[Subclavian artery aneurysms: pathogenesis, diagnosis, and therapeutic decision-making]. / Anevrizmy podkliuchichnoi arterii: patogenez, diagnostika, vybor taktiki i metoda lecheniia.

The article deals with the relevant literature data concerning diagnosis and treatment of subclavian artery aneurysms. This nosological entity is relatively uncommon, however its importance for modern medicine should not be underestimated. Despite a low incidence of the pathology, it should be understood that the disease's course for the patient is associated with the development of severe complications which may lead to disability or even death. The development of complications is extremely difficult to predict and stratification of risks for such patients is too complicated. It is also known that the diagnosis of a subclavian artery aneurysm is frequently an accidental finding, since the pathology may for a long time proceed symptom-free. At the same time, the subclavian artery occupies the first place by the frequency of localization of upper-limb aneurysms, thus making this problem currently important. Besides, separate attention should be paid to modern methods of correction of this disease, since implementation of high-tech interventions into vascular surgery have significantly expanded the arsenal of the operating surgeon.

[Surgical treatment of patients with upper- and lower-limb arterial aneurysms].

From 1968 to 2005, a total of 161 patients presenting with upper- and lower-limb arterial aneurysms were treated at the Federal Facility Russian Scientific Centre of Surgery named after Academician B. V. Petrovskii under the Russian Academy of Medical Sciences. Amongst the most frequently encountered causes of their development appeared to be an injury [86 (53.4%) patients] and atherosclerosis [33 (20.5%) patients]. Radiopaque angiography was performed in 147 (91.3%) of the 161 patients. The presence of a thrombus in an aneurysm was revealed in 97 (66.0%) of the 147 patients. Ultrasonographic duplex scanning carried out in fifty-eight patients demonstrated the presence of a thrombus inside the aneurysmal cavity in forty-three (74.1%) of them. Hundred and thirty-nine (86.3%) patients diagnosed as having arterial aneurysms were subjected to reconstructive operations. More frequently, we performed aneurysmal resections with prosthetic repair of the affected artery or lateral suture of the artery, as well as bypass grafting. Relapses of aneurysms in the remote period were encountered significantly more often in patients who had endured reconstructive operations for infectious, posttraumatic and postoperative aneurysms by means of synthetic plastic materials. Hence, carrying out reconstructive arteries aneurysms irrespective of their sizes is the only reliable method of preventing the development of life-threatening and disabling complications. Operations of choice in the patients diagnosed as having mycotic, postoperative, and posttraumatic arterial aneurysms include aneurysmal resection with an "end-to-end" or an "end-to-side" arterio-arterial anastomosis, or bypass grafting.

[Surgical treatment of an aneurysm of the superficial femoral artery 40 years after an injury: a case report].

Presented herein is a case report of a male patient with a posttraumatic aneurysm revealed 40 years after an injury. The presence of a foreign body in the lumen of the artery for such a long time had had no manifestations and was detected by ultrasonographic duplex scanning. The patient was subjected to resection of the aneurysm of the superficial femoral artery on the right lower limb with prosthetic repair performed by a reversed autovein.

Surgical treatment of patients with extracranial carotid artery aneurysms.

Between January 1998 and December 2003 thirty-one patients with extracranial common and internal carotid artery aneurysms underwent surgical treatment at the Department of Vascular Surgery, Russian Scientific Center of Surgery. Of these patients, 29 subjects were provided reconstructions on these arteries and two patients underwent ligature operations. In the short-term postoperative period, one (3.2%) patient died. The lethal outcome was induced by acute disorder of cerebral circulation (ADCC). Disorders of cerebral circulation (DOC) occurred in 4 (12.8%) patients. Of 2 (3.2%) cases of stroke, one eventuated in lethal outcome and 2 (6.4%) patients developed transient ischemic attacks (TIA). The lethality in the long-term postoperative period (the follow up lasted as long as 5 years) accounted for 6 (19.3%) cases. In patients who had undergone reconstructions, the long-term postoperative lethality reached 13.8% (4 cases) whereas the lethality following ligature operations constituted 100% (2 cases). So, the reconstructive operation is a highly effective and safe enough approach to the treatment of patients with extracranial carotid artery aneurysms. The short- and long-term results were beneficial.

[The treatment of false iatrogenic arterial aneurysms (review of literature)].

Recently an ever growing importance has been acquired by the problem of the treatment of iatrogenic aneurysms of the peripheral arteries, first of all, this is linked with a steady growth of the number of endovascular interventions. The development of false post-puncture aneurysms is one of the most hazardous complications from such interventions. Along with traditional surgical treatment (reconstructive operations) much attention is paid to the use of little invasive treatment methods for these aneurysms, e.g. the compression modality under ultrasound guidance.

[Successful treatment of a patient with internal carotid aneurysm]. / Uspeshnoe lechenie bol'noi s anevrizmoi vnutrennei sonnoi arterii.

Presented herein is a clinical report of the surgical treatment of a female patient with left internal carotid aneurysm. Patient M, aged 58 years was hospitalized to the Department of Vascular Surgery, RSCS RAMS, with complaints of a pulsatile formation in the area of the neck on the left, persistent headaches, frequently occurring dizziness, and multiple episodes of loss of consciousness. The patient has been ailing for 20 years. Examination discovered a rounded pulsatile formation about 3 cm in diameter in the left lateral area of the neck in the internal carotid projection. Duplex scanning revealed aneurysm of the left internal carotid artery measuring 2,3 cm x 3.8 cm. Computerized tomography confirmed aneurysm of the left internal carotid artery. On December 10, 2002 the patient underwent resection of aneurysm of the left internal carotid artery followed by establishment of an end-to-end anastomosis. The immediate postoperative period was uneventful. The patient was discharged home in a satisfactory condition.

[Surgical treatment of aneurysms of unpaired visceral branches of the abdominal aorta]. / Khirurgicheskoe lechenie anevrizm neparnykh vistseral'nykh vetvei briushnoi aorty.

Aneurysms of unpaired visceral branches of the abdominal aorta are rare diseases but they are dangerous for life. Russian Research Center of Surgery RAMS has an experience of diagnosis and surgical treatment of 23 patients with aneurysms of the celiac trunk (2), superior mesenteric artery (4), inferior mesenteric artery (1), hepatic artery (4), splenic artery (7), gastroduodenal artery (2), inferior pancreatoduodenal artery (1), multiple aneurysms of celiac trunk and superior mesenteric artery (2). 21 of 23 patients were operated. 20 patients were discharged with complete recovery. 1 (4.8%) patient died due to gastroduodenal bleeding 4 months after surgery. The results show that patients with aneurysms of unpaired visceral branches of abdominal aorta require surgical treatment.