[Interdisciplinary approach to treatment of multiple arterial aneurysms in patient with eighth recurrence of incisional hernia--a case report]. / Interdisciplinární prístup k riesení mnohocetných tepenných aneuryzmat u pacienta s osmou recidivou incizionální kýly--kazuistika.

Vascular surgery is not the only option for arterial aneurysm treatment. Minimally invasive techniques are being increasingly used, especially methods of interventional radiology. We present a case of a 51-year-old man who came to our department in July 2005 because of sonographically diagnosed popliteal artery aneurysm. Simultaneous presence of subrenal abdominal aortic aneurysm, bilateral iliac and femoral artery aneurysms and left popliteal artery aneurysm was found. This patient was operated on for pancreatic pseudocyst in 2000 and then during next three years eight times for incisional hernia and its recurrences. The operations were carried out in other surgical departments. Eighth recurrence of incisional hernia was already present. Because of these facts, the risk of resection was deemed too high. Therefore, we chose stent graft implantation for abdominal aortic aneurysm treatment. The endovascular approach was also used to treat some complications that occurred. In this case report, we would like to present a combination of surgical and interventional radiological approaches to treatment of arterial aneurysms as a typical example of interdisciplinary cooperation.

[The subclavian steal syndrome]. / Subclavian steal syndrom.

The aim of this work is to summarize the authors' experience gathered during surgical procedures for the subclavian steal syndrome. The authors put forward the method of anaesthesia with patient's vigility and mobility preserved, favouring the arterial transposition procedures against the prostheses implantation methods. The main common feature of the above approaches is to increase the procedure's safety.

Ruptured abdominal aortic aneurysm--outcomes in the last ten years.

Ruptured abdominal aortic aneurysm (AAA) remains to be represent a common and highly lethal problem. We reviewed the records of 92 patients (73 men and 19 women) operated on for ruptured infrarenal AAA within the past 10 years (January 1989 to October 1999) in the 2nd Department of Surgery in Brno, Czech Republic. The mean age was 71 years (range 57 to 92 years). Only 10 patients (10.9%) were known to have an AAA before the rupture. Preoperative systolic blood pressure below 90 mmHg was present in 70 patients (76%) and 15 patients (16.3%) experienced cardiac arrest before surgery. The in-hospital mortality rate was 47.8% (44 patients). Among the total of 92 patients, haemoperitoneum was discovered only in 30 patients (32.6%) with the mortality rate of 40% (12 patients). In 62 patients (67.4%) also hemoperitoneum was present, the mortality rate was 51.6% (32 patients) in these patients. Multiorgan failure due to an irreversible hemorrhagic shock was the main cause of death in 23 patients (25%). Further causes were: heart failure--8 patients (8.7%), pulmonary complications--5 patients (5.4%), renal failure--4 patients (4.3%), bleeding--3 patients (3.3%), and sepsis--1 patient (1.1%). The patient's prognosis depends on early diagnostics and on the quality of peroperative and postoperative care. (Tab. 2, Ref. 8.)