Endovascular arterialization of deep crural and pedal veins in a patient with critical lower limb ischaemia. / Éndovaskuliarnaia arterializatsiia glubokikh ven goleni i stopy u patsienta s kriticheskoi ishemiei nizhnikh konechnostei.

Described in the article is a clinical case report regarding complete endovascular arterialization of deep crural and pedal veins in a male patient with accompanying pathology and impossibility of intraluminal restoration of the arterial bed. Peculiarities of the presented case report consisted in creation of an arteriovenous anastomosis in the upper third of the crus using an endovascular technique. During treatment, a repeat intervention was required, i. e., balloon angioplasty of veins and implantation of an additional stent graft due to reocclusion of veins because of long-term local treatment of wounds and cytostatic therapy for background diseases (chronic myeloleukaemia and rheumatoid arthritis). The performed treatment resulted in a clear trend towards healing of the wounds on the foot and limb salvage.

[First experience with "SUPERA Veritas" stent in treatment of patients with occlusive and stenotic lesions of the femoropopliteal arterial segment]. / Pervyi opyt primeneniia stenta «SUPERA Veritas¼ pri lechenii patsientov s zabolevaniiami arterii nizhnikh konechnostei

Surgical interventions are used more often for treatment of patients with lesions of arteries of the femoropopliteal segment. Considerable role in widening indications for using an endovascular method of treatment is played by improvement of roentgenosurgical tools and equipment. Implantation of stents into arteries of this segment has become a standard intervention whose results are the starting point for comparing with the results of other methods of roentgenendovascular revascularization. The SUPERA Veritas system is the first nitinol interwoven stent that is fracture-resistant due to special manufacturing technology. The results of multicenter randomized studies are suggestive of its good clinical effect in restoration of the lumen of arteries of the femoral-popliteal segment. According to the findings of European and American researchers, the stent's primary patency lies within the range from 79.2 to 87.7% which is comparable to primary patency of nitinol stents with antiproliferative drug coating. The authors share the first experience with this stent in Russia, reflecting peculiarities of its implantation, as well as describing clinical case reports of using this stent in arteries of the femoropopliteal segment in patients with atherosclerosis of lower limb arteries and diabetes mellitus, also providing the data on stent's patency one year after implantation according to the findings of noninvasive studies.

[Pyo-necrotic injuries in case of the neuro-ischemic form of diabetic foot syndrome].

It was analyzed the results of examination and treatment of 217 patients with neuro-ischemic form of the diabetic foot syndrome. Diabetic macroangiopathy with critical limb ischemia (TASC II) was diagnosed in all patients. Tissue foot damage of grade 3 (Wagner) was observed in 100 (46.1%) patients, grade 4 - in 117 (53.9%) patients. The developed strategy of surgical treatment includes the revascularization of an affected limb, surgical management of a pyo-necrotic focus and the plastic reconstruction of the foot after rapid relief of ischemia symptoms. An application of such treatment strategy led to preserve a foot or a stump of the foot in 205 (94.5%) patients.

[The specific features of coronary artery lesion in patients with signs of high cardiac risk in non-ST segment elevation acute coronary syndrome].

The paper covers risk stratification for cardiac events in patients with non-ST segment elevation acute coronary syndrome. It defines an association between risk factors, the specific features of coronary artery lesions, and the outcomes of the disease in relation to the used treatment policy. Particular emphasis is laid on the factors that are a handicap to the detection of a symptom-associated coronary artery in this category of patients.

[Clinical application of directional catheter-mediated atherectomy in patients with ischaemic-form diabetic foot syndrome].

The authors share their experience gained with the device designed for directional catheter-mediated atherectomy SilverHawk (eV3, U.S.A.) used as an alternative to the conventional procedure of balloon angioplasty and stenting in patients presenting with an ischaemic form of the diabetic foot syndrome. A conclusion was drawn on feasibility of directional catheter-mediated atherectomy in management of diabetic patients presenting with occlusive and stenotic lesions of lower-limb arteries.

[Directional catheter-mediated atherectomy as a method for treatment of occlusive and stenotic lesions of lower-limb arteries].

The authors consider a possibility of employing devices for catheter-assisted atherectomy as an alternative or addition to the conventional procedure of balloon angioplasty and stenting of occlusive and stenotic lesions of lower-limb arteries. This is followed by a detailed review of research on employing the device intended for directional catheter-mediated atherectomy SilverHawk (eV3, USA). It was revealed that the outcomes following interventions using this device were substantially superior to those obtained using balloon angioplasty and stenting of lower-limb arteries, with the primary arterial patency in the intervention zone being preserved in more than 60% of cases within the first 12 months postoperatively and in more than 50% of cases within the terms up to 18 months. The limb-salvage rate at 18 months exceeded 88% in patients with critical ischaemia, amounting to 100% in those with intermittent claudication.