[Obstructive scleroobliteration as atreatment of varicocele].

Authors developed and used the method of obstructive scleroobliteration with use of occlusive balloon catheter as a treatment for 32 patients. Advantages of this method: 1. Possibility of scleroobliteration in isolated area of the left internal testicular vein and its branches. 2 Improvement of sclerosant influence on venous wall by means of aspiration of blood and contrast agent of blocked vein. 3. Decrease of contrast agent by means of it aspiration after performed phlebography. 4. Prophylaxis of negative effect (allergy, thrombotic complications) of sclerosant by means of it partial aspiration and extravasal compression of proximal part of vein. 5. No late relapse. This method allow to perform an effective scleroobliteration with exclusion of testicular vein and venous collateral without special technical skills and cost increase. Aspiration of sclerosant in a lumen of vein allows to decrease the amount of surgical complications.

[Regional circulation in gunshot wounds of the ankle joint and foot]. / Regionarnoe krovoobrashchenie pri ognestrel'nykh raneniiakh golenostopnogo sustava i stopy.

Problems of treatment of battle injuries of the ankle joint and foot are discussed. These injuries are characterized with severe disturbances of regional circulation and microcirculation causing hypoxia and metabolic disorders both in soft tissues and in bones. Digital substraction angiography (DSA) was used in 7 wounded (7.53%) of all patients with battle injuries of the foot and ankle joint. Combined treatment including surgery, drugs, physical and exercise therapy, hyperbaric oxygenation was used in all the patients. Prolonged intraarterial infusion of drugs was carried out in 4 of 7 patients. It is concluded that early evaluation of regional circulation permits to clarify expediency of applied combined treatment. Injury of three arteries is the indication for amputation, but even one functioning artery enables use of combined therapy with intraarterial infusion for extremity salvage.

[Radiographic endovascular correction of hyperaldosteronism in patients with arterial hypertension]. / Rentgenoéndovaskuliarnaia korrektsiia giperal'dosteronizma u bol'nykh arterial'noi gipertenziei.

The authors describe a new method of X-ray endovascular destruction of the adrenal in patients with arterial hypertension and hyperaldosteronism. Destruction of the adrenal is accomplished by acute occlusion of its venous channel by introduction of a 3% thrombovar solution through a catheter installed in the central vein of the suprarenal gland. This method was applied in 22 patients with arterial hypertension; essential hypertension with secondary hyperaldosteronism was found in 18 of them, renoparenchymatous hypertension in 2, aldosteroma of the left adrenal in one, and Itsenko-Cushing's disease in one patient. Acute occlusion of the adrenal venous channel was achieved in 20 patients. The intervention normalized blood pressure in 16 and reduced it significantly in 4 patients.

[Intraoperative dilatation of the ilio-femoral segment combined with reconstructive operations on the femoral arteries in "multi-level" lesions in patients from the risk group]. / Intraoperatsionnaia dilatatsiia podvzdoshno-bedrennogo segmenta v sochetanii s rekonstruktivnymi vmeshatel'stvami na bedrennykh arteriiakh pri "mnogoétazhnykh" porazheniiakh gruppy riska.

The authors analyse experience in the treatment of 96 patients at an increased risk of intervention. Ischemia of the lower extremities with relatively maintained peripheral vascular bed was the main criterion of an indicated operation. The malleolar systolic pressure index of at least 0.35 +/- 0.15 was considered essential in this case. With consideration for the risk, the interventions were carried out mainly under peridural anesthesia. Intraoperative dilatation of the iliac arteries was conducted under radiotelecontrol in combination with profundoplasty, thrombendarterectomy from the femoral arteries, and femoropopliteal autovenoplasty. The efficacy of the operations was appraised by intraoperative angiography, electromanometry, and blood flow measurement. The results were studied in follow-up periods of up to 3 years. In the group of 96 patients 8 had poor results. Amputation of the extremity was performed in different periods.

[Diagnostic and therapeutic choices in lung diseases complicated by hemorrhage]. / Diagnosticheskaia i lechebnaia taktika pri zabolevaniiakh legkikh, oslozhnivshikhsia krovotecheniem.

The results of treatment of 76 patients with various diseases of the lungs complicated by hemorrhage are analysed. A complex of diagnostic and therapeutic measures were applied in a certain order, including bronchoscopy with temporary occlusion of the bronchi, bronchial arteriography with acute embolization of the bronchial artery. Hemorrhage was arrested in 73 patients with the use of such tactics, in 48 of them an economical operative intervention was carried out.