Claudication due to adventitial cystic degeneration: A differential diagnosis of peripheral artery disease.

BACKGROUND: Cystic adventitial disease (CAD) is an important and rare non-atherosclerotic cause of intermittent claudication and critical limb ischemia. Since the first case of CAD involving the external iliac artery was described by Atkins and Key in 1947, approximately 300 additional cases have been reported. OBJECTIVES: The aim of this article is to report a rare vascular disorder, predominantly seen in young healthy men with minimal cardiovascular risk factors. METHODS: We report a rare case of cystic adventitial disease of a young policeman. To confirm the diagnosis, an ultrasonography and a conventional angiography were performed. The therapeutic approach was surgical first. RESULTS: The procedure was successful without any complication, and the patient was discharged to home 4 days after procedure. CONCLUSION: While CAD is rare, the diagnosis should be suspected in a young patient who presents with arterial insufficiency and no risk factors for atherosclerosis. Catheter angiography is the investigation of choice in the absence of multislice CT and good MRA. It seems that the treatment that assures the best long-term results is reconstructive arterial bypass surgery.

[Stagewise treatment of a patient with multifocal atherosclerosis, limb ischaemia, and surgical infection]. / Étapnoe lechenie patsienta s mul'tifokal'nym aterosklerozom pri ishemii konechnosti i khirurgicheskoi infektsii.

UNLABELLED: The authors share herein their experience in successful treatment of a male patient with multifocal atherosclerosis and lower-limb critical ischaemia complicated by erysipelas. THE AIM OF THE WORK: to show not only efficacy of iloprost (Ilomedin) used as conservative treatment in patients presenting with critical ischaemia and surgical infection in both pre- and postoperative periods in order to save the limb, but also the possibility of postponing reconstructive intervention, improving the patient's quality of life during this period, as well as shortening the duration of the postoperative period, and also to demonstrate both immediate outcomes of endovascular repair of an abdominal aortic aneurysm and remote results of comprehensive treatment for disseminated multifocal atherosclerosis with severe accompanying pathology.

[Surgical treatment of the internal carotid artery atherosclerotic occlusion].

Internal carotid artery occlusion is the cause of carotid territory transient ischemic attacks or infarction approximately in 15% of patients. Extracranial-lntracranial (EC-IC) Bypass Study and Carotid Occlusion Surgery Study (COSS) failed to show a benefit of EC-IC bypass over medical therapy in patients with symptomatic carotid artery occlusion. Weak sides of COSS were investigators reliance on post hoc analysis, use of specific thresholds in the definition of impaired cerebral hemodynamics and high perioperative morbidity. In selected subset of patients with medically refractory ischemic symptoms, EC-IC bypass, can provide benefit from surgery performed with sufficiently low perioperative morbidity. The potential of functional and cognitive improvement after cerebral revascularization needs further investigation.

[Surgical correction of cerebral blood flow steal syndrome by aortic branches stenosis].

Results of surgical treatment of 119 patients with cerebral/coronary blood flow steal syndrome were analyzed. Vertebro-subclavian steal syndrome was registered in 91.5%. 80 patients were treated with the use of endovascular methods, open procedure was performed in 62 cases. Physiological blood flow was successfully reconstructed in 95.8%. Postoperative lethality was 5,1% after open operations, there were no deaths among patients, treated endoscopically. Bypass thrombosis was registered in 3.4% of patients treated by traditional method; restenosis or occlusion occurred after 34.3% of endovascular operations. Endovascular operations should be a method of choice in treatment of patients with severe occlusion of branches of aorta and cerebro-vascular insufficiency. By impossibility of subclavian artery or brachiocephal trunk recanalization with the use of endovascular techniques, open procedure should be performed.

[Aneurysmal degeneration of the autovenous carotid-subclavian bypass: experience with the treatment, review of literature].

The authors describe an experience gained with successful surgical treatment of a 73-year-old patient with a genuine aneurysm of the autoveinous carotid-subclavian bypass, iwelve years ago the patient was operated on for stenosing atherosclerosis of the coronary and left subclavian arteries (SCA). Aneurysm emergence was consequent on the use of v.saphena magna as a bypass in the given <> and was not associated with appreciable circulatory disorders in the left upper limb. However, its further existence was conjugated with the risk of rupture and bleeding. Examination (duplex scanning, angiography) confirmed the diagnosis of aneurysm. Besides, critical stenosis of segment I of the left SCA and opening of the left internal carotid artery (ICA) were verified as well. The patient was operated on: the first stage involved angioplasty and stenting of segment I of the left SCA; the second stage involved carotid endarterectomy on the left, resection of bypass aneurysm together with its disengagement. On control angiography performed 11 months later the patency of the reconstructed arteries appeared satisfactory; stenosis was not recorded. The given case demonstrates a modern approach to the treatment of patients with coexistent vascular pathology (atherosclerotic stenosis plus aneurysm).

[Experience in the determination of iodine in the urine by the kinetic cerium arsenite method]. / Opyt opredeleniia ioda v moche kineticheskim tserii-arsenitnym metodom.

The authors describe the kinetic cerium arsenite method for measuring iodine in the urine using reagents made in Russia. The urine is prepared for analysis by wet calcination with a mixture of chlorous and perchloric acids. The method of synthesizing chlorous acid, preparing reagents, collecting urine, and procedure of analysis are described. The method was used for assessing iodine excretion with the urine in schoolchildren of Novosibirsk and Kemerovo.

[Effectiveness of diet therapy in patients with ischemic heart disease and a history of myocardial infarction at young age]. / Effektivnost' dietoterapii u bol'nykh ishemicheskoi bolezn'iu serdtsa, perenesshikh infarkt miokarda v molodom vozraste.

To elucidate the effect of dietetics on the onset and course of coronary heart disease (CHD) patients who survived myocardial infarction at young age were investigated. The analysis of clinical and metabolic changes, psycho-vegetative disorders permitted the authors to distinguish two groups of patients: group 1--patients with normal body mass, and group 2--those with excessive body mass who received, respectively, A1 (basic) and Ar (reduced) variants of theanti- arteriosclerotic diet. It was established that the Ar diet produced positive effects on the dynamics of body mass reduction, on the cardiovascular system, on parameters of lipid metabolism, hemostasis and psycho-physiologic parameters of group 2 patients. Diet therapy combined with tranquilizers is recommended for group 1 patients.