The present article describes the case of a 53-year-old patient with subarachnoid hemorrhage caused by the rupture of the saccular aneurysms of the anterior communicating artery, complicated by persistent cerebral vasospasm, who has undergone successful chemical angioplasty. This treatment strategy allowed to maintain effective cerebral perfusion and prevent severe brain injury. The improvement of the patient’s clinical state resulted in restored consciousness and regressed focal neurological symptoms.

Purpose. Improvement of a demographic situation in theKemerovoregion by development and introduction of innovative klinikoorganizational approaches in activity of cardiological service. Materials and methods. System and situation analysis, comprehensive approach, modeling. Results. The adverse demographic situation in economically developed industrial region of the Siberian federal District of (Kemerovoregion) is caused by mainly high mortality of the population from diseases of system of blood circulation (DSBC). Among operated factors the important role is allocated for system of rendering of specialized medical care, in particular: to ensuring continuity in prevention, treatment and rehabilitation of patients with DSBC; to close interaction of doctors of primary link (therapist, surgeon) and specialized institutions (cardiologist, кардиохирург); to creation of conditions for introduction of scientifi c and reasonable modern clinical approaches in practice. More than two decades in gKemerovothe integration model of cardiological service based on technology of «the closed cycle» with participation of establishments of health care of municipal and federal levels, medical science and education was formed. Conclusions. Availability of specialized hi-tech medical care to the population allowed to increase introduction of the concept of the general ideology, it is rational to use health care resources, to develop creative cardiology and to broadcast results of basic scientifi c researches in practice that affected improvement of a demographic situation in the region. In2010 incomparison with 2005 mortality from DSBC at able-bodied age in Kuzbass decreased by 33,7 %.

The presented herein clinical case report concerns successful endovascular closure of a iatrogenic lesion of the iliac artery and inferior vena cava with formation of a pathological arteriovenous anastomosis manifesting itself by venous thromboembolic syndrome and severe right-ventricular insufficiency.

AIM:To study the medical and social aspects of in-hospital mortality after myocardial infarction (MI) in the cardiology center of a major industrial city in Western Siberia.PATIENTS AND METHODS:The material of the study was the database of patients with acute coronary syndrome (19 283 patients), formed by a continuous method retrospectively. The volume of the study were 6463 patients with MI for 2006-2011.RESULTS:In-hospital mortality of patients with MI was 11.8%, with MI complicated by cardiogenic shock--87.4%, in the primary MI--7.4%, during the second MI--22.1%. In-hospital mortality in MI depends on the age of the patients: in group of patients of working age mortality was 4.7%, the retirement age--12.4%, old age--22.7%. In the working-age group mortality in men is almost three times higher than in women. The mortality of patients with MI without reperfusion was 13.4%, in the case of reperfusion therapy--9.2%.CONCLUSIONS:Hospital mortality depends on the patient's age, type of MI (primary or repeated), the severity of the condition, applied treatments.

Aim. To assess the effectiveness of the new clinical and organisational strategies for specialised treatment of patients with acute coronary syndrome (ACS) — residents of a large industrial city. Material and methods. The object of the study was the system of specialised medical treatment of ACS patients in Kemerovo City. The study venue was the Kuznetsk Basin Cardiology Centre. The study period was 2004-2008, with 16752 ACS patients included. Results. Over the study period, the rates of urgent endovascular interventions increased by 16,8 times. The average time from admission to percutaneous coronary intervention decreased from 95 to 60 minutes. The inconsistencies in ACS diagnosis were registered in less than 9 % of the hospitalised patients. In-hospital case fatality among myocardial infarction patients decreased from 11,1 % to 9,7 % ( р ≤0,05). Conclusion. The adequate ACS management requires early admission of the patients with possible ACS to a specialised hospital; urgent cardiosurgery interventions in ACS individuals; and multi-level, risk-stratified strategies of invasive and conservative treatment, starting from the moment of admission to the specialised hospital.

Aim: to assess the impact of new forms of medical care of patients with acute coronary syndrome (ACS). Kemerovo health services activity in rendering assistance to with ACS composed a research objective. Kuzbass Cardiology Center represented by the association of organizations with different ownership patterns. Information was gathered retrospectively, analysis of case histories of patients with ACS hospitalized to the Cardiology Center during 2005-2009 was carried out. The official statistical data was used: form No. 30, form No. 14, form No. 12. Staged model of medical care rendered to patients with ACS in the Cardiology Center is applied in Kemerovo, where percutaneous coronary interventions are performed 24/7. The Center operates according to a single algorithm with the services of prehospital stage. The number of emergency treatment of endovascular procedures has increased from 30 to 612 per year during the period 2005-2009. The proportion of patients with myocardial infarction subjected to emergency coronary angioplasty constituted 57.4%. The level of hospital mortality in patients with myocardial infarction younger then 70 y/o decreased from 11.4% in 2005 to 6.6% (p