[Embolization of a pseudoaneurysm of the inferior gastroduodenal artery]. / Émbolizatsiia lozhnoi anevrizmy nizhnei zheludochno dvenadtsatiperstnoi arterii.

Aneurysms and pseudoaneurysms of visceral arteries are relatively rare clinical entities and their pathogenesis has not yet been fully understood. Aneurysmal rupture appears to be a complication leading to life-threatening internal haemorrhage and is a cause of high mortality. However, advances in endovascular surgery techniques have extended the capabilities of treating aneurysms, allowing microemboli to be delivered even to the hard-to-reach portions of the vascular bed with complicated anatomy. Presented in the article is a clinical case report regarding embolization of a false aneurysm of the inferior gastrointestinal artery, separated by a microcoil, and demonstrating possibilities of endovascular superselective embolization of the target vessel.

[Experience of Endovascular Implantation of the WATCHMAN Device in Patients With Atrial Fibrillation].

Atrial fibrillation is one of most frequent heart rhythm disorders in clinical practice. In this article, we present data of review of relevant literature including consideration of prevention of thromboembolic complications. We also present our own experience of endovascular implantation of the WATCHMAN device in left atrial appendage of patients with atrial fibrillation.

[Stagewise bilateral stenting of vertebral arteries in a patient with occlusion of both internal carotid arteries].

The authors describe herein a case report concerning stagewise endovascular treatment of a 69-year-old male patient presenting with occlusion of the right and left internal carotid arteries admitted to Clinical Hospital № 1 of the RF President's Affairs Administration with the following diagnosis: atherosclerotic occlusion of carotid arteries, arterial hypertension, chronic bronchitis, chronic prostatitis, and a history of multiple episodes of unconsciousness. Duplex scanning and angiography of the brachiocephalic arteries revealed occlusion of the both internal carotid arteries, as well as pronounced narrowing of the ostium of the right and left vertebral arteries supplying blood to all portions of the brain. Computed tomography revealed no signs of endured stroke. The first stage consisted in stenting of critical stenosis of the left vertebral artery ostium, followed by stenting of the right vertebral artery ostium performed 2 weeks after (with implanting drug-covered stents «Promus¼ in both cases). The patient was discharged home in a satisfactory condition.

[Landmark of the internal carotid artery stenting, anterior interventricular branch of the left coronary artery and vertebral artery in a patient with multifocal atherosclerosis].

Presented herein is a clinical case report concerning a 59-year-old male patient suffering from multifocal atherosclerosis after endured repeat acute ischaemic attacks in various arterial basins of the brain. Analysing his case history revealed functional class II-IV angina of effort. Ultrasonographic and angiographic findings showed a haemodynamically significant plaque in the ostium of the left internal carotid artery, hypoplasia of the right vertebral artery, a haemodynamically meaningful narrowing of the left vertebral artery, subtotal stenosis of the anterior interventricular branch and pronounced alterations in the right vertebral artery. The first stage of surgery consisted in stenting of the left internal carotid artery and anterior interventricular branch, followed by the second stage consisting in the stenting of the left vertebral artery with an angiographically good outcome. The check-up CT of the brain and 24-hour ECG monitoring showed no negative dynamics. In July 2005, the patient was subjected to craniocerebral microarterial shunting on the right. No relapses of AIAs have so far been observed.

[Short- and long-term effects of internal carotid arteries stenting in high-risk patients].

The efficacy of endovascular treatment of internal carotid arteries (ICA) stenosis (20 patients) has been compared to that of conventional carotid endarterectomy (25 control cases). ICA stenting was performed in case of stenosis, narrowing arteries to > or = 60% in "symptomatic" patients and to > or = 80% in "asymptomatic" ones. Angiographic indices revealed favorable outcome after stenting in 100%. Mean extent of residual stenosis was 8.3 +/- 0.8%. Significant complications (stroke/fatal outcome) after 22 procedures developed in 3 (13.6%) cases. Mortality was estimated as 4.5%. Taking stroke and fatal cases into account, the interventions were successful in 86.4% cases. The duration of follow-up study was from 1 to 48 months, with 1 case resulting in death and 2--in development of acute disturbance of cerebral blood circulation of contralateral ICA. Short- and long-term results of the intervention did not significantly differ between the study and control groups thus indicating ICA stenting as an alternative to carotid endarterectomy procedure.