Providing of a highly specialized medical care for servicemen of the Armed Forces of Ukraine by roentgen-endovascular interventional methods

Abstract

Aim: to provide high-quality and full-fledged minimally invasive highly specialized medical care by X-ray endovascular methods, according to modern world standards, for the Armed Forces of Ukraine on all territories of the country and direct participants of combat operations in the context of Joint Forces Operation (JFO) in certain parts of Donetsk and Luhansk regions. Materials and methods. The provision of minimally invasive highly specialized medical care by X-ray endovascular techniques for servicemen of the Armed Forces of Ukraine in the conditions of JFO in certain parts of Luhansk and Donetsk regions and the National Military Medical Clinical Center of Kyiv (NMMCC) in critical internal bleedings, pathology and injuries of the main vessels, acute cardiovascular pathology over a period of 2018–2020 was analyzed: 1038 diagnostic coronary interventions to servicemen with acute coronary syndrome, 346 stenting of coronary arteries in an emergency, 36 – angioplasty of coronary arteries. A total of 296 interventions for pathology of the peripheral vascular system including combat trauma were performed. Transcatheter arterial embolization was performed for 100 patients with internal bleeding. An emergency care mechanism was implemented for patients with acute coronary syndrome in the Joint Forces Operation in certain parts of Donetsk and Luhansk regions. Results. The implementation of these methods of highly specialized care in the Armed Forces of Ukraine allowed to realize the standards of emergency care for acute coronary syndrome, the average time of “door – balloon” was 100 minutes (CI 95 %, 98–103 minutes, P < 0.05). In the conditions of JFO, care for patients with acute coronary syndrome, the interval “door – balloon” takes time from 2 to 12 hours (CI 95 %, 5.5–6.5 hours, P < 0.05), fatalities were absent. At transcatheter arterial embolization, technical success of arterial occlusion was 100 %. In the treatment of main vessels, the length of hospital stay after endovascular interventions was 1–18 days (CI 95 %, 1.96–2.51 days, P < 0.05). The main complications were postpuncture hematoma – 4.73 %, acute occlusion after intervention within 24 hours – 2.36 %, pseudoaneurysm – 0.68 %. Effective recanalization of the main blood flow was achieved in 262 cases (88.51 %). Conclusions. The implementation of X-ray endovascular techniques into the medical service of the Armed Forces of Ukraine allowed for providing high-quality highly specialized medical care directly to participants of Joint Forces Operation in certain parts of Donetsk and Luhansk regions in the shortest possible time.