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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">kpccz</journal-id><journal-title-group><journal-title xml:lang="ru">Комплексные проблемы сердечно-сосудистых заболеваний</journal-title><trans-title-group xml:lang="en"><trans-title>Complex Issues of Cardiovascular Diseases</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2306-1278</issn><issn pub-type="epub">2587-9537</issn><publisher><publisher-name>Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.17802/2306-1278-2018-7-4S-157-162</article-id><article-id custom-type="elpub" pub-id-type="custom">kpccz-521</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>СЛУЧАЙ ИЗ ПРАКТИКИ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>CASE STUDY</subject></subj-group></article-categories><title-group><article-title>Тромбоэкстракция при ишемическом инсульте у пациента с выраженной сопутствующей патологией</article-title><trans-title-group xml:lang="en"><trans-title>Clinical case of thrombus extraction in ischemic stroke in a patient with severe concomitant pathology</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шилов</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Shilov</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Шилов Александр Александрович - кандидат медицинских наук, заведующий кабинетом рентгенхирургических методов диагностики и лечения КОККД им. академика Л.С. Барбараша; старший научный сотрудник лаборатории интервенционных методов диагностики и лечения НИИКПССЗ.</p><p>Сосновый бульвар, 6, Кемерово, 650002</p></bio><bio xml:lang="en"><p>Shilov Aleksandr A. - PhD, Head of the Endovascular Surgery and Diagnosis Unit SBHIKRCCD n.a. Academician L.S. Barbarash; senior researcher at the Laboratory of Interventional Diagnosis and Treatment RICCD.</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ганюков</surname><given-names>В. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Ganyukov</surname><given-names>V. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>ГанюковВладимирИванович - доктормедицинскихнаук,за-ведующий лабораторией интервенционных методов диагностики и лечения НИИКПССЗ; врач по рентгенэндоваскулярным диагностике и лечению кабинета рентгенхирургических методов диагностики и лечения КОККД им. академика Л.С. Барбараша.</p><p>Сосновый бульвар, 6, Кемерово, 650002</p></bio><bio xml:lang="en"><p>Ganyukov Vladimir I. - PhD, Head of the Laboratory of Interventional Diagnosis and Treatment RICCD; interventional cardiologist at the Endovascular Surgery and Diagnosis Unit, SBHIKRCCD n.a. Academician L.S. Barbarash.</p><p>6, Sosnoviy Blvd., Kemerovo, 650002</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Молдавская</surname><given-names>И. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Moldavskaya</surname><given-names>I. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Молдавская Ирина Валерьевна - кандидат медицинских наук, заведующая отделением неврологии КОККД им. академика Л.С. Барбараша.</p><p>Сосновый бульвар, 6, Кемерово, 650002</p></bio><bio xml:lang="en"><p>Moldavskaya Irina V. - PhD, Head of the Department of Neurology.</p><p>6, Sosnoviy Blvd., Kemerovo, 650002</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Хромов</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Chromov</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Хромов Антон Александрович - заведующий рентгендиагностическим отделением КОККД им. академика Л.С. Барбараша; врач отделения лучевой диагностики НИИКПССЗ.</p><p>Сосновый бульвар, 6, Кемерово, 650002</p></bio><bio xml:lang="en"><p>Chromov Anton A. - Head of the Department of Radiology SBHIKRCCD n.a. Academician L.S. Barbarash, radiologist at the Department of Radiology RICCD.</p><p>6, Sosnoviy Blvd., Kemerovo, 650002</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Токмаков</surname><given-names>Е. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Tokmakov</surname><given-names>E. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Токмаков Евгений Васильевич - врач анестезиолог-реаниматолог НИИКПССЗ; врач анестезиолог-реаниматолог кабинета рентгенхирургических методов диагностики и лечения КОККД им. академика Л.С. Барбараша.</p><p>Сосновый бульвар, 6, Кемерово, 650002</p></bio><bio xml:lang="en"><p>Tokmakov Evgeniy V. - intensivist RICCD; intensivist at the Endovascular Surgery and Diagnosis Unit, SBHIKRCCD n.a. Academician L.S. Barbarash.</p><p>6, Sosnoviy Blvd., Kemerovo, 650002</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Наумов</surname><given-names>Д. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Naumov</surname><given-names>D. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Наумов Данил Юрьевич, врач по рентгенэндоваскулярным диагностике и лечению кабинета рентгенхирургических методов диагностики и лечения КОККД им. академика Л.С. Барбараша; лаборант-исследователь лаборатории интервенционных методов диагностики и лечения НИИКПССЗ.