[Effect of renal artery stenting on the clinical and geriatric status of elderly patients with vasorenal hypertension.]

The study consists in determining the effect of renal artery stenting in patients with arterial hypertension in combination with renal artery stenosis on the dynamics of clinical and geriatric status in terms of such indicators as the number of drugs taken, cognitive status, determined by the MMSE scale, prevalence of the frequency of falls, psycho-emotional status by the Beck scale, the quality of sleep on the VAS scale, the index of age discrimination according to the E.Palmore ageism questionnaire, the quality of life according to the SF 36 questionnaire. The study involved 72 elderly patients with arterial hypertension in combination with renal artery stenosis. According to the results of the study, as a result of stenting of the renal arteries, there is a decrease in the number of drugs taken, an improvement in the cognitive status on the MMSE scale, a decrease in the frequency of falls, an improvement in the psycho-emotional status on the Beck scale, an improvement in the quality of sleep on the VAS scale, a decrease in the level of age discrimination, an increase in the quality of life according to questionnaire SF-36 on all scales.

[Determination of cytokines and adhesion molecules in elderly and senile patients with aortic valve calcification.]

A laboratory study of the cytokine profile and the content of the intercellular adhesion molecules was performed in 38 patients with initial signs of aortic hemilunus calcification. It has been determined that the content of IL-6 and IL-8 had significantly higher values compared with the control group, which indicates the direct role of nonspecific chronic inflammation in the development of calcifying aortic valve damage. A significantly lower content of sE-selectin was also identified, which may indicate the absence of activation of adhesion molecules at the initial stage of aortic valve calcification. Further study of the dynamics of sE- and sP-selectins content in the process of development of acceleration of blood flow in the aortic valve and the formation of stenosis is needed.

[Indicators of lipid exchange as early markers of development calcific aortic valve disease.]

A comprehensive study of lipidograms of 36 patients with initial signs of calcification of aortic semilunium was performed. It was determined that the content of apolipoprotein A-1 was significantly lower in comparison with the control groups, which requires further studies of the evaluation of the effect on the process of early development of calcification of drugs capable to increasing its content. If the concentration of apolipoprotein A-1 is less than 1,1 mg/dl and/or the apoB/apoA ratio is increased by more than 1, it is advisable to recommend dispensary follow-up with regular (no less than 1 time in 5 years) echocardiographic study with a detailed study of the functional state of the aortic valve.

[Actuality of pathomorphogenesis investment in calcific aortic valve stenosis.]

The increasing of lifetime industrial countries population leads to widespreading diseases of age. Dramatic growth of sclerodegenerative heart valve diseases in last decades is one of the best examples. We observed 814 patients of different gender and age with acquired heart valve diseases using echocardiography. We found out that the most common heart valve disease is degenerative aortic stenosis. Unfortunately, nowadays in Russia no more than 20% of the necessary operations on aortic valve are performed, the main reason of it is, more likely, insufficient and untimely diagnosis of the defect. However, the surgery of vice serves only as a mechanical elimination of the problem, without affecting the causes which led to its development. So we need modern data about sclerodegenerative heart valve diseases epidemiology and discloses actuality of the problem.

[Embolization of prostate arteries - an alternative technology for treatmetment of prostatic adenoma in patients with diabetes mellitus.]

The article details the examination plan and recommendations for the endovascular treatment of patients with prostate adenoma with concomitant diabetes mellitus. The results of the work of the Department of Andrology and Urology at the Endocrinological Research Center for prostate artery embolization are also displayed. A clinical case of care for a patient with prostate adenoma and severe diabetes mellitus is presented.

[Modern look at endovascular treatment bleeding the gastrointestinal tract in elderly patients.]

A literature review of the publications of foreign authors on the treatment of non-varicose bleeding from the upper gastrointestinal tract of elderly and senile patients is presented. The authors showed a modern view of the possibilities of endovascular hemostasis in comparison with a surgical operation with inefficiency of endoscopic hemostasis and characterized patients in whom it is possible this will be most effective.

[CAROTID STENTING EXPERIENCE IN THE ACUTE PHASE OF ISCHEMIC STROKE IN PATIENTS OF ELDERLY AND SENILE AGE].

Age has been shown to be a predictor of neurological complications during carotid stenting (CS). However, carotid stenting in acute period of ischemic stroke has recently been demonstrated safely in patients over 70 and even 80 years. Early intervention is desirable in patients presenting with stroke referable to carotid artery stenosis because of the high incidence of recurrent ischemic events. However, he optimal timing to perform CS in the acute phase of ischemic stroke in elderly remains unclear due to the threat of perioperative complications. In our hospital (Aleksandrovskaya) was searched for consecutive cases of extracranial internal CS procedures performed for symptomatic atherosclerotic carotid stenosis in the acute phase of ischemic stroke in a total of 65 elderly patients. The primary outcome was not statistically different among groups stratified based on intervention timing, with a combined incidence of stroke, MI or death of 5.9 % in patients treated within 2 days, 0% in patients treated between days 3 and 7, 15% in patients treated between days 8 and 14 and 0% in patients treated between days 15 and 30. Our results support the conclusion that early CS (within 2 days) carries no additional risks compared with CAS after 2 days or any other timing of the intervention up to 30 days in elderly.