Zingerman L S, Topchiian G S, Galankina I E, Belozerov G E, Zvereva T V, Rudnev D V
Grud Serdechnososudistaia Khir. 1991 Sep(9):19-24.
The radio-angiographic features of coronary blood flow were studied in 119 patients in the first 24 hours of a macrofocal myocardial infarction. In 100 (84%) patients with recognized occlusion of the coronary artery responsible for the infarction the semeiotics of the occluding coronary thrombosis is described, and the characteristics of the residual stenoses after intracoronary thrombolysis were studied. In more than 60% of cases the radiographic features of these stenoses were found to be similar to those of primarily revealed stenoses responsible for infarction of the coronary arteries in degree, form, and the presence of mural thrombus. The mechanism of the formation of these stenoses was of a common character--lysis of the occluding thrombus, which was medicinal in the first case and spontaneous in the second. Medicinal thrombolysis is an analogue of the natural physiological mechanism--spontaneous coronary thrombolysis. It was established that the process of medicinal lysis of the coronary thrombus, a mural thrombus among others, is fully completed by the end of the second day of myocardial infarction. The obtained information makes it possible to formulate some principles of radiologically-guided intravascular treatment of patients with myocardial infarction.
在119例大面积心肌梗死患者发病后的最初24小时内，对其冠状动脉血流的放射血管造影特征进行了研究。在100例（84%）已确认导致梗死的冠状动脉闭塞患者中，描述了闭塞性冠状动脉血栓形成的症状，并研究了冠状动脉内溶栓后残余狭窄的特征。在超过60%的病例中，发现这些狭窄的放射学特征在程度、形态以及壁内血栓的存在方面与最初发现的导致冠状动脉梗死的狭窄相似。这些狭窄形成的机制具有共同特点——闭塞性血栓溶解，第一种情况是药物性的，第二种情况是自发性的。药物溶栓是自然生理机制——自发性冠状动脉溶栓的类似物。已确定，冠状动脉血栓（包括壁内血栓）的药物溶解过程在心肌梗死第二天结束时完全完成。所获得的信息使得制定一些针对心肌梗死患者的放射学引导下血管内治疗原则成为可能。