</p><p>Сосновый бульвар, 6, Кемерово, 650002</p></bio><bio xml:lang="en"><p>Naumov Danil Yu. - interventional cardiologist at the Endovascular Surgery and Diagnosis Unit SBHIKRCCD n.a. Academician L.S. Barbarash; research assistant at the Laboratory of Interventional Diagnosis and Treatment RICCD.</p><p>6, Sosnoviy Blvd., Kemerovo, 650002</p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru">Государственное бюджетное учреждение здравоохранения Кемеровской области Кемеровский областной клинический кардиологический диспансер имени академика Л.С. Барбараша<country>Россия</country></aff><aff xml:lang="en">State Budgetary Healthcare Institution of the Kemerovo Region Kemerovo Regional Clinical Cardiology Dispensary n.a. Academician L.S. Barbarash<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru">Федеральное государственное бюджетное научное учреждение Научно-исследовательский институт комплексных проблем сердечно-сосудистых заболеваний<country>Россия</country></aff><aff xml:lang="en">Federal State Budgetary Institution Research Institute for Complex Issues of Cardiovascular Diseases<country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2018</year></pub-date><pub-date pub-type="epub"><day>03</day><month>02</month><year>2019</year></pub-date><volume>7</volume><issue>4S</issue><fpage>157</fpage><lpage>162</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Шилов А.А., Ганюков В.И., Молдавская И.В., Хромов А.А., Токмаков Е.В., Наумов Д.Ю., 2020</copyright-statement><copyright-year>2020</copyright-year><copyright-holder xml:lang="ru">Шилов А.А., Ганюков В.И., Молдавская И.В., Хромов А.А., Токмаков Е.В., Наумов Д.Ю.</copyright-holder><copyright-holder xml:lang="en">Shilov A.A., Ganyukov V.I., Moldavskaya I.V., Chromov A.A., Tokmakov E.V., Naumov D.Y.</copyright-holder><license license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.nii-kpssz.com/jour/article/view/521">https://www.nii-kpssz.com/jour/article/view/521</self-uri><abstract><p>Представлено описание первого опыта тромбоэкстракции при ишемическом инсульте у молодого пациента с выраженной сопутствующей патологией. Пациент 33 лет с давностью развития клиники ОНМК в течение 4 часов. По МСКТ задокументирована окклюзия дистального М1 сегмента левой средней мозговой артерии. Получен удовлетворительный клинический результат тромбоэкстракции при ишемическом инсульте, несмотря на отход от стандарта лечения данной патологии (тромболитическая терапия и тромбоэкстракция). Отказ от проведения тромболитической терапии был связан с наличием туберкулеза легких в фазе распада и высокой вероятностью развития легочного кровотечения. Выполнена успешная тромбоэкстракция из бассейна M1 сегмента левой средней мозговой артерии с финальным кровотоком по левой внутренней сонной артерии на уровне TICIIII. На момент выписки отмечается положительная динамика в неврологическом статусе со степенью инвалидизации по модифицированной шкале Рэнкина в 3 балла.</p></abstract><trans-abstract xml:lang="en"><p>The clinical case reports the first experience of thrombus extraction in a young patient with ischemic stroke and severe concomitant pathology. The 33-year old patient was admitted to the hospital with stroke 4 hours after its onset. The occlusion of the distal Ml segment of the left middle cerebral artery was documented with MSCT. A satisfactory clinical result of the thrombus extraction in ischemic stroke was achieved, despite the changed treatment strategy commonly used for from this pathology (thrombolytic therapy and thrombus extraction). The refusal of thrombolytic therapy was associated with the presence of destructive pulmonary tuberculosis and a high risk of pulmonary hemorrhage. Successful thrombus extraction from the M1 segment of the left middle cerebral artery segment with the final blood flow in the left internal carotid artery at the level of TICI III was performed. At discharge the patient demonstrated improved neurological status with the modified Rankin score of 3.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>тромбоэкстракция</kwd><kwd>ишемический инсульт</kwd></kwd-group><kwd-group xml:lang="en"><kwd>thromboextraction</kwd><kwd>ischemic stroke</kwd></kwd-group><funding-group xml:lang="ru"><funding-statement>Поисковоге научное исследование «Мультифокальный атеросклероз и коморбидные состояния. Особенности диагностики, управления рисками в условиях крупного промышленного региона Сибири (№ 0546-2017-0001)», источник финансирования - федеральный бюджет</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Johnston S.C., Mendis S., Mathers C.D. Global variation in stroke burden and mortality: estimates from monitoring, surveillance, and modelling. Lancet Neurol 2009; 8: 4: 345354. doi: 10.1016/S1474-4422(09)70023-7.</mixed-citation><mixed-citation xml:lang="en">Johnston S.C., Mendis S., Mathers C.D. Global variation in stroke burden and mortality: estimates from monitoring, surveillance, and modelling. 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