[Individual selection of immunocorrector in surgical treatment of obliterating atherosclerosis of the aorta and its branches].

The method for individual selection of immunocorrector in surgical treatment of patients, suffering obliterating atherosclerosis of abdominal aorta and its branches, was proposed. There were examined 69 patients, suffering affection of abdominal aorta and its branches. Inhibition of phagocytic function of neutrophils was observed; on background of activation of the oxygen-dependent metabolism; decompensation of the phagocytic cells function, not depending from the disease stage present. Introduction of the proposed method for the immunocorrector selection secures rising of the diagnosis accuracy and the immunotherapy efficacy.

[Aneurysm of the unpaired visceral aortal branches].

Clinical signs, data of additional methods of examination, results of surgical treatment of patients for aneurysm of unpaired visceral aortal branches were analyzed. Specific complaints and clinical signs are absent. Most informative and trustworthy method of investigation is a computer tomography. In the sizes of aneurysm more than 2 cm surgical treatment is indicated.

[Remote results of endoprosthesis of the infrarenal aorta aneurysm].

Endovascular endoprosthesis of infrarenal aorta aneurysm (EEIAA)--is miniinvasive highly technological method of treatment of a life-threatening disease. The rate of the endovascular interventions conduction for aortal aneurysm enhances every year in the world, the prosthesis construction and operative technique are upgrading constantly. The experience of the EEIAA endoprosthesis in 75 patients, aged 51-80 years old, 70 men and 5 women, was presented. The aneurysm size was from 4.3 to 8 cm. Preoperative examination of the patients have included the ultrasound scanning, computeric tomography (CT). Among existing complications there is haemorrhage from the access site more than 500 ml in volume, demanding the erythrocytic mass transfusion in 2 patients. The patients were followed up from 1 mo till 7 yrs. A hospital lethality was absent. Major cardiovascular accidents in the terms of observation up to 30 days postoperatively were absent. During the follow up period the mortality, connected immediately with the abdominal aorta aneurysm rupture, was absent.

[Evaluation of the blood coagulation system after surgeries on abdominal aortic aneurysms].

Basing on data of analysis of the hemostasis system state in the patients, suffering abdominal aorta aneurysm, a tendency for raising of postoperative soluble fibrin and D-dimer content in the blood plasm and reduction of these indices on the third day was noted. The abovementioned markers content depends on the aneurysm size, the fibrin deposits presence, the terms from clinical signs beginning to the certain therapy administration and anticoagulants application. Information about correlation between content of D-dimer and soluble fibrin in the treatment dynamics is important for determination of activation degree in the patients blood coagulation system and the thrombotic complications prognosis.

[Tactic of surgical treatment of the multifocal vessel lesions from different arterial basins].

The results of examination and treatment of 140 patients with multifocal atherosclerosis in the Department of Surgery of the Main Vessels were analyzed. In 88 patients the affection of truncus brachiocephalicus arteries (TBCA), aorta and the lower extremities main arteries was diagnosed, in 8--hemodynamically significant affection of TBCA and coronary arteries, in 11--coronary arteries, aorta and the lower extremities main arteries, in 13--the affection of all three arterial basins. There was applied differentiated surgical tactic--the staged or one-stage reconstruction of arteries, depending on the degree of compensation present of cerebral hemodynamics, coronary and the lower extremities main arteries blood flow. In 97% patients good and fair results of treatment were noted.

[Choice of plastic surgical methods of the common carotid artery bifurcation in its atherosclerotic occlusion-stenotic lesion].

The results of treatment of 264 patients were analyzed, which were operated for hemodynamically significant atherosclerotic affection of common carotid artery bifurcation. The patients were divided into 4 groups, depending on the carotid arteries type of affection present, what have permitted than to determine a choice of the bifurcation plasty method. The surgical tactics application have permitted to achieve a positive result in 98.5% patients in the early postoperative period and in 80% of them--throughout five--year follow-up.

[Prophylaxis of thrombotic complications of reconstructive interventions for occlusion of the main arteries of femoral-popliteal segment].

Comparative evaluation of effectiveness of the usage of the Pentosan polysulfas SP 54 and low molecular heparins after reconstructive interventions by the patients with occlusion of the main arteries of femoral-popliteal segment for the prevention of postoperative thrombotic complications was held. The obtained results show the great hypocoagulation and hypocholesterol effect of Pentosan polysulfas SP 54, and the expediens its application in that patients.

[Treatment tactics in patients with popliteal artery aneurysm].

The quality of diagnosis and treatment of 72 patients, suffering popliteal artery aneurysm and hospitalized to the Department of the main arteries surgery in 1980-2007 yrs, were analyzed. Basing on the disease clinical signs analysis and diagnostic data obtained the tactics and choice of surgical treatment of patients, suffering popliteal artery aneurysm, was substantiated.

[Perspectives of using popliteo-tibial shunting in distal portions of the lower extremities arteries lesions].

In the treatment of ischemic disorders in patients, suffering diabetes mellitus, the venous shunting toward a. pedis dorsalis and/or paramalleolar segment of a. tibialis posterior are aplied most frequently. Distal shunting was performed in 3 patients suffering critical ischemia of the lower extremities with possible alternative of amputation operation. The diameter and the state of internal vessel surface, the presence of its calcification, as well as the state of the blood inflow and outflow ways, had constituted the criterions of choice of certain segment of arteries for anastomosing. In the presence of several available vessels, the better surgical access to the artery and shorter way for shunting were taken into account. In 2 patients popliteoposterotibial shunting was performed, using autoven (1 observation) and the composed shunt (1 observation); and in one--distal anastomosis was formed with a. pedis dorsalis. In 2 mo after the operation the composed shunt thrombosis occurred. In patients, to whom autovenous shunting was performed, the regional hemodynamics indices were stable, the shunts are functioning.

[Use of simvatin for obliterating atherosclerosis after reconstructive operations on the main arteries of the lower extremities].

The results of application of simvatin in 207 patients after performance of reconstructive operations on the main arteries of femoro-popliteo-tibial segment were analyzed. Durable usage of simvatin had permitted to improve the immediate and the late results of reconstructive operations, to lower postoperative lethality significantly, caused by cardiovascular and vascular-cerebral insufficiency.

[New technologies in diagnosis and surgical treatment of the abdominal aorta aneurysm].

Modern views about occurrence, pathogenesis, and methods of diagnosis and surgical treatment of abdominal aorta aneurysm are adduced. Application of new highly informative diagnostic methods, an adequate anesthesiological support, differentiated methods of surgical intervention have permitted to reach marked progress in the treatment of patients with abdominal aorta aneurysm.

[The choice of operative method for the arterial occlusion in the femoro-popliteo-tibial segment].

The results of surgical treatment of 198 patients suffering atherosclerotic occlusion of the femoro-popliteo-tibial segment arteries were analyzed, of them endarterectomy from superficial femoral artery was performed in 75 (37.9%) patients, femoro-popliteal shunting using autovena--in 93 (47%), synthetic prosthesis--in 17 (8.6%), in 4 (2%)--distal anastomosis was formatted with "hanged" segment of popliteal artery, revascularization of the limb via the deep femoral artery system was done in 9 (4.5%) patients. Good immediate result was noted in 86.4% patients, in 2 years and more--in 68.6%. Comparative analysis of methods of the femoro-popliteo-tibial segment arteries reconstruction had trusted, that more stable indices of hemodynamics were achieved after performance of autovenous shunting with formation of distal anastomosis via proximally than the knee joint fissure localisation.

[Surgical treatment of occluding lesion of the subclavian artery]. / Khirurgicheskoe lechenie okkliuziruiushchego porazheniia podkliuchichnoi arterii.

Results of cerebral hemodynamics investigation and operative treatment of 53 patients with the subclavial artery (SA) occlusion were presented. It was established that the course of the cerebral vascular disorders occurrence in patients with the SA proximal segment occlusion is the vertebro-subclavial robbing syndrome. The consider that the SA resection with her implantation to ipsilateral a. carotis communis (ACA) is operation of choice. The vessel prosthesis is indicated in presence of widespread affection. It is expedient to performed one-stage correction of blood flow in the vessels mentioned in patients with ipsilateral localization of the SA and ACA affection.