[Hemobilia as a sign of arterio-biliary fistula]. / Gemobiliya kak proyavlenie arteriobiliarnoi fistuly.

Hepatic artery aneurysms (HAA) are rare (20% of all visceral arteries). Most often, HAAs are asymptomatic and detected at autopsy. However, their ruptures and/or bleeding following pressure ulcers in visceral gastrointestinal organs are a significant clinical and diagnostic problem. We present 2 patients with obstructive jaundice and hemobilia. Diagnostics revealed aneurysm of the right hepatic artery with arterio-biliary fistula. Life-threatening hemobilia is a consequence of HAA rupture into biliary system. Endovascular approach is preferable for HAA without clinical manifestations. Awareness of this disease is important for early detection and active surgical intervention before possible complications.

[Three years experience of catheter treatment of patients with acute coronary syndrome in conditions of 24-hour work of endovascular service].

In this work we have summarized 3-years experience of the treatment of acute coronary syndrome with the use of endovascular methods and presented organizational basis allowing to realize 24-hour work of the endovascular service, and algorithm of examination and treatment of patients admitted with diagnosis of acute coronary syndrome. During the analyzed period invasive interventions were carried out in 1417 patients (transluminal angioplasty - in 93, angioplasty with stenting - in 1356 patients) with mean door to balloon time 37.7 min. For stenting we used 925 standard metal stents and 584 drug eluting stents. Coronary artery bypass surgery was performed in 150 patients. Severe complications during hospital stay developed in 3% of patients. Fifteen patients died, 14 of them were admitted in a state of cardiogenic shock. Repeat coronary angiography in remote period was fulfilled in 170 patients with recurrence of angina. Restenoses were found in 31.2% of these patients, predominantly in those with implanted standard metal stents.