе (n = 18) после механической реканализации проводником в зону окклюзии вводили катетер для аспирации тромба. Далее в зависимости от ангиографического результата выполнялось прямое стентирование поражения или предварительная баллонная ангиопластика с последующим стентированием. Во второй группе (n = 20) после механической реканализации выполнялась баллонная ангиопластика с последующим стентированием. Адекватность реперфузии оценивалась по степени восстановления кровотока по шкале TIMI по результатам коронарной ангиографии и по снижению сегмента ST по данным ЭКГ через 30 минут после окончания вмешательства. При сравнении результатов первой и второй групп установлено, что достоверно чаще в первой группе пациентов удавалось достигнуть адекватной реперфузии

Superluminal source of directional pulsed wideband electromagnetic radiation

A photoemission source of directional pulsed wideband electromagnetic radiation in the microwave region is developed, and the time profile of the generated pulse is investigated. The source is a vacuum photodiode of a parabolic shape in which a Cherenkov radiation pulse is formed by an electron current wave excited by an incident laser pulse and propagating along the surface of the anode mesh with a phase velocity higher than the speed of light. © 2014, Allerton Press, Inc

Superluminal source of directional pulsed wideband electromagnetic radiation

A photoemission source of directional pulsed wideband electromagnetic radiation in the microwave region is developed, and the time profile of the generated pulse is investigated. The source is a vacuum photodiode of a parabolic shape in which a Cherenkov radiation pulse is formed by an electron current wave excited by an incident laser pulse and propagating along the surface of the anode mesh with a phase velocity higher than the speed of light. © 2014, Allerton Press, Inc

Investigation of reactions using polarized and unpolarized deuteron beam at Nuclotron: current status and perspectives

Deuteron induced reactions at intermediate energies are investigated at Internal Target Station (ITS) of Nuclotron. The dp elastic scattering data have been accumulated in the angular range (70° - 120°) in c.m from 0.3 to 2.0 GeV of deuteron energy. Part of the obtained results of differential cross sections and analyzing powers of dp elastic scattering are compared with theoretical predictions based on relativistic multi-scattering model. The dp breakup data are obtained with the detection of two outgoing protons at the angles of (19° - 54°) in laboratory frame at the deuteron energies from 0.3 to 0.5 GeV in various detector configurations. One of the tools to study spin structure of short range correlations is the measurements of the cross section, tensor analyzing power T20 and spin correlation parameter Cy,y in the d3He → p(0°)4He reaction at the energies between 1.0 and 1.75 GeV using polarized 3He target and extracted polarized deuteron beam from new polarized ion source at Nuclotron. For this purposes the feasibility study has been performed. Proposed experiments on extracted deuteron beam of Nuclotron is aimed to investigate: non-nucleonic degrees of freedom and baryonic resonances properties in the d(A,d(0°))X and d(A,π-(0°))X reactions at different energies, non-nucleonic degrees of freedom via the measurements of the tensor Ayy and vector Ay analyzing powers in d(A,π-)X reaction and polarization properties of the baryonic resonances in the d(A,d)X reaction and others. First measurement of vector and tensor polarization of new polarized ion source has been performed in June-July of 2016y

Investigation of reactions using polarized and unpolarized deuteron beam at Nuclotron: current status and perspectives

Deuteron induced reactions at intermediate energies are investigated at Internal Target Station (ITS) of Nuclotron. The dp elastic scattering data have been accumulated in the angular range (70° - 120°) in c.m from 0.3 to 2.0 GeV of deuteron energy. Part of the obtained results of differential cross sections and analyzing powers of dp elastic scattering are compared with theoretical predictions based on relativistic multi-scattering model. The dp breakup data are obtained with the detection of two outgoing protons at the angles of (19° - 54°) in laboratory frame at the deuteron energies from 0.3 to 0.5 GeV in various detector configurations. One of the tools to study spin structure of short range correlations is the measurements of the cross section, tensor analyzing power T20 and spin correlation parameter Cy,y in the d3He → p(0°)4He reaction at the energies between 1.0 and 1.75 GeV using polarized 3He target and extracted polarized deuteron beam from new polarized ion source at Nuclotron. For this purposes the feasibility study has been performed. Proposed experiments on extracted deuteron beam of Nuclotron is aimed to investigate: non-nucleonic degrees of freedom and baryonic resonances properties in the d(A,d(0°))X and d(A,π-(0°))X reactions at different energies, non-nucleonic degrees of freedom via the measurements of the tensor Ayy and vector Ay analyzing powers in d(A,π-)X reaction and polarization properties of the baryonic resonances in the d(A,d)X reaction and others. First measurement of vector and tensor polarization of new polarized ion source has been performed in June-July of 2016y

Deuteron beam polarimeter at Nuclotron internal target

The current deuteron beam polarimetry at the Nuclotron is provided by the Internal Target polarimeter based on the use of the asymmetry in dpelastic scattering at large angles in the cms at 270 MeV. The upgraded deuteron beam polarimeter has been used to obtain the vector and tensor polarizations during 2016/2017 runs for the DSS experimental program. The polarimeter has been also used to tune the polarized ion source parameters for 6 different spin modes. The data analysis has been performed using the developed software based on C++ language and ROOT5 librar

Deuteron beam polarization measurement at 270 MeV at Nuclotron internal target

The current deuteron beam polarimetry at Nuclotron is provided by the Internal Target polarimeter based on the use of the asymmetry in dp-elastic scattering at large angles in the cms at 270 MeV. The upgraded deuteron beam polarimeter has been used to obtain the vector and tensor polarization during 2016 runs for the DSS experimental program. The polarimeter has been used also for tuning of the polarized ion source parameters for 6 different spin modes. The data analysis has been performed using developed software based on C++ language and ROOT5 library