RESUMO
To achieve the objectivization of the operation results performance, to compare them, to conduct a dynamic control of the reconstructed arterial segments passability and the course of the disease as well, the estimation of treatment efficacy in patients with obliterating atherosclerosis of the lower extremities arteries must be standardized for some factors, considering the change in the patient state and locus morbi. The authors had performed the analysis of approaches to solve this problem and proposed the criterions of the operative treatment efficacy estimation in patients with intermittent claudication and critical ischemia of lower extremities.
Assuntos
Arteriosclerose Obliterante/cirurgia , Perna (Membro)/cirurgia , Prontuários Médicos/normas , Procedimentos Cirúrgicos Vasculares , Humanos , Perna (Membro)/irrigação sanguínea , Resultado do TratamentoAssuntos
Neoplasias Abdominais , Aneurisma da Aorta Abdominal , Leiomiossarcoma/patologia , Leiomiossarcoma/cirurgia , Neoplasias Abdominais/complicações , Neoplasias Abdominais/patologia , Neoplasias Abdominais/cirurgia , Aneurisma da Aorta Abdominal/complicações , Aneurisma da Aorta Abdominal/patologia , Aneurisma da Aorta Abdominal/cirurgia , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
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.
Assuntos
Arteriosclerose Obliterante/cirurgia , Artéria Subclávia/cirurgia , Procedimentos Cirúrgicos Vasculares/métodos , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
There were analyzed 4675 histories of cases of patients, who were operated on for disease of the digestion organs (3349) and for obliterating atherosclerosis of abdominal aorta and peripheral arteries (1326). The risk factors of occurrence were established, the prophylaxis methods for venous thromboembolic complications (TEC) in postoperative period were elaborated. High efficacy of application of fraxiparine in the venous TEC prophylaxis in abdominal and vascular surgery was noted.
Assuntos
Aorta Abdominal/cirurgia , Arteriosclerose Obliterante/cirurgia , Embolia/etiologia , Embolia/prevenção & controle , Doenças Vasculares Periféricas/cirurgia , Complicações Pós-Operatórias , Trombose Venosa/etiologia , Trombose Venosa/prevenção & controle , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Aorta Abdominal/patologia , Arteriosclerose Obliterante/patologia , Embolia/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Vasculares Periféricas/patologia , Estudos Retrospectivos , Fatores de Risco , Ultrassonografia , Trombose Venosa/diagnóstico por imagemRESUMO
Results of treatment of 93 patients with diabetes mellitus and occlusive-stenotic affection of arteries of femoro-popliteal and popliteal-tibial segments were analyzed. Indications for performance of operation were established, basing on analysis of clinical manifestations of the disease and results of instrumental methods of investigation. Femoro-popliteal autovenous shunting performed in 47 (50.5%) patients, endarterectomy from the same segment--in 26 (28%), roentgenoendovascular dilatation of segments of femoral superficial and popliteal arteries--in 11 (11.8%), popliteal-tibial autovenous shunting--in 9 (9.7%). In 84 (90.4%) of patients succeeded to preserve the extremity. Postoperative lethality was 4.3%. Passability of autovenous femoro-popliteal-tibial shunts during 5 years was noted in 49.5%, passability of arteries after endarterectomy--in 38.7% of observations.
Assuntos
Arteriosclerose Obliterante/complicações , Arteriosclerose Obliterante/cirurgia , Complicações do Diabetes , Pé Diabético/etiologia , Procedimentos Cirúrgicos Operatórios/métodos , Idoso , Idoso de 80 Anos ou mais , Arteriosclerose Obliterante/fisiopatologia , Constrição Patológica/fisiopatologia , Feminino , Artéria Femoral/fisiopatologia , Pé/irrigação sanguínea , Humanos , Masculino , Artéria Poplítea/fisiopatologia , Índice de Gravidade de Doença , Artérias da Tíbia/fisiopatologiaRESUMO
Results of investigation of collateral blood flow in 159 patients with atherosclerotic occlusion of abdominal aorta of various kinds were presented. There was shown, that a. mesenterica superior constitutes the main visceral branch, securing the blood circulation compensation in total, high and middle occlusion of abdominal aorta and in low occlusion--a. mesenterica inferior. The change of direction and enhancement of blood flow along a. epigastric inferior was noted in all the patients. In spite of identity of total volumetric blood flow along the collateral branches, the volumetric blood flow velocity along the lower extremities arteries is determined by the level and spread of aortal occlusion.
