[Prophylaxis and treatment of purulent-septic complications of reconstructive operations on abdominal aorta and peripheral arteries