[Use of topical haemostatic agents in cardiovascular surgery]. / Ispol'zovanie mestnykh gemostaticheskikh sredstv v serdechno-sosudistoi khirurgii.

The problem of haemostasis in cardiovascular surgery is of current concern. Recent trends are towards increased use of topical haemostatic agents. Tachocomb has been used for more than 30 years in abdominal surgery and oncology. The purpose of the present publication is to analyse the literature data and formulate the indications for the use of Tachocomb in cardiovascular surgery. Multicenter randomized and local studies have demonstrated efficacy of Tachocomb in treatment of surgical haemorrhage in operations on the heart, thoracic aorta, carotid arteries and lower-limb arteries, resulting in significantly decreased time to achieve haemostasis, decreased volume of blood loss and haemotrasfusion, as well as reduced frequency of complications. Also shown was economic efficacy, including a shortened length of patients' hospital stay. This is followed by describing a wide spectrum of examples of alternative use of Tachocomb, including its use for seamless closure of defects of cardiac chamber walls, aero- and lymphostasis, prevention of formation of commissures. Convincing experimental and clinical results make it possible to formulate a series of indications for the use of Tachocomb in cardiovascular surgery.

Spontaneous recanalization of chronic occlusion of the internal carotid artery.

Described in the article is a rare case concerning spontaneous recanalization of the extracranial portion of the internal carotid artery (ICA) eleven months after occlusion. Only few publications have been dedicated to recanalization of ICA chronic occlusion. Spontaneous recanalization of the ICA is more common than it is generally understood. The authors have analysed all available articles about this problem from PubMed (1957 to 2013), reviewing the mechanisms of recanalization of the ICA, methods of diagnosis and treatment. The purpose of this case report is to emphasize the importance of ICA spontaneous recanalization and consequences thereof.