Assuntos
Aorta Abdominal/diagnóstico por imagem , Aorta Abdominal/fisiopatologia , Arteriopatias Oclusivas , Doença da Artéria Coronariana , Perna (Membro)/irrigação sanguínea , Angiografia , Arteriopatias Oclusivas/complicações , Arteriopatias Oclusivas/diagnóstico por imagem , Arteriopatias Oclusivas/fisiopatologia , Doença Crônica , Doença da Artéria Coronariana/complicações , Doença da Artéria Coronariana/diagnóstico por imagem , Doença da Artéria Coronariana/fisiopatologia , Hemodinâmica/fisiologia , Humanos , Índice de Gravidade de Doença , Ultrassonografia Doppler em Cores/métodosRESUMO
Examination and treatment of 8 patients with the abdominal aorta aneurysm (AAA) chronic rupture (CHR) was done. The interval between the aneurysm rupture occurrence and of the operation performance had constituted 3.6 months. The disease was diagnosed basing on the anamnesis data, on the results of clinical, invasive and noninvasive methods of investigation. The authors suggest necessary to operate all the patients with the AAA CHR.
Assuntos
Aneurisma da Aorta Abdominal , Ruptura Aórtica/diagnóstico , Ruptura Aórtica/cirurgia , Procedimentos Cirúrgicos Operatórios/métodos , Idoso , Aneurisma da Aorta Abdominal/diagnóstico por imagem , Aneurisma da Aorta Abdominal/patologia , Aneurisma da Aorta Abdominal/cirurgia , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , UltrassonografiaRESUMO
Reconstructive operation was performed in 4926 patients for occlusive affection of the abdominal aorta, of them in 132 (2.7%) the infectioning of aorto-femoral transplant was noted. Original methods of reoperation were presented, depending on the prevalence of the infection. Preventive performance of reoperation before the erosive hemorrhage occurred, had permitted to lower postoperative mortality from 52.3% to 13.5% and to achieve the lower extremities revascularization in 77.5% of patients.
Assuntos
Aorta Abdominal/microbiologia , Aorta Abdominal/transplante , Arteriopatias Oclusivas/cirurgia , Artéria Femoral/microbiologia , Artéria Femoral/cirurgia , Infecção da Ferida Cirúrgica/diagnóstico , Infecção da Ferida Cirúrgica/microbiologia , Infecções EstafilocócicasRESUMO
Complex examination of 73 patients with post-thrombophlebitic occlusion of iliac veins was performed. The regional venous hemodynamics indexes and the results of surgical treatment depended upon the disease duration. The indications for surgical correction of the pelvic venous hemodynamics disorders while presence of one-sided occlusion of iliac veins were substantiated.
Assuntos
Veia Ilíaca/cirurgia , Pelve/irrigação sanguínea , Síndrome Pós-Flebítica , Procedimentos Cirúrgicos Operatórios/métodos , Tromboflebite/cirurgia , Hemodinâmica , Humanos , Pelve/cirurgiaRESUMO
The results of examination and treatment of 734 patients with postthrombophlebitic syndrome of lower extremities were adduced. The pathogenesis diagram for chronic venous insufficiency was proposed. The possibilities of the regional blood flow correction using reconstructive operations on veins were shown. In 73% of patients good result in immediate postoperative period was noted and in late follow-up period--in 64%.
Assuntos
Perna (Membro)/irrigação sanguínea , Complicações Pós-Operatórias , Tromboflebite/cirurgia , Adulto , Idoso , Doença Crônica , Feminino , Hemodinâmica , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Vasculares Periféricas , Estudos RetrospectivosRESUMO
The regional hemodynamics peculiarities were studied in patients with various types of occlusive-stenotic affection of abdominal aorta and iliac arteries, using ultrasonic duplex scanning. The character of the blood flow peculiarity along main arteries and collateral branches was determined depending on the affection level. The quantitative indexes of blood flow along the most significant collaterals were studied as well as their role in the compensation process of the disordered distal blood flow.
Assuntos
Estenose da Valva Aórtica/diagnóstico , Arteriopatias Oclusivas/diagnóstico , Perna (Membro)/irrigação sanguínea , Perna (Membro)/diagnóstico por imagem , Ultrassonografia Doppler Dupla/métodos , Aorta Abdominal/diagnóstico por imagem , Humanos , Artéria Ilíaca/diagnóstico por imagemRESUMO
The peroxidal oxidation of the lipids state was studied up, as well as of the whole blood neutrophils functional activity, hemodynamics and microcirculation of lower extremities in surgical treatment of the abdominal aorta aneurysm. The main significance in the reperfusional syndrome pathophysiology, caused by temporary overcompression of aorta, has the neutrophils activation, their interrelationship with the endothelium cells and the activity lowering of the tissue antioxidant system, manifestated by vascular spasm, which is mostly expressed in the patients with stenotic affection of the lower extremities arteries. Positive effect was noted in application of preparation corvitin, which has antioxidant action.
Assuntos
Abdome , Aneurisma da Aorta Abdominal , Traumatismo por Reperfusão , Abdome/irrigação sanguínea , Abdome/fisiopatologia , Abdome/cirurgia , Idoso , Aneurisma da Aorta Abdominal/diagnóstico , Aneurisma da Aorta Abdominal/prevenção & controle , Aneurisma da Aorta Abdominal/cirurgia , Hemodinâmica , Humanos , Masculino , Pessoa de Meia-Idade , Traumatismo por Reperfusão/diagnóstico , Traumatismo por Reperfusão/fisiopatologia , Traumatismo por Reperfusão/prevenção & controle , SíndromeRESUMO
The results of treatment of 110 patients with an acute and chronic venous insufficiency of the lower extremities were analysed. The original access to the v. saphena magna opening of the leg and the vein stripper are proposed. The necessity of the concomitant veins excision was substantiated, and the expediency of the antibiotics, antiaggregants and the heparin-containing preparations administration also.
Assuntos
Fibrinolíticos/uso terapêutico , Cuidados Pós-Operatórios/métodos , Insuficiência Venosa/terapia , Doença Aguda , Adulto , Idoso , Doença Crônica , Terapia Combinada , Géis , Humanos , Pessoa de Meia-Idade , Tromboflebite/complicações , Varizes/complicações , Insuficiência Venosa/etiologiaRESUMO
Method of ultrasonic duplex scanning was applied for studying of hemodynamics of lower extremities in the norm and while the femoropopliteal segment occlusion. Three most hemodynamically significant ways of the blood flow collateral compensation in a. femoralis superficialis and a. poplitea occlusion: in upper third of femur--a. femoralis profunda, in canalis adductorius region--a. genus descendens; on the crus--a. suralis. Spectral characteristics of the main and collateral blood flow were studied, the criterions of the lower extremities hemodynamics compensation were established.
Assuntos
Arteriopatias Oclusivas/diagnóstico por imagem , Circulação Colateral/fisiologia , Artéria Femoral/diagnóstico por imagem , Perna (Membro)/irrigação sanguínea , Artéria Poplítea/diagnóstico por imagem , Arteriopatias Oclusivas/cirurgia , Artéria Femoral/cirurgia , Hemodinâmica/fisiologia , Humanos , Perna (Membro)/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Neovascularização Fisiológica/fisiologia , Artéria Poplítea/cirurgia , Ultrassonografia Doppler em Cores/métodosRESUMO
The results of examination and surgical treatment of 22 patients with a.poplitea aneurysm were analyzed. Ultrasonic duplex scanning and roentgencontrast angiography were the objective methods of the disease diagnosis.
Assuntos
Aneurisma/diagnóstico por imagem , Angiografia/métodos , Artéria Poplítea/diagnóstico por imagem , Ultrassonografia Doppler/métodos , Adolescente , Adulto , Idoso , Criança , Meios de Contraste , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeAssuntos
Procedimentos Cirúrgicos Operatórios/normas , APACHE , Idoso , Erros de Diagnóstico , Previsões , Humanos , Doença Iatrogênica , Auditoria Médica , Complicações Pós-Operatórias/prevenção & controle , Qualidade da Assistência à Saúde , Análise de Regressão , Procedimentos Cirúrgicos Operatórios/efeitos adversos , Procedimentos Cirúrgicos Operatórios/mortalidadeRESUMO
The abdominal aorta aneurism (AAA) surgery experience in 110 patients was analysed. The topographic-anatomic investigations were conducted, a new surgical access to suprarenal and infrarenal AAA parts was proposed.
Assuntos
Aneurisma da Aorta Abdominal/cirurgia , Adulto , Idoso , Humanos , Pessoa de Meia-Idade , Complicações Pós-OperatóriasRESUMO
Principal scientific achievement of the department of vessels surgery staff were presented. They were devoted to fundamental problems of the vessels surgery. Introduction of mentioned achievements in clinical practice improved considerably the results of abdominal aorta aneurysm surgical treatment, long-term complications of reconstructive operations on the main vessels, occlusion diseases of the venous system, what promoted to reduce the lethality and invalidization of patients.
Assuntos
Procedimentos Cirúrgicos Vasculares/tendências , Aorta Abdominal/cirurgia , Aneurisma da Aorta Abdominal/diagnóstico , Aneurisma da Aorta Abdominal/cirurgia , Arteriosclerose Obliterante/cirurgia , Transtornos Cerebrovasculares/diagnóstico , Transtornos Cerebrovasculares/cirurgia , Angiopatias Diabéticas/cirurgia , Humanos , Isquemia/cirurgia , Perna (Membro)/irrigação sanguínea , Ucrânia , Procedimentos Cirúrgicos Vasculares/métodos , Procedimentos Cirúrgicos Vasculares/estatística & dados numéricosRESUMO
Complex investigation of 1737 patients with occlusion of abdominal aorta, iliac and femoral arteries was conducted. Ischemia grade of the extremities tissues, absolute and relative indications for the operative treatment were established. In the early postoperative period good result of treatment was noted in 58.7% of patients, fair--in 36.8%, in long-term follow-up (from 6 mos till 10 yrs period of time)--in 48.4% and 42.2% accordingly.