A N Vachev

Samara State Medical University, Kuibyshev, Samara, Russia

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Publications (17)0 Total impact

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    ABSTRACT: Presented herein is a clinical case report of successful stagewise surgical treatment of a patient with atherosclerotic occlusion of the main trunk of the renal artery of the single kidney. Clinically, the patient had signs of ischaemic renal disease in the form of pronounced azotemia being characteristic of the terminal stage of renal insufficiency, as well as malignant arterial hypertension. Besides, the patient had previously endured ischaemic stroke in the vertebrobaslar basin. The patient was subjected to stagewise surgical intervention, i.e., stenting of the upper-pole renal artery followed by open operation--prosthetic repair of the left renal artery with a synthetic prosthesis. Three months thereafter, the patient underwent carotid endarterectomy and operation of transposition of the subclavian artery. The postoperative period turned out uneventful. Currently, no progression of azotemia is observed, neither are there any indications for carrying out restorative therapy of the renal function.
    Angiologii͡a i sosudistai͡a khirurgii͡a = Angiology and vascular surgery 06/2015; 21(2):192-7.
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    05/2015; 9(1):42. DOI:10.14341/serg2015142-47
  • A N Vachev · V K Koryttsev · I V Antropov ·
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    ABSTRACT: Treatment results of 59 patients with the complicated ulcer disease were analyzed. Authors prove, that in cases of perforative duodenal ulcer, the operation should aim the treatment of all the complications. The use of 2/3 gaster resection in combination with Jadd pyloroplasty and trunk vagotomy led to the decrease of the lethality rate on 21%.
    Khirurgiia 12/2013;
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    ABSTRACT: 299 patients with spontaneous pneumothorax were treated. All patients were divided in two groups. Patients of the first group (n=182) received thoracic puncture and/or drainage. The second group (n=117) has surgery, directed at liquidation of the source of pneumothorax, i.e., they received either atypical lung resection or subtotal parietal pleurectomy. The recurrent pneumothorax was registered in 24 (13.2%) patients of the first group and in 4 (3.4%) patients of the second. Authors state that radical surgical procedure for the spontaneous pneumothorax is an atypical lung resection with parietal pleurectomy. The use of active surgical tactics allows to decrease the number of recurrencies on 9.8%.
    Khirurgiia 07/2013;
  • A N Vachev · D A Chernovalov · M S Mikhailov ·
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    ABSTRACT: Assessed herein are the results of treating a total of 119 patients presenting with chronic critical ischaemia of the lower extremities accompanied by necrosis of distal portions of the foot. All patients underwent various successful operations of lower-limb revascularization, followed by evaluating the terms of healing of the wounds on the foot after necrectomy and minor amputations. A conclusion was made that after successful limb revascularization for critical ischaemia in patients with atherosclerosis accompanied by coagulative necrosis, performing minor amputations and necrectomies should be delayed.
    Angiologii͡a i sosudistai͡a khirurgii͡a = Angiology and vascular surgery 08/2012; 18(2):131-7.
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    ABSTRACT: The article deals with outcomes of managing a total of twenty-nine patients of high operational risk with TASK II type С and D lesions of the aortoiliac segment. All patients were subjected to single-stage hybrid operations: open reconstructive interventions on the infrainguinal zone and stenting of iliac arteries. High risk of coronary complications these patients were running was confirmed in accordance with the European guidelines on perioperative assessment of the patients being elected for extracardiac operative treatment. Critical ischaemia was in all cases reliably relieved. Two patients during predilatation developed haemorrhage due to iliac artery rupture which was the cause of changing over to open operation. No lethal outcomes were observed.
    Angiologii͡a i sosudistai͡a khirurgii͡a = Angiology and vascular surgery 07/2012; 18(1):88-91.
  • A N Vachev · E V Frolova · N A Smolina ·
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    ABSTRACT: The article deals with surgical treatment of patients presenting with resistant arterial hypertension and detected pathology in the adrenal glands. The authors analysed the outcomes of surgical management of 97 patients with resistant arterial hypertension, also determining the factors contributing to prediction of the antihypertensive effect of adrenalectomy depending on morphological damage to the adrenal glands.
    Angiologii͡a i sosudistai͡a khirurgii͡a = Angiology and vascular surgery 01/2011; 17(3):37-41.
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    ABSTRACT: The experience of 34 operations of omental implantation to the patients with the critical lower limb ischemia due to the obliterative thrombangiitis was analyzed. 5 patients had the procedure on the both limbs simultaneously. The operative technique had been thoroughly described in the article. The procedure, being accomplished according to the certain standards, proved to be extremely effective.
    Khirurgiia 01/2011;
  • A N Vachev · V V Sukhorukov · E V Frolova ·
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    ABSTRACT: Presented herein is a successful outcome of stagewise surgical management of a young adult suffering from nonspecific aortoarteritis accompanied renal artery lesions. The patient was subjected to a stagewise intervention consisting of stenting of the renal arteries and an open operation, i.e. bilateral aortorenal bypass grafting performed with the synthetic stent B-Braun.
    Angiologii͡a i sosudistai͡a khirurgii͡a = Angiology and vascular surgery 01/2011; 17(4):148-51.
  • A N Vachev · A A Kozlov · P A Sukhachev · S V Dergal · T V Larina ·
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    ABSTRACT: 102 tissue samples, resected during treatment of the perforated duodenal ulcers. The most pronounced fibroplastic and acute inflammatory tissue changes were registered in the immediate perforation zone and 0,5 sm above. At a distance of 1,0 sm these changes become less evident. Therefore, in patients with the perforated duodenal ulcer and palpable surrounding infiltrate less than 3,0 sm in diameter, the resection line should be no shorter than 1,0 sm away from the perforation.
    Khirurgiia 01/2011;
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    ABSTRACT: A retrospective analysis of 365 completed patient records received by the duty surgical hospital with perforated gastric ulcer and duodenal ulcer. All the patients were operated on urgently. Diagnosis of purulent peritonitis was set 17% of patients, "serous"--47.4%, "seroplastic"- 35.6%. 75.3%, perform suturing of perforated openings, regardless of the form of peritonitis. The remaining 24.7%--interventions that address as a perforation, and the impact on the pathogenesis of peptic ulcer. When radical surgery, which were performed in selected patients even with purulent peritonitis, deaths were reported. And when suturing the ulcer defect lethality was 14.5%. In this group of patients were comparable in age and severity of general condition. It is concluded that that the operations of suturing perforated ulcers were used unnecessarily broad, and the majority of patients admitted to hospital with a perforated stomach ulcer and duodenum may increase the volume of surgical benefit for radical treatment of complications as well as most of peptic ulcer.
    Ėksperimental'nai͡a i klinicheskai͡a gastroėnterologii͡a = Experimental & clinical gastroenterology 01/2010;
  • A N Vachev · V K Koryttsev · T V Larina ·
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    ABSTRACT: Treatment tactics of patients with duodenal ulcer bleeding were analyzed. Criteria of recurrent ulcer bleeding were defined. The importance of consideration of thrombocyte hemostasis component in treatment of such conditions was studied.
    Khirurgiia 01/2010;
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    ABSTRACT: Presented herein are favourable outcomes of surgical management in six patients suffering from thromboangiitis obliterans (TO) with accompanying critical ischaemia of either the both lower extremities (5 subjects) or the both upper limbs (1 patient). They were all treated by means of a surgical intervention with simultaneous transplantation of the greater omentum on a vascular pedicle onto the both limbs. A total of 12 revascularizing procedures were performed. With an overall of the 12 extremities eventually spared, the remote limb-salvage rate amounted to 100%. A detailed description of the procedural technique is followed by analysing long-term therapeutic outcomes having proved encouraging. The obtained results confirmed a possibility of reliably relieving critical ischaemia inpatients with TO by means of transplanting the greater omentum on a vascular pedicle simultaneously onto the both limbs.
    Angiologii͡a i sosudistai͡a khirurgii͡a = Angiology and vascular surgery 01/2010; 16(3):139-42.
  • A N Vachev · O V Dmitriev · O V Tereshina · M Iu Stepanov ·
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    ABSTRACT: The work was aimed at determining appropriate surgical policy in patients presenting with atherosclerotic occlusion of the internal carotid artery (ICA), who had endured ischaemic carotid stroke on the side of the occluded ICA. The study was based on the findings obtained in a comprehensive examination and surgical management of 140 patients. All the 140 patients at the first stage were subjected to surgical resection of the ICA with autovenous plasty of the external carotid artery (ECA). The obtained results were evaluated at 3 and 6 months postoperatively. The outcome measures included studying the clinical course of the disease (assessed by a neuropathologist), the extent of the cerebral perfusion reserve (CPR), the direction the blood flow along the suprapubic artery (SPA), and the type of the collateral compensation of the cerebral blood flow. Failure of the first operation to have turned out either clinically or haemodynamically efficient was followed by determining the indications for carrying out the operation of the extra - intracramal micro anastomosis (EICMA), with the number of such cases amounting to 24 (24.3 %). The surgical policy used to treat the patients with atherosclerotic occlusion of the ICA with endured ischaemic stroke has proved efficient both clinically and haemodynamically in a total of 133 (95%) patients. The findings obtained in the present study made it possible to work out specific indications for performing the operation of the EICMA in patients with occlusion of the CA.
    Angiologii͡a i sosudistai͡a khirurgii͡a = Angiology and vascular surgery 02/2006; 12(3):105-10.
  • A N Vachev · V K Koryttsev ·
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    ABSTRACT: Results of treatment of 308 patients under 60 years of age with verified stopped ulcer duodenal bleeding were analyzed retrospectively. The number of recurrent bleedings among 85 women was less than among 223 men with similar location of ulcer, severity of blood loss and methods of treatment. Basing on the results of treatment of 99 patients who received no transfusions of blood components it was demonstrated that the velocity of erythrocytes and hemoglobin natural recovery after blood loss was significantly higher among women than among men.
    Khirurgiia 02/2006;
  • A N Vachev ·
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    ABSTRACT: The paper presents general principles of care for patients with different grades of cerebral ischemic disorders. From total 539 patients operated in Samara Regional Center of Surgical Angioneurology, 87 were recruited to the study including 49 with preoperative ischemic stroke. The only one inclusion criterion was that those 87 patients were affiliated to a single community polyclinics. Postoperative mortality in the study group was 3.4% (3 patients). Two deaths were caused by recurrent intraoperative stroke, the third patient died from myocardial infarction 8 days after surgery. The rest 84 patients were followed up for 5 months to 2 years. During the outpatient follow-up only 2 from 84 patients demonstrated cerebral transitory ischemic attacks against hypertension background. The study helped to elaborate general principles of care for patients with chronic cerebral ischemic disorders.
    Angiologii͡a i sosudistai͡a khirurgii͡a = Angiology and vascular surgery 02/2003; 9(4):21-4.
  • A N Vachëv · M Iu Stepanov · E V Frolova · O V Dmitriev ·
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    ABSTRACT: This paper is concerned with an evaluation of the clinical effect of reconstructions on the brachiocephalic vessels in patients who suffered ischemic stroke. Altogether 143 patients with the above pathology were operated on. Of these, mild hemiparesis was present in 72 patients, moderate hemiparesis in 49, and severe hemiparesis was recognized in 17 subjects. The postoperative lethality accounted for 1.4% (2 subjects). Intraoperative development of repeated stroke was ascertained in three more subjects. The follow up of the operated patients lasted from three months to two years. In the postoperative period, a study was made of the time course of changes in motor pyramidal deficit. The study allowed the conclusion to be drawn that reconstructions on the brachiocephalic vessels are not only of preventive importance but also favour the elimination of motor disorders in patients who suffered ischemic stroke.
    Angiologii͡a i sosudistai͡a khirurgii͡a = Angiology and vascular surgery 02/2003; 9(2):99-105.