The presented review concerns to current interventional methods of acute pulmonary embolism treatment. The article provides a rationale for catheter approaches, detailed description of patient selection and risk stratification including an estimation of thromboembolic burden, risk degree of acute pulmonary embolism, bleeding risk assessment, and patient-specific considerations. The review contains the up-to-date classification of pulmonary embolism on the basis of 30-day mortality assessment and estimation of disease outcome according to the conventional and simplified Pulmonary Embolism Severity Index. A special attention is paid to interventional methods peculiarly, in particular to catheter directed thrombolysis, rheolytic thrombectomy, thrombus fragmentation and aspiration. The results of studies concerning efficiency and safety of endovascular methods in treatment of pulmonary embolism patients are reported. It was emphasized importance of further investigation of various clinical aspects using these methods for obtaining of comprehensive information about treatment of the dangerous disease associated with significant morbidity and mortality.

Tis review focused on prevalence of anemia and iron defciency (ID) in CHF and their effect on the course and prognosis of this condition. Based on evaluation of numerous laboratory data defnitions of anemia and ID were suggested. Specifcally, a diagnostic value of measuring serum iron, serum ferritin, transferrin saturation, total iron-binding capacity, and concentration of soluble transferrin receptors was discussed. Te review highlighted the importance of measuring bone marrow iron, which is rarely used in everyday clinical practice even though this test is considered a «gold standard» of ID diagnosis. Te review provided an insight into pathogenetic mechanisms of ID in CHF including insufcient iron supply, role of inflammation, erythropoietin, RAS, and effects of some pharmacological therapies. Te authors described physiological consequences of ID and anemia, activation of hemodynamic and non-hemodynamic compensatory mechanisms, which develop in response to anemia and not infrequently aggravate CHF. Special atention was paid to current approaches to treatment of anemia and ID in CHF, including a discussion of efcacy and safety of oral and intravenous dosage forms of iron and hemopoiesis stimulators.

Н есмотря на всевозможные меры, предпринимаемые для своевременной диагностики и адекватного лечения тромбоэмболии легочной артерии [ТЭЛА или легочной эмболии (ЛЭ)], это заболевание занимает крайне важное положение в клинической практике врача любого профиля [1, 2]. Проблема ТЭЛА сохраняет свою высокую актуальность благодаря широкой распространенности, трудностям ее диагностики и лечения, непредсказуемости клинического течения, а также весьма высокой летальности [3, 4]. Венозный тромбоэмболизм (ВТЭ), включающий в себя ЛЭ и венозный тромбоз [5, 6], является распро

The article concerns one of the common adverse effects during treatment — steroid myopathy. The information about pathogenic specifics of myopathy development in administration of glucocorticoids, the most typical clinical manifestations are described, and results diagnostic methods with estimation of a role of enzyme level evaluation, electromyography, ultrasound study of the muscle tissue, computer and magnetic resonance tomography. There is description of muscle weakness development in 49-year old woman who has been receiving methylprednisolone 88 mg/day due to revealed thrombocytopenia. One week after the treatment was started the patient experienced onset and progression of muscle weakness limiting her motion and self-maintenance. After performing of investigation including electromyography steroid genesis of myopathy was suggested. The patient’s condition began to improve after disc ontinuation of glucocorticoids and administration of calcium supplements, vitamin D, and anabolics, and the patient was discharged.

The presented review concerns contemporary views on specific aspects of anticoagulant and thrombolytic treatment of venous thromboembolism and mostly of acute pulmonary embolism. Modern classifications of patients with acute pulmonary embolism, based on early mortality risk and severity of thromboembolic event, are reproduced. The importance of multidisciplinary approach to the management of patients with pulmonary embolism with the assistance of cardiologist, intensive care specialist, pulmonologist, thoracic and cardiovascular surgeon, aimed at the management of pulmonary embolism at all stages: from clinical suspicion to the selection and performing of any medical intervention, is emphasized. Anticoagulant treatment with the demonstration of results of major trials, devoted to efficacy and safety evaluation of anticoagulants, is highlighted in details. Moreover, characteristics, basic dosage and dosage scheme of direct (new) oral anticoagulants, including apixaban, rivaroxaban, dabigatran, edoxaban and betrixaban are described in the article. In particular, the management of patients with bleeding complications of anticoagulant treatment and its application in cancer patients, who often have venous thromboembolism, is described. Additionally, modern approaches to systemic thrombolysis with intravenous streptokinase, urokinase and tissue plasminogen activators are presented in this review. The indications, contraindications, results of clinical trials devoted to various regimens of thrombolytic therapy, including treatment of pulmonary embolism by lower doses of fibrinolytic agents, are described.