ABSTRACT
The authors carried out a retrospective analysis of clinical efficacy of streptokinase and alteplase (actilyse®) in patients presenting with high- and intermediate-to-high risk pulmonary artery thromboembolism (PATE) who were discharged from hospital after appropriate treatment performed. Of the total number of the treated patients, we formed 2 groups comprising 20 patients each, receiving alteplase (group 1) and streptokinase (group 2). The patients were comparable by the main clinical characteristics, predisposing factors, severity of pulmonary artery thromboembolism (PATE) and duration of treatment. Efficacy of thrombolytic therapy assessed clinically and instrumentally did not differ. However, by the stratified risk and frequency of PATE relapses, the condition of patients receiving alteplase turned out to be more severe. Based on the obtained results, a conclusion was made that actilyse is a drug of choice for treatment of patients with PATE.
Subject(s)
Fibrinolytic Agents , Pulmonary Embolism , Fibrinolytic Agents/therapeutic use , Humans , Pulmonary Embolism/drug therapy , Retrospective Studies , Thrombolytic Therapy , Tissue Plasminogen ActivatorABSTRACT
The authors studied dilatation of a biological prosthesis (a specially treated xenograft made of bovine arteries) used as a femoropopliteal bypass in patients presenting with diseases of peripheral arteries. Structural alterations (ectasia) were examined in a total of 15 patients within the terms varying from 1 year to 7 years after the operation, resulting in working out a methodology of calculating structural changes of the conduit with characteristics of the composite index of dilatation of the conduit. The presence of aneurysmatically dilated portions whose dimension exceeded the initial size of the xenograft 3-4-fold did not influence the long-term patency of the shunt with preserved blood flow approximated to the major one. This made it possible to avoid a repeat surgical intervention.
Subject(s)
Arterial Occlusive Diseases , Bioprosthesis/adverse effects , Femoral Artery , Popliteal Artery , Postoperative Complications , Vascular Grafting , Adult , Aged , Angiography/methods , Animals , Arterial Occlusive Diseases/diagnosis , Arterial Occlusive Diseases/surgery , Cattle , Computed Tomography Angiography/methods , Female , Femoral Artery/diagnostic imaging , Femoral Artery/surgery , Humans , Male , Middle Aged , Outcome and Process Assessment, Health Care , Popliteal Artery/diagnostic imaging , Popliteal Artery/surgery , Postoperative Complications/diagnosis , Postoperative Complications/etiology , Prosthesis Failure , Vascular Grafting/adverse effects , Vascular Grafting/instrumentation , Vascular Grafting/methods , Vascular PatencyABSTRACT
The authors carried out a comparative retrospective study of the efficacy of ultrasonic endarterectomy used for the restoration of the blood flow in patients diagnosed with atherosclerotic lesions of the femoral artery. The long-term outcomes of the operation (with the duration of the follow-up period amounting to 16 years) were analysed in a total of 535 patients. Based on the variety of different types of the operations performed, the patients were subdivided into three groups: Group I consisted of 208 subjects having undergone ultrasound-mediated endarterectomy, Group II comprised 244 patients having endured femoropopliteal bypass grafting with the reversed autovein above the knee joint; and Group III was composed of 83 patients following mechanical endarterectomy. The groups of the patients analysed were matched by sex, age, duration of the disease, the prevalence rate of concomitant diseases, and the degree of chronic ischaemia of the extremity involved. The criteria for assessment of the remote outcomes were the indices of the patency of the reconstructed vessels and limb salvage. It was determined that ultrasonic endarterectomy was accompanied and followed by better results of the patency as compared with mechanical endarterectomy, being however inferior to the operation of the femoropophteai bypass grafting by the criteria applied. No differences in the parameters of limb salvage after various modalities of the restoration of the blood flow were observed.
