[Simultaneous operations in patients with infrarenal aortic aneurism].

During the period between 1982 and 2007 years, 125 patients had been simultaneously operated on the infrarenal atherosclerotic aortic aneurism (aorto-femoral by-pass) and other organs. 86 of them overcame simultaneous surgery considering vascular interventions, the rest 39 had been operated on general surgical and oncologic diseases of abdomen. The acquired results were satisfactory and proved the reasonability of simultaneous operations by aortic aneurism.

[Organization of an out-patient surgical aid and ways of it's improvement]. / Puti uluchsheniia ambulatorno-poliklinicheskoí khirurgicheskoí pomoshchi.

The organization of an out-patient surgical aid is analysed. The results of 2363 surgical operations performed in the outpatients clinics in 1990-1992 are analysed. 277 (11.7%) of these operations are usually done in hospital. 348 roentgen-contrast examinations (including iliacography, arteriography, retroe femoral and popliteal phlebography) were performed in the Roentgenological division of clinics for outpatients.

[Outpatient surgical treatment of chronic venous insufficiency of the lower extremities]. / Khirurgicheskoe lechenie bol'nykh khronicheskoi venoznoi nedostatochnost'iu nizhnikh konechnostei v poliklinike.

The results are analyzed for 30 surgical interventions on the legs for chronic venous insufficiency. Feasibility is considered of surgical correction of the function of the deep vein valvular apparatus, of retrograde circulation arrest by obturation of posterior tibial veins in varicosity and postthrombotic diseases.

[Ultrasonic methods of diagnosis of late complications after reconstructive surgery of the aorta and major arteries of the lower limbs]. / Ul'trazvukovye metody diagnostiki pozdnikh oslozhnenii posle rekonstruktivnykh operatsii na aorte i magistral'nykh arteriiakh nizhnikh konechnostei.

Long-standing results were studied in 587 patients who sustained reconstructive vascular surgeries when aged under 16 years (the average age was 6 years and 4 months). Out of them 141 patients faced the necessity of repeated surgeries: in 115 (81.6%) patients the extremity function was preserved, in 19 (13.5%) a repeated amputation was performed, 7 patients (4.9%) expired. All those operated on had been actively followed up with the use of periodical instrumental investigation which included dopplerography and ultrasonic angiography. High significance of ultrasonic technique was proved as the use of it permitted one to detect late complications on the early stages of their development and perform surgical corrections before the development of life-threatening complications. Therefore repeated preventive surgeries were performed in 53 patients, 52 of them were a success. Repeated amputations were performed in 1 patient. All those operated on survived.

[Characteristics of blood flow in the vertebral arteries in scalenus anticus syndrome]. / Osobennosti krovotoka po pozvonochnym arteriiam pri skalenus-sindrome.

The authors studied hemodynamics in the vertebral arteries in 62 patients with the scalenus-anticus syndrome by means of radioconstrast angiography and ultrasonic angiography which produced a colour image of the vessels with calculation of the diameter and the linear and volume blood flow rate. The results of the study showed that in constriction of the subclavian artery to 60% of its diameter in the typical place, the volume blood flow rate in the vertebral arteries remained normal (184 +/- 6.9 ml/min) but reduced 1.5-2 times during the functional test. Adequate surgical correction restored normal hemodynamics, control ultrasonic angiography recorded increase of the volume blood flow rate in the vertebral values to normal values. Ultrasonic angiography provides authentic information on the character of affection of the subclavian artery in the scalenus-anticus syndrome and makes it possible to appraise the hemodynamic significance of affection of the vertebral arteries. Besides, the method allows objective evaluation of the efficacy of treatment and quantitative characteristics of hemodynamics.

[Diagnosis and treatment of impotence of vascular etiology]. / O diagnostike impotentsii sosudistogo geneza i lechenii bol'nykh.

Most complete information on vascular components of erection can be obtained by using three methods: a pharmacological test for creation of artificial passive erection, roentgen-contrast arterio-cavernography on both sides, perfusion graded cavernometry and cavernography. Of 50 patients examined, 5 had no disorders of vascular components of erection. In 34 patients pathology of the arterial duct was revealed, 11 patients had a pathological venous drain. 46 operations were performed on the vessels. Satisfactory and good results were observed in 31 patients (68.8%) within 3 years after operation.

[Diagnosis and surgical treatment of pathological venous drainage from the cavernous bodies of the penis]. / Diagnostika i khirurgicheskoe lechenie patologicheskogo venoznogo drenazha iz kavernoznykh tel polovogo chlena.

In examination of 50 patients with impotence, pathological venous drainage (PVD) was revealed in 11 of them. Perfusion graded cavernosometry/cavernosography is the only method by which PVD can be detected and studied thoroughly. Analysis of the cavernosograms revealed a sphincter of the deep dorsal vein of the penis, the dysfunction of which in 10 of the 11 patients was the cause of PVD; in 5 of these patients the dysfunction was combined with excessive development of the subcutaneous veins of the penis. In one patient PVD was caused by a large venous trunk which emptied into the ostium of the left major subcutaneous vein. The 11 patients underwent operation after which they returned to a normal sex life.

[Surgical treatment of impotence of vascular origin]. / Khirurgicheskoe lechenie impotentsii sosudistogo geneza.

Examination of 50 patients suffering from impotence of vascular genesis included selective angiography of the penis conducted against the background of artificially induced erection, Doppler sonography of the penis and angiography and measurement of the corpora cavernosa. The following causes of impairment of erection were revealed: abnormal venous drainage of corpora cavernosa, derangement of arterial inflow due to occlusion of the aorta, iliac arteries, internal iliac artery, internal pudendal and penile arteries. Surgical correction was aimed at elimination of abnormal venous drainage, inclusion in the major blood flow of the internal iliac arteries and shunting of the penile arteries. Direct favourable results were obtained in 37 (74 per cent) of the patients operated on.

[Clinico-morphologic and electron microscopic characteristics of chemodectoma of the neck]. / Kliniko-morfologicheskaia i élektronno-mikroskopicheskaia kharakteristika khemodektomy shei.

Chemodectoma of the neck is one of the rare tumors occurring in man. The paper presents an observation of cervical chemodectoma found in a patient aged 31 years. For preoperative differential diagnosis, carotid angiography, ultrasound and radioisotopic examinations were used, which allowed the tumor located at the bifurcation of the left carotid artery to be diagnosed. The material taken during the surgery was histologically and electron microscopically examined to verify benign chemodectoma (an alveolar variant).

[Ultrasonic angiography in the diagnosis of occlusive diseases of major arteries of the legs]. / Ul'trazvukovaia angiografiia v diagnostike okkliuziruiushchikh zabolevanii magistral'nykh arterii nizhnikh konechnostei.

A positive feature of non-invasive ultrasonic angiography is thought by the authors to be its high informative value. A generalized experience with 657 examinations performed in 285 patients is presented.

[Surgical tactics in patients with multi-stage occlusions]. / Nekotorye aspekty khirurgicheskoi taktiki u bol'nykh s "mnogoétazhnymi okkliuziiami."

Reconstructive operations on the vessels proved to be possible in 275 of 330 patients with "multi-stage occlusions": in 227 patients profound femoral arteries were included into the main blood flow, in 48 patients the blood flow was reestablished in the aorto-iliac and femoro-popliteal segments. Good results were obtained in 81.2% of the patients. Secondary amputation was performed in 9.1%, 8.7% of the patients died. In the postoperative period repeated interventions proved to be necessary in 46 (16.7%) patients.

[Surgical tactics in the case of injuries to small-diameter arteries]. / Khirurgicheskaia taktika pri povrezhdenii magistral'nykh arterii malogo diametra.

The paper describes the experience in the treatment of 30 patients with injured 35 arteries of distal portions of the forearm and shin. The artery diameter at this level is no more than 3 mm requiring the microvascular surgery technique. The blood flow along the injured vessel was repaired in 22 patients on 25 arteries, with good near and late results in 20 of the patients. In half of the patients subjected to ligation of the artery phenomena of functional arterial insufficiency were developed.

[Repeated reconstructive operations on the vessels in Leriche's syndrome]. / Povtornye rekonstruktivnye operatsii na sosudakh u bol'nykh s sindromom Lerisha.

The work analyzes the causes and results of repeated operations in patients operated earlier for Leriche's syndrome. Primary operations were performed in the following cases: 38 operations for aorto-femoral shunting or prosthesing in patients with "one-storeyed" occlusions of the aorto-iliac segments; 172 operations for the inclusion of the deep femoral artery into the magistral blood flow in patients with associated occlusions of the aorto-iliac and femoro-popliteal segments; 48 operations for simultaneous recovery of blood flow on the both segments when there is a diffuse injury of the femoro-popliteal segment in patients with "many-storeyed" occlusions. Within 7 years repeated operations were performed in 57 patients.