Pulmonary artery thrombosis prophylaxis and treatment in clinical practice and experiment
- Authors: Porembskaya O.Y.1, Lobastov K.V.2,3, Tsaplin S.N.2,4, Pashovkina O.V.4, Ilina V.А.5, Starikova E.A.6, Mammedova J.T.6, Tsinserling V.A.7, Toropova Y.G.7, Galchenko M.I.8, Laberko L.A.2,3, Kravchuk V.N.1, Saiganov S.A.1
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Affiliations:
- North-Western State Medical University named after I.I. Mechnikov
- Russian National Research Medical University named after N.I. Pirogov
- City Clinical Hospital No. 24
- Clinical Hospital No. 1 (Volynskaya)
- Saint Petersburg Research Institute of Emergency Medicine named after I.I. Dzhanelidze
- Institute of Experimental Medicine
- National Medical Research Center named after V.A. Almazova
- State Agrarian University
- Issue: Vol 26, No 1 (2024)
- Pages: 23-33
- Section: Research paper
- URL: https://journals.rcsi.science/1682-7392/article/view/255213
- DOI: https://doi.org/10.17816/brmma623151
- ID: 255213
Cite item
Abstract
The effectiveness of anticoagulant therapy in the prevention and treatment of pulmonary artery thrombosis and the possibility of anti-inflammatory therapy in preventing this complication in clinical practice and experiments were assessed. Data from patients with a new coronavirus infection and those suffering from urgent noninfectious pathology with confirmed pulmonary artery thrombosis were retrospectively analyzed. The outcomes of anticoagulant therapy and anticoagulant therapy combined with glucocorticoid and/or anticytokine drugs were assessed. Histological preparations of the lung vessels of patients were examined. Using an experimental model of rats with induced thrombosis of the posterior vena cava, changes in the pulmonary artery branches were assessed in the main group administered with edible mussel (Mytilus edulis) hydrolyzate and the control group given a physiological solution. No statistically significant relationship was found between the therapeutic, intermediate, and preventive anticoagulant therapy regimens and mortality, changes in lung dynamics, and D-dimer levels in 313 patients with new coronavirus infection. No predominance of any anticoagulant therapy regimen used was found among deceased patients. Thirty-nine patients were treated with glucocorticoid and/or anticytokine drugs in the presence of anticoagulant therapy. No statistically significant relationship in the onset of thrombotic complications was found between the groups receiving therapy with glucocorticoid and anticytokine drugs. No differences were noted in the drug-induced pathomorphosis of the wall of the pulmonary artery branches in the group receiving anticoagulant therapy or in the group receiving a combination of anticoagulant therapy and glucocorticoid and/or anticytokine drugs. Pulmonary artery thrombosis developed in all 19 patients suffering from urgent noninfectious pathology, 11 of whom were under anticoagulant therapy. In 12 of 15 rats in the control group with thrombosis of the posterior vena cava, blood clots were found in the lumen of the pulmonary artery branches. In 14 rats of the main group administered M. edulis hydrolyzate, no blood clots were found in the pulmonary artery branches. Thus, the systemic effects of anticoagulant therapy were offset by the local prothrombotic effects of the vascular wall caused by inflammation. Glucocorticoid and anticytokine drugs did not affect inflammatory changes in the vascular wall and did not prevent pulmonary artery thrombosis. The introduction of M. edulis in the experiment prevented pulmonary artery thrombosis in the presence of posterior vena cava thrombosis, which indicates a promising direction in the search for pathogenetic prevention of this complication.
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##article.viewOnOriginalSite##About the authors
Olga Ya. Porembskaya
North-Western State Medical University named after I.I. Mechnikov
Author for correspondence.
Email: porembskaya@yandex.ru
ORCID iD: 0000-0003-3537-7409
SPIN-code: 9775-1057
MD, Cand. Sci. (Med.)
Russian Federation, Saint PetersburgKirill V. Lobastov
Russian National Research Medical University named after N.I. Pirogov; City Clinical Hospital No. 24
Email: lobastov_kv@mail.ru
ORCID iD: 0000-0002-5358-7218
SPIN-code: 2313-0691
MD, Cand. Sci. (Med.)
Russian Federation, Moscow; MoscowSergey N. Tsaplin
Russian National Research Medical University named after N.I. Pirogov; Clinical Hospital No. 1 (Volynskaya)
Email: tsaplin-sergey@rambler.ru
ORCID iD: 0000-0003-1567-1328
SPIN-code: 8827-1385
MD, Cand. Sci. (Med.)
Russian Federation, Moscow; MoscowOlga V. Pashovkina
Clinical Hospital No. 1 (Volynskaya)
Email: dr.pashovkina@mail.ru
ORCID iD: 0000-0001-6955-4595
SPIN-code: 3448-9764
pathologist
Russian Federation, MoscowVictoria А. Ilina
Saint Petersburg Research Institute of Emergency Medicine named after I.I. Dzhanelidze
Email: profkomniisp@mail.ru
ORCID iD: 0000-0001-7336-8146
SPIN-code: 8934-1156
MD, Dr. Sci. (Med.)
Russian Federation, Saint PetersburgEleonora A. Starikova
Institute of Experimental Medicine
Email: starickova@yandex.ru
ORCID iD: 0000-0002-9687-7434
SPIN-code: 6488-4036
MD, Cand. Sci. (Biol.)
Russian Federation, Saint PetersburgJanet T. Mammedova
Institute of Experimental Medicine
Email: jennet_m@mail.ru
ORCID iD: 0000-0003-4381-6993
SPIN-code: 1418-6373
researcher
Russian Federation, Saint PetersburgVsevolod A. Tsinserling
National Medical Research Center named after V.A. Almazova
Email: Tsinzerling_VA@almazovcentre.ru
ORCID iD: 0000-0001-7361-1927
SPIN-code: 4601-1482
MD, Dr. Sci. (Med.), professor
Russian Federation, Saint PetersburgYana G. Toropova
National Medical Research Center named after V.A. Almazova
Email: yana.toropova@mail.ru
ORCID iD: 0000-0003-1629-7868
SPIN-code: 2020-4213
MD, Cand. Sci. (Biol.)
Russian Federation, Saint PetersburgMaxim I. Galchenko
State Agrarian University
Email: maxim.galchenko@gmail.com
ORCID iD: 0000-0002-5476-6058
SPIN-code: 8858-2916
senior lecturer
Russian Federation, Saint PetersburgLeonid A. Laberko
Russian National Research Medical University named after N.I. Pirogov; City Clinical Hospital No. 24
Email: laberko@list.ru
ORCID iD: 0000-0002-5542-1502
SPIN-code: 8941-5729
MD, Dr. Sci. (Med.), professor
Russian Federation, Moscow; MoscowVyacheslav N. Kravchuk
North-Western State Medical University named after I.I. Mechnikov
Email: kravchuk9@yandex.ru
ORCID iD: 0000-0002-6337-104X
SPIN-code: 4227-2846
MD, Dr. Sci. (Med.), professor
Russian Federation, Saint PetersburgSergey A. Saiganov
North-Western State Medical University named after I.I. Mechnikov
Email: sergey.sayganov@szgmu.ru
ORCID iD: 0000-0001-8325-1937
SPIN-code: 2174-6400
MD, Dr. Sci. (Med.), professor
Russian Federation, Saint PetersburgReferences
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