[False aneurysms of the vascular anastomoses after reconstructive operations on the aorta and arteries of the lower extremities]. / Lozhnye anevrizmy sosudistykh anastomozov posle rekonstruktivnykh operatsii na aorte i arteriiakh nizhnikh konechnostei.

The authors have performed an analysis of examination and surgical treatment of false aneurysms of vascular anastomoses (34) in 29 patients after reconstructive operations on the aorto-iliac and femoro-popliteal segments. This late complication was found to develop in 3.3% of the patients operated upon. In 66.5% of them the aneurysms had complicated the clinical course. Multifactorial genesis of false aneurysms was confirmed. The first place among etiological factors belongs to infection. Reconstructive operations with resection of the aneurysm and restoration of blood flow were performed on 27 patients. Good results were obtained in 25 of them, reamputation of the femur and shin was made in 2 patients. The authors insist on early diagnosis and active surgical treatment of false aneurysms of anastomoses.

[Recurrence of ischemia of the lower limbs in patients with functioning vascular prosthesis]. / Retsidiv ishemii nizhnikh konechnostei u bol'nykh s funktsioniruiushchimi sosudistymi protezami.

On the basis of experience in surgical treatment of 242 patients with recurrent ischemia of the lower limbs in late periods after operations on the aorta and peripheral arteries, the authors singled out a group of patients (44) with unobstructed but hemodynamically incompetent vascular prostheses. Their hemodynamic changes were caused by stenosis of the vascular anastomoses and shunts or by the development of occlusions of arteries beyond the reconstructed segments. The authors relate all these complications to the prethrombotic stage of late reocclusions and insist in their recognition before the development of thrombosis of the vascular prosthesis. The important role of dynamic Doppler flowmetry in early diagnosis is shown. Reoperations for correction of the blood flow were conducted on 40 patients. The results were good in 92.5% of them. The authors recommend wider use of preventive operations which contribute to the improvement of surgical treatment of patients with late reocclusions of arteries and vascular prostheses.

[Experimental validation of a method for the early diagnosis of the infection of vascular prostheses using 99m-TC-labelled leukocytes]. / Eksperimental'noe obosnovanie metoda rannei diagnostiki infitsirovanniia sosudistykh protezov s pomoshch'iu leikotsitov, mechennykh 99mTc.

Experiments on 9 dogs were staged for a study of a method of early diagnosis of infectivity of vascular prostheses of the abdominal aorta with the help of 99m-Tc-labelled leukocytes. A sterile synthetic vascular prosthesis was used for prosthetics of the abdominal aorta in the 1st control group of animals, a prosthesis, previously infected with St. aureus, was used in the 2nd group, a sterile prosthesis with its subsequent infecting by i.v. injection of St. aureus was used in the 3rd group. The role of antibiotic therapy in infectivity of vascular prostheses was studied on the animals of the 3rd group. A radionuclide study with autologous 99m-Tc-labelled leukocytes was conducted using the Deina-2 camera (Picker). Visualization of the prostheses was unobserved in the 1st control group; in the 2nd group the accumulation of 99m-Tc-leukocytes in the zone of the prosthesis and its visualization on the 4th-5th min. were noted; in the 3rd group the prosthesis was visualized on the 10th-15th min. After antibiotic therapy in the 3rd group visualization of the prosthesis was undetectable. The proposed method permitted visualization of a zone of infection in the early postoperative period, observation of the time course of infection development, and assessment of the efficacy of antibiotic therapy.

[Obturator shunting in suppuration of vascular prostheses]. / Obturatornoe shuntirovanie pri nagnoenii sosudistykh protezov.

An experience with using obturatory shunts in 10 patients with suppurations of vascular prostheses after reconstructive operations on the aorto-iliac segment for its occlusive lesion is presented. The authors have come to a conclusion that extra-anatomical shunting through the closing inlet of the pelvis when combined with resection or removal of the infected vascular prosthesis, local and general antibacterial therapy is an effective method of treatment of the pathology in question. The modified method of shunting facilitates performing the operation in most critical patients. Good results were obtained in 7 of 10 patients operated upon. Two patients died. The amputation of the extremity was fulfilled in 1 patient.

[Experience in the clinical use of vein grafts from the umbilical cord of newborn infants for arterioplasty]. / Opyt klinicheskogo primeneniia transplantatov iz veny pupochnogo kanatika novorozhdennykh dlia arterial'noi plastiki.

The work analyzes the first experience of clinical using the xenograft from the neonatal umbilical cord vein for different kinds of arterial plasty in chronic occlusion diseases. For a year 19 patients were operated. In most cases the femoropopliteal shunting or prosthetics above or under the knee joint was made. The observations continued from 3 till 13 months.