[Significance of the deep femoral ertery in repeat reconstructions]. / Znachenie glubokoi arterii bedra pri povtornykh rekonstruktsiiakh.

Atherosclerosis obliterans is managed by various reconstructions of lower-limb arteries, but despite this, in the immediate and remote postoperative period there appears the necessity to carry out repeat reconstructions, which might be caused by shunt thrombosis, progression of atherosclerosis, etc. One of the methods of solving this problem is revascularization of lower-limb arteries through the deep femoral vein with plasty thereof. In occlusive lesions of the superficial femoral artery, the deep femoral artery plays the key role in blood supply of the entire extremity. The article deals with the principles of repeat surgical treatment of lower-limb arteries with the use of the deep femoral artery, also discussing the problems concerning the frequency of occurrence of thromboses in various positions, and the role of the deep femoral artery in blood supply of the lower extremity. The problem of efficacy of redo operations on lower-limb arteries using the deep femoral artery is still important. Despite the possibility of revascularization of lower extremities through the deep femoral vein, a high percentage of amputations remains. The terms of patency of the reconstructed deep femoral artery has proved to be several times longer than those of femoropopliteal and femorotibial shunts in the remote postoperative period. Besides, there are no clear-cut criteria for prognosis of efficacy of reconstructive interventions on the deep femoral artery in patients with multi-segment lesions of arteries of lower extremities after primary interventions, therefore, no common surgical policy exists. The use of the deep femoral artery in patients with ischaemia of lower extremities is explained by the minimally traumatic nature and confirmed efficacy after a series of previously performed multilevel operations, severe lesions of the distal bed, as well as in patients with severe concomitant diseases.

[Robot-assisted operations in vascular surgery]. / Robot-assistirovannye operatsii v sosudistoi khirurgii.

The article contains a systematic review of the literature dedicated to vascular robot-assisted operations, also discussing the use of robotic technologies in vascular surgery, their advantages and disadvantages. In so doing, we studied the experience of Russian and leading international surgical centres, comparing the reported outcomes by such parameters as the average duration of the operation, mean time of aortic cross-clamping, time spent for anastomosis formation, frequency of postoperative complications, etc. Benefits of robot-assisted operations allowed the latter to occupy the leading positions in various fields of surgery, although the use of robots in vascular surgery has only begun to gain popularity. A robotically assisted system eliminates the main shortcomings of laparoscopy and opens opportunities for expanding robot-assisted surgery in this field.