Doctors spoke about modern methods of bloodless surgery
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“Such operations involve minimal disability for the patient”
The youngest, but also the most actively developing field of medicine in the world has a complex name – interventional cardioangiology (IC). It allows you to carry out complex interventions on the heart, blood vessels, liver, uterus and other organs using bloodless methods. IR appeared at the end of the twentieth century, but thanks to it, millions of people around the world have already been saved.
The 7th Congress of the Russian Scientific Society of Interventional Cardioangiologists (RNOIK) opened in Moscow. Leading doctors from all over the country and invited foreign “stars” of cardiac angiosurgery spoke about what new techniques have appeared today and how medicine will change with the development of cardiopulmonary bypass.
Today, X-ray endovascular techniques – a bloodless surgery method in which complex operations are performed through tiny punctures – have become a part of medicine and no longer surprise anyone. But interventional cardiac angiosurgery began to emerge in the 1980s. And Russian doctors were in the vanguard. The country’s first stenting of coronary arteries in a patient with acute myocardial infarction was performed by an outstanding domestic cardiac angiosurgeon, academician of the Russian Academy of Sciences, honorary director of the Center for Interventional Cardioangiology of the First Moscow State Medical University named after. I.M.Sechenova, RAS academician David Ioseliani. As David Georgievich says, today endovascular operations, which make it possible to perform interventions on blood vessels, the heart and many organs without a scalpel and without an incision, have become routine: “Sometimes we leave cardiac surgeons without work, but imagine how much easier it is for the patient when he does not have an incision in the sternum, and the operation is performed by making a small incision in the femoral artery. During the operation, the patient can talk and listen to music with the doctor. Such surgical interventions are gentle, but no less, and sometimes even more effective, than cardiac surgery. Today, according to world standards, the mortality rate after them does not exceed 1.5%, and our leading clinics meet these standards.”
Chairman of the Board of the RNOIK Avtandil Babunashvili says that since the last congress, in just 6 years, literally tectonic changes have occurred in the IR. “The agenda is the widespread introduction of hybrid technologies: when different interventions are simultaneously performed in one operation.”
Academician Ioseliani says that techniques that were unique just a few years ago have now become widespread and have even become part of treatment standards: “For example, endovascular treatment of cerebral strokes: the technique appeared a long time ago, but was really introduced 5-6 years ago. Or treatment of heart valves. Previously, we treated heart attacks: the vessel closed, and we opened it, that is, we placed a stent. Today this is already a routine, and we have begun to work on the structures of the heart: for example, we replace valves endovascularly, without incisions: we insert the prosthesis into the artery with catheters, and when we bring it to the right place, the catheter opens. But the most important thing is that IR is being introduced today in all areas of modern medicine: gastroenterology, urology, gynecology, pulmonology, neurology… And it has great prospects in oncology. What’s so great about our methods? For example, during chemotherapy, the main method of treatment for cancer patients, a huge amount of a drug is introduced into the body, which not only kills the tumor, but also causes damage to the body. And our methods make it possible to deliver the drug directly to the affected area: less medicine is used, there are fewer side effects, and there is more effect. In addition, embolization of the blood vessels supplying the tumor can be performed. I think oncology will soon become the main area of application of endovascular techniques, and this will improve patient survival.”
The famous cardiac surgeon, academician of the Russian Academy of Sciences, director of the Institute of Cardiothoracic Surgery of the Russian Scientific Center for Surgery named after Petrovsky, Yuri Belov, is proud to have been at the origins of angiovascular surgery: “We together promoted this direction in the country. Such operations involve minimal disability for the patient, and this makes it possible to operate even on patients over 90 years of age with good outcomes.”
One of the honorary guests of the congress was the legendary cardiac surgeon from Italy, one of the founders of interventional cardioangiology, Antonio Colombo. He made revolutionary discoveries in this area. For example, he figured out how to avoid thrombosis when stenting arteries – in the early stages, the frequency of thrombosis during such manipulations reached 30%, and stents were recommended to be used only in extraordinary cases. It turned out that full deployment of the stent even eliminates the need to prescribe blood-thinning drugs to patients. “As a result, we managed to reduce blood clots after such operations to 0.9% – and this is the most important thing I have done in my life,” Dr. Colombo told the congress participants. Antonio Colombo came up with several innovative techniques, and books have been written about his technical insights. RNOIK awarded Antonio Colombo the highest award of the society – a medal named after the outstanding Russian cardiac surgeon Yuri Petrosyan. In his lecture, Dr. Colombo talked about how the field of infrared in medicine was born, how it developed and what the future holds for it. Today he urges his colleagues to move away from indiscriminate stenting and to implant stents only where necessary. And gradually switch to bioresorbable stents that can adapt to the body.
After the lecture, congress participants were able to watch live the operation that Colombo performed in the Milan operating room. In total, during the event there were six live broadcasts from various operating countries. Doctors heard 282 presentations during 53 scientific sessions and five symposia. Many leading cardiac surgeons said that they are happy people. “Every time we leave the operating room, we feel happy that we helped a person. I am confident that the 21st century will be the century of our narrow specialty, because this profession is flourishing in all areas of medicine. Today there is not a single area of medicine where our methods are not used effectively. When we held the first congress, X-ray endovascular specialists could be counted on one hand, but today there are a huge number of them, and our methods are very widespread,” David Ioseliani told MK.
Newspaper headline:
Without noise and blood
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