[Complications of transcutaneous transhepatic endovascular interventions in patients with portal hypertension]. / Oslozhneniia chreskozhnykh chrespechenochnykh éndovaskuliarnykh vmeshatel'stv u bol'nykh portal'noi gipertenziei.

Results of endovasal treatment of 196 patients with portal hypertension and its complications are analysed. The total rate of complications is 23.4%, the most serious of them were intraabdominal bleeding (2.5%), portal vein thrombosis (2.1%). The rate of mortality, related to the complications of transhepatic procedures, was 2.5%. The majority of the complications were specific to the character of the disease: liver cirrhosis, ascites, high portal pressure, coagulating system disorders.

[Method for draining purulent parts of the liver]. / Sposob drenirovaniia gnoinykh polostei pecheni.

Percutaneous draining of purulent cavities in the liver is an effective method for the treatment of pyogenic diseases of the organ. The traditional method, however, has some shortcomings which often lead to serious complications (intraperitoneal hemorrhage, escape of bile, breaking away of the catheter, hypostatic pneumonia, etc). The work deals with the results of treatment of 32 patients with purulent diseases of the liver. Abscess of the liver was found in 8 patients, subdiaphragmatic abscess in 6, suppurating hydatid cyst in 8, nonparasitic cyst in 5 patients. In 18 patients the traditional method of draining was applied, in 14 patients draining was conducted by a method suggested by the authors. Complications occurred in 11 patients treated by the traditional method, whereas in patients treated by the improved method the postoperative course was uneventful, no complications were encountered. Thus, the improved method for draining purulent cavities in the liver reduces significantly the incidence of postoperative complications and improves the results of treatment.

[Endovascular surgery and the validation of immunocorrection in patients with liver cirrhosis complicated by portal hypertension]. / Endovaskuliarnaia khirurgiia i obosnovanie immunokorrektsii u bol'nykh tsirrozom pecheni, oslozhnennym portal'noi gipertenziei.

An analysis of results of complex clinico-immunological studies in 110 patients with liver cirrhosis complicated by portal hypertension has been made. A scheme of immunocorrective therapy with T-activin in patients with liver cirrhosis complicated by portal hypertension is substantiated and developed for performing roentgen endovascular interventions.

[Endovascular diagnosis and transcatheter procedures in portal hypertension]. / Endovaskuliarnaia diagnostika i chreskateternoe vmeshatel'stvo pri portal'noi gipertenzii.

The results of endovascular diagnosis and transcatheter surgery in 113 patients with various forms and stages of portal hypertension are analysed. A total of 761 diagnostic and 194 therapeutic radiologically-guided endovascular interventions were carried out. Purposeful study of the arteriovenous angioarchitectonics in the hepato-lienal system, the character and degree of disorders of the portal-hepatic hemodynamics, and the peculiar features of collateral circulation before and after various radiologically-guided interventions allowed the authors to elaborate an orderly system of stage-by-stage endovascular treatment of patients suffering from portal hypertension.

[Transhepatic transportal embolization of gastroesophageal veins in profuse esophageal hemorrhage]. / Chrespechenochnaia transportal'naia émbolizatsiia gastroézofageal'nykh ven pri profuznykh pishchevodnykh krovotecheniiakh.

The article deals with the results of treatment of 27 patients with profuse esophageal hemorrhage in portal hypertension. Sixteen patients were treated by roentgen-guided endovascular surgery, namely, transhepatic transportal embolization of varicose veins of the esophagus and stomach. In view of the peculiarities of blood drainage and for the prevention of recurrent bleeding, seven patients were subjected to additional manipulations: embolization of the splenic artery (4) and the left gastric artery (3). Despite reliable arrest of bleeding, 3 patients died in the first 2-3 days from progressive hepatorenal failure. Only one patient had recurrent bleeding in the late-term period. The authors believe transhepatic transportal embolization of the gastroesophageal veins at the peak of hemorrhage to be a hardly injurious and effective method for its arrest.

[Mechanism of action of endotoxins in chronic renal failure]. / Mekhanizm deistviia éndotoksinov pri khronicheskoi pochechnoi nedostatochnosti.

Altogether 76 patients with terminal chronic renal failure (CRF) were examined for the intensity of endogenous intoxication and its action mechanism in blood serum. To determine the degree of intoxication, use was made of neuromuscular preparations of Rana temporaria. In order to study the action mechanism of the toxic substances of uremic genesis, a study was made of the effect of CRF patients' blood serum on the conduction of bilayer lipid membranes. All the patients underwent adequate hemodialysis with respect to nitrous residues. It is established that substances occurring in CRF patients' blood serum possess neurotoxic properties at the basis of which there lie their channel-former action on the excitable membranes of the nerve cells. The data obtained correlate well with the clinical status of the patients. The conventional programmed hemodialysis turned out ineffective in the relief of the syndrome of uremic endogenous intoxication. This confirms the role in endogenous intoxication of the substances with medium molecular weight, which are removed poorly via the common dialysis membranes.