-
[show abstract]
[hide abstract]
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 01/2012; 18(1):88-91.
-
[show abstract]
[hide abstract]
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 01/2012; 18(2):131-7.
-
[show abstract]
[hide abstract]
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.
-
[show abstract]
[hide abstract]
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;
-
[show abstract]
[hide abstract]
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;
-
[show abstract]
[hide abstract]
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.
-
[show abstract]
[hide abstract]
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;
-
[show abstract]
[hide abstract]
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.
-
[show abstract]
[hide abstract]
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;
-
[show abstract]
[hide abstract]
ABSTRACT: Aim of the study was to assess effect of therapy with b-adrenoblockers and If-inhibitors on the rate of development of coronary complications of carotid endarterectomy. Patients (n=111, mean age 61 +/- 4 years) subjected to carotid endarterectomy in 2006 - 2007 were divided into 3 groups according to therapy in pre-, intra-, and postoperative period. Group 1 consisted of 48 patients treated with metoprolol. Group 2 comprised 33 patients with contraindications to b-adrenoblockers who were treated with If-inhibitor ivabradine. Patients of control group 3 (n=30) received neither b-adrenoblocker nor If-inhibitor. There were no significant differences between groups in sex, age, concomitant pathology, and degree of stenosis of operated carotid artery. We assessed rate of development of ischemia and myocardial infarction during operation and in first 24 hours after surgery. In group 1 mean 24 hour heart rate according to Holter ECG monitoring after 7 days of therapy decreased by 14 +/- 3,7 beats/min, episodes of ischemia after surgery were registered in 4 patients (8%). In group 2 mean 24 hour heart rate decreased by 10 +/- 2,5 beats/min, 4 patients (12%) had signs of myocardial ischemia during first 24 hours after surgery. There were no myocardial infarctions in groups 1 and 2. In control group mean 24 hour heart rate did not significantly change. Significantly higher number of postoperative coronary complications was revealed among patients of this group: 2 (6%) developed myocardial infarctions, in 5 (17%) appeared signs of myocardial ischemia. Administration of b-adrenoblocker metoprolol and If-inhibitor ivabradine significantly lowers rate of development of coronary complications after carotid endarterectomy. Ivabradine is indicated to patients with contra indications to b-adrenoblockers.
Kardiologiia 02/2008; 48(5):56-9. · 0.20 Impact Factor
-
[show abstract]
[hide abstract]
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;
-
[show abstract]
[hide abstract]
ABSTRACT: The aim of the study was to decrease the risk of ischemia and myocardial infarction (MI) in intraoperative and early postoperative period after carotid endarterectomy (CEA).
295 patients underwent CEA from 2001 till May 2005 in the Clinics of faculty surgery, Samarsky state medical university. Besides clinical investigation, patients underwent Doppler ultrasonography of brachiocephalic arteries, transcranial Doppler, brain CT (if appropriate), echocardiography, repeated ECG and intraoperative ECG monitoring.
Patients were divided into 3 groups. The first group (n=78, 26.4%) did not receive any special preoperative cardiological care. Among them MI developed in 8 patients (10.2%) on the first postoperative day. The second group (n=131, 44.4%) received nitrates, desaggregants, calcium antagonists, ACE and metabolic drugs preoperatively. In this group there were 6 cases (4.6%) of MI in early postoperative period. The third group (n=86, 29.2%) received cardioselective lipophilic beta-blockers (Atenolol, Metoprolol), in addition to drugs that were given for the second group. No cases of MI in early postoperative period were registered in the third group. Differences were statistically significant (p<0.05).
Inclusion of beta-blockers into preoperative medical care before CEA procedure significantly decreases the risk of myocardial ischemia and infarction in early postoperative period (24 hours).
Angiologii͡a i sosudistai͡a khirurgii͡a = Angiology and vascular surgery 02/2006; 12(2):97-100.
-
[show abstract]
[hide abstract]
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
[show abstract]
[hide abstract]
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.
