Patent RU-2714075-C1 (RU)
Title: Method for assessing the mesenteric blood flow in endovascular interventions in the mesenteric basin by electrophysiological monitoring and resonance stimulation
Inventor: PARFENOV IGOR PAVLOVICH
IPC: A61N1/00
Filed: 2019-10-08
Granted: 2020-02-11
Abstract: FIELD: medicine. 
     SUBSTANCE: invention relates to medicine, namely to diagnosis. Prior to the planned endovascular intervention, a non-invasive electrographic examination of each portion of the digestive tract is performed, obtaining in a row at least 10 cycles of background spectral curves of peristaltic activity of the departments comparable in amplitude. That is followed by electric stimulation of each portion of the digestive tract for 10–15 min using a resonance effect by stimulating sinusoidal pulses with a current intensity of 10–12 mcA by means of a resonance stimulator of the gastrointestinal tract (GIT). Following sequence of pulses is used: stomach duodenum – small intestine – large intestine – 5-20-12-8 pulses respectively. That is followed by graphical recording of spectral curves obtained in response to stimulation and after obtaining synchronization of recorded spectra of peristaltic waves of stomach, duodenum, small and large intestine, curves of fine- and large intestinal peristaltic activity are analyzed. If observing at least 10 cycles of spectral curves comparable to each other in terms of amplitudes, the result is an estimate of the preoperative propulsive reserve of the digestive tract. If the background recording amplitude is lower than 29 mcV and amplitude gain in electric stimulation is less than 50 %, stimulation tolerance to the load is considered to be low, which is an indication for reperfusion surgical intervention – therapeutic angiography. If background recording amplitude is lower than 29 mcV, and amplitude gain in electric stimulation ranges from 50 to 75 % of background stimulation, then tolerance to load is considered doubtful, which is an indication for diagnostic angiography. If background recording amplitude corresponds to 29 mcV, and amplification gain in electric stimulation is less than 75 % compared to background recording, then tolerance to load is considered to be doubtful, which is an indication for diagnostic angiography. If background recording amplitude corresponds to 29 mcV, and amplitude gain in electric stimulation is more than 75 % of background, wherein clinical symptoms in the form of pains are absent, then tolerance to load is considered satisfactory, which is an indication for conservative therapy without therapeutic angiography with reperfusion endovascular intervention. Further, in the case of reperfusion endovascular intervention 2–2.5 hours after the operation, electrographic examination of each digestive tract is performed to produce at least 10 cycles of background spectral curves of peristaltic activity of the areas comparable in amplitude. That is followed by electric stimulation of each portion of the digestive tract for 10–15 min using a resonance effect, for which stimulating sinus pulses are applied by a resonance GIT stimulator with a current intensity of 10–12 mcA. Pulse supply sequence is used: stomach – duodenum – small intestine – large intestine – 5-20-12-8 pulses, respectively, before synchronizing spectra of oscillations of all recorded digestive tract. Graphical recording and analysis of spectral curves obtained in response to stimulation is carried out for 30–60 minutes. When observing at least 10 cycles of spectral curves comparable to each other in terms of amplitudes, a result of assessing the postoperative propulsive reserve of the digestive tract is considered to be achieved. If the background postoperative amplitude is below 29 mcV and the amplification amplitude in electric stimulation is less than 75 % of the postoperative background, tolerance to load by stimulation is considered to be low that is unsatisfactory result of treatment, and MSCT-angiography with assessment of mesenteric blood flow is considered to be shown to determine further tactics. If the background recording amplitude is lower than 29 mcV, the amplification amplitude during stimulation is 75 % or more, the evaluation is carried out in dynamics with the decision on the adequacy of collateral blood flow at the arcade vascular level. If amplitude of background recording curves is more than 29 mcV, as well as gain of amplitude, having value at background recording below 29 mcV, above 75 % in electric stimulation, reperfusion endovascular intervention is adequately conducted. If observing an amplitude of background recording lower than 29 mcV within a day, and an increase in stimulation is 75 % or more, a risk of developing acute intestinal ischemia is considered to be high, which is an indication for performing MSCT angiography or reagiography with resolving the question of recurrent surgical treatment. 
     EFFECT: method enables providing adequate electrophysiological monitoring and resonance stimulation of GIT in the examined pathology, both immediately before angiography or stenting, and on the first day after this procedure. 
     1 cl, 4 ex