[Surgical treatment of injuries of the vertebral artery]. / Khirurgicheskoe lechenie povrezhdenii pozvonochnoi artery.

Surgical treatment of injury to the vertebral artery is one of the most difficult problems of modern vascular surgery. Six operations were carried out for injury to the vertebral artery at the Department of Vascular Surgery of the Tashkent Research Center of Surgery, Uzbekistan. In 3 patients the artery was ligated at the orifice. The performance of the compression test for excluding the possibility of the development of cerebral circulatory disorders is obligatory in all such cases. Two patients with injury to the vertebral artery in the medullary canal were treated by a method elaborated in the clinic and consisting in the tight filling of the canal with a mixture of warm wax and a collagen hemostatic sponge. In none of the cases were disorders of cerebral circulation and a clinical picture of vertebrobasilar insufficiency encountered. One patient died.

[Collateral circulation of cerebral hemispheres in occlusive lesions of carotid arteries]. / Kollateral'noe krovosnabzhenie polusharii golovnogo mozga pri okkliuziruiushchikh porazheniiakh sonnykh arterii.

The collateral blood supply to the cerebral hemispheres was studied in 58 patients with occlusive diseases of the carotids on an ultrasonic apparatus based on an undamped wave with a beam frequency of 4 and 8 MHz by appraising the character of the blood flow in the supratrochlear artery in compression of the ipsilateral common carotid artery. The disease was caused by atherosclerosis in 32 and by nonspecific aortoarteritis in 26 patients. Correlation of the character of the blood flow in the supratrochlear artery in compression of the ipsilar common carotid artery and the quantitative value of retrograde pressure in the internal carotid artery showed that the retrograde pressure in the internal carotid in patients with a safe residual antegrade flow of blood in the supratrochlear artery was significantly higher in compression of the ipsilar common carotid artery than in reduced and retrograde blood flow and was 70 +/- 12.6 mm Hg, 33 +/- 12.4 mm Hg, and 34 +/- 10.7 mm Hg, respectively.

[Cerebrovascular CO2 reactivity in carotid artery occlusions]. / Tserebrovasculiarnaia CO2 -reaktivnost pri okkliuziruiushchikh porazheniiakh sonnykh arterii.

Transcranial Doppler echocardiography (TCECG) was used to study a response of enhanced blood flow after 5% CO2 inhalation in 30 patients with carotid atherosclerotic lesions. The technique significantly distinguishes critical stenosis and occlusion of the internal carotid artery from normal and stenotic carotid artery. It is concluded that the values of cerebrovascular CO2 reactivity can be an indicator of differences available between hemodynamically significant carotid lesions and the degree of collateralization in the carotid, tree.

[The noninvasive assessment of intracranial hemodynamics by transcranial dopplerography]. / Neinvazivnaia otsenka intrakranial'noi gemodinamiki posredstvom transkranial'noi doplerografii.

Transcranial dopplerography investigations of intracranial hemodynamics in healthy subjects and patients with occlusion of the internal carotid artery, in compression tests of common carotid artery made it possible to evaluate the function of the circle of Willis anterior and posterior communicating arteries with determination of the sources of collateral compensating blood flow. A significant slowing down of the flow (p < 0.05) along the middle and anterior meningeal arteries occurs with aging. In unilateral occlusion of the internal carotid artery collateral blood flow takes place in intracranial shunts of the anterior and posterior parts of the circle of Willis, in bilateral occlusion--in posterior parts of the circle and natural extra- and intracranial shunts via ophthalmic artery system.

[Surgical treatment of non-specific aortoarteritis of the aorto-femoral segment]. / Khirurgicheskoe lechenie nespetsificheskogo aortoarteriita aorto-bedrennogo segmenta.

For 15 years, the authors observed 158 patients with non-specific aortoarteritis. Of them in 37 (23.4%), isolated lesion of the terminal aorta, iliac and femoral arteries was revealed; in 81.1%--severe degree of ischemia of the lower extremities, 39.4% of men had impotency. Associated lesions of the aorta and arteries of the lower extremities was revealed in patients with acute inflammatory process. The extent of vascular occlusion depended on its presence. Surgical treatment was performed in 35 patients; in 30, the reconstructive operations were performed, in 3--lumbar sympathectomy, in 2--amputation of an extremity. At the early postoperative period, a good result has been noted in 82.9%, 5.7% of patients died. Twenty six patients were followed up for 5 years, 60.1% of them have shown a good result.

[Characteristics of the blood flow in the vertebral artery before and after the surgical treatment of the proximal segment of the subclavian artery]. / Osobennosti krovotoka v pozvonochnoi arterii do i posle khirurgicheskogo lecheniia proksimal'nogo segmenta podkliuchichnoi arterii.

The features of the blood flow in the vertebral artery were studied by ultrasonic dopplerography with functional test for reactive hyperemia in 52 patients. The authors claim this to be an objective screening method allowing the sequelae of occlusion of the vertebrosubclavian segment to be studied and providing information for establishing the diagnosis and appraising the efficacy of reconstructive operations.

[Problems of diagnosis and surgical tactics in the treatment of occlusion of the abdominal aorta]. / Voprosy diagnostiki i khirurgicheskoi taktiki v lechenii okkliuzii briushnoi aorty.

Ultrasonic examination in occlusion of the abdominal aorta and its visceral branches is effective in 87.7% of cases. In combined lesions of the aorta and its visceral branches the authors suggest one-stage reconstructive operations to correct the blood flow. The mortality rate in such cases reduced by 6.76%.

[Doppler ultrasonography in Takayasu syndrome]. / Ul'trazvukovaia dopplerografiia pri bolezni Takaiasu.

The authors by means of ultrasound Doppler examined 26 patients with non-specific aortoarteritis involvement of the aortic arch branches. The use of compressive tests permitted accurate diagnosis of the routes of blood overflow to the affected segment of the arterial basin of the brain. It was established that the main route of blood inflow in patients with non-specific aortoarteritis was the system of intracranial anastomoses; extracranial blood supply of the brain was noted in occlusion of the internal carotid artery.

[Changes in erythrocytes, acid-base equilibrium and blood gases in acute thromboembolism of the aorta and major arteries]. / Izmeneniia éritrotsitov, kislotno-shchelochnogo ravnovesiia i gazov krovi pri ostrykh trombozakh i émboliiakh aorty i magistral'nykh arterii.

The article deals with the analysis of the course of the disease, the postoperative period, and complications in 293 patients and the results of study of the red cell ultrastructure and the acid-base equilibrium and blood gas composition in 33 patients with thrombosis and embolism of the main limb arteries. It was shown that the blood, its red cells, is the system which is mainly affected by endotoxins and high concentrations of biologically active substances occurring in the blood flow. According to the form of the red cells (normocytes, echinocytes, spheroechinocytes) and the quantitative relationship the depth of the pathological process can be judged. Shifts of the acid-base equilibrium in the direction of metabolic acidosis is compensated by intensified lung ventilation. Metabolic alkalosis appears in advanced cases. The revealed shift should be taken into account in applying intensive therapy.

[Characteristics of reconstructive surgery in occlusion of the abdominal aorta]. / Osobennosti rekonstruktivnykh operatsii pri okkliuzii briushnoi chasti aorty.

For the 10-year period, 70 patients with occlusion of the abdominal aorta were operated on (10% of the patients operated on for Leriche's syndrome). Severe ischemia of the lower extremities was noted in 25 (35.8%) patients. Low occlusion was diagnosed in 24, middle--in 15, high--in 31 patient. In low and middle occlusion, the end-to-side anastomosis was performed in 17 patients, end-to-end--in 49. In 4 patients, the axillary-femoral shunting was performed. In 32 of 48 cases, the patency of the inferior mesenteric artery was restored. Correction of renal blood flow was performed in 2 patients. Good results were obtained in 92.8% of the cases. The lethality was 7.1%.

[Carbohydrate metabolism of the skeletal muscle of the ischemic extremity in acute and chronic occlusion of the major arteries in man]. / Uglevodnyi obmen v skeletnoi myshtse ishemizirovannoi konechnosti pri ostrykh i khronicheskikh okkliuziiakh magistral'nykh arterii u cheloveka.

Activation of glycolysis and glycogenolysis as well as stimulation of the pentosephosphate pathway of glucose oxidation occurred in skeletal muscle of the ischemized legs of patients with occlusive impairments of main arteries.

[Reconstructive surgery for traumatic aneurysms of the major vessels]. / Rekonstruktivnye operatsii po povodu travmaticheskikh anevrizm magistral'nykh sosudov.

Forty six patients were operated for traumatic aneurysms, 29 of them having arterial aneurysms and 17 patients having arterio-venous aneurysms. The optimal method to reestablish the patency of the vessels was the making of the lateral or circular suture, autovenous prosthesis being used for defects of the vessels longer than 3 cm. Good and satisfactory results were obtained in 93,3%. One patient died.