[Extracranial aneurysms of carotid arteries in the practice of a vascular surgeon]. / Ékstrakranial'nye anevrizmy sonnykh arterii v praktike sosudistogo khirurga.

The present study was aimed at retrospectively analysing the results of examination and open surgical treatment of patients diagnosed with extracranial aneurysms of carotid arteries. PATIENTS AND METHODS: We analysed the results of examination and outcomes of surgical treatment in a total of 11 patients (6 men and 5 women) presenting with an aneurysm of the extracranial portion of the carotid artery and undergoing treatment at the Department of Vascular and CAD Surgery of the Moscow Regional Research Clinical Institute from 2005 to 2016. The mean age of the patients amounted to 56.5±13.9 years (ranging from 33 to 73 years). The diagnosis of an aneurysm was made based upon the findings of duplex scanning with colour mapping (DS+CM), four patients were additionally subjected to computed tomography (CT) and one to magnetic resonance tomography (MRT). 8 aneurysms turned out to be true aneurysms and 3 appeared to be pseudoaneurysms. 8 aneurysms were localized in the internal carotid artery (ICA) and 3 - in the common carotid artery (CCA). RESULTS: Eight cases were treated by resection of the aneurysm followed by prosthetic repair (5 with an autovenous graft and 3 with a synthetic graft), a further two cases were managed by resection of the aneurysm and an 'end-to-end' anastomosis made, and in one case a false aneurysm was removed, with the arterial defect sutured. The check-up examinations were carried out at 2 and 6 months of the postoperative period. Neither lethal outcomes nor acute cerebral circulation impairments (ACCIs) were registered within the time frame the follow up period. Two patients were found to suffer from cranial nerve injury having disappeared during follow-up. CONCLUSION: An open reconstructive operation is a safe and effective method of preventing complications of aneurysms of the extracranial portion of the carotid artery.

[Characteristics of ischemic stroke in patients with congenital anomalies of the circle of Willis].

The study included 76 patients with ischemic stroke in the carotid system (56 patients) and in the vertebrobasilar system (20 patients). The magnetic resonance angiography (MRA) revealed congenital anomalies of Willis circle in 31 patients. These anomalies were stratified as follows: back trifurcation of the internal carotid artery (ICA) (19 patients), anterior trifurcation of the ICA (4 patients), the combination of anterior trifurcation of the one of ICA and posterior trifurcation of the other ICA (4 patients), double back trifurcation of ICA (2 patients), the normal structure of the circle of Willis (45 patients). Patients with anomalies of the circle of Willis scored significantly higher on the Neurological deficit scale NIH-NINDS. Despite the lack of significant differences in the size of lesions in 2 groups, the foci in patients with the abnormalities of the circle of Willis were frequently localized in adjacent blood supply zones. The signs of vascular encephalopathy were seen as well. The data obtained suggest that the presence of anomalies in the circle of Willis is a risk factor, together with in the additional adversities, including iatrogenic factor, for the development of hemodynamic ischemic stroke.

[Kawasaki disease in an adult European].

A case of Kawasaki disease is reported with manifestations of autoimmune vasculitis and predominant affection of coronary arteries. The relevant literature review describes major symptoms of this pathology and risk factors of its atypical forms. It is emphasized that rare occurrence of Kawasaki disease among non-mongoloid subjects should not make the general practitioner les suspicious of this condition.

[Diagnostic algorithms and features of clinical course of congenital heart diseases in infants with lung anomalies].

The paper discusses the influence of lung anomalies on the progress of congenital heart diseases (CHD) in infants, as well as diagnostic value of radiography and ultraspeed computed tomography (CT). The four-year experience of the authors includes preoperative examination of 178 infants with CHD (mean age 5.8 +/- 0.6 months, mean weight 5.2 +/- 0.3 kg). Lung anomalies were determined in 24 patients (13.5%) on plain films and in 85 patients (47.8%)--by means of CT. The stenosis of main bronchi in combination with lobar emphysema and lung hypoplasia were found to be the most frequent and severe predictors of respiratory disorders. The obtained data suggest that CT examination may be recommended in infants with CHD for precise diagnostics of associated lung anomalies and further prevention or early management of respiratory complications.

[X-ray study in infants of the first year of life who had congenital heart diseases: traditions, specific features, new capacities]. / Rentgenologicheskoe issledovanie detei pervogo goda zhizni s vrozhedennymi porokami serdtsa: traditsii, osobennosti, novye vozmozhnosti.

The paper analyzes the experience with ultrafast computed tomography (CT) used for 4 years to examine 178 babies with complicated congenital heart diseases (CHD), admitted to A.N. Bakulev Research Center of Cardiovascular Surgery, Russian Academy of Medical Sciences, for surgical treatment. It shows the comparative capacities of X-ray study, CT, and catheterized angiography in the diagnosis of CHD and concomitant lung diseases in patients of the first year of life in terms of the physiological and anatomic features of the course of disease. A complex of noninvasive radiation studies is shown to be of high informative value in evaluating the actual anatomy of complicated cardiac and pulmonary anomalies and in detecting the predictors of respiratory complications. The introduction of CT into the traditional algorithm of preoperative examination of patients with CHD has resulted in a considerable reduction in intracardiac diagnostic studies in neonates and infants of the first year of life.

[The puncture and catheterization of the peripheral vessels using ultrasonic scanning]. / Punktsiia i kateterizatsiia perifericheskikh sosudov s ispol'zovaniem ul'trazvukovogo skanirovaniia.

Having many-year experience with angiographic interventions, the authors examined the potentialities of ultrasonic angioscanning to monitor the implementation of endovascular interventions (EVI). During the study, they developed an original procedure of different EVI with intraoperative ultrasonic monitoring, refined the ultrasonic semiotics of the procedure, achieved positive results in preventing possible complications. The authors made indications for the procedure and rational ways of its application more concrete. They provide evidence for that the proposed procedure greatly facilitates the performance of different intravascular procedures and reduces the time (or excludes) teleradioscopy, thus lowering the radiation burden on the staff and the patient.

[The use of bioceramic materials and cryosurgery in the treatment of patients with the Gorlin-Goltz syndrome]. / Primenenie biokeramicheskikh materialov i kriokhirurgii pri lechenii bol'nykh s sindromom Gorlina--Gol'tsa.

Cryosurgical treatment of basal cell carcinomas was carried out and keratocystic cavities formed after cystectomy filled with hydroxyapatite-based biocomposites in 11 patients with the Gorlin-Goltz syndrome. Remote results of treatment are assessed. The authors emphasize that this patient population is in need of multiple-modality treatment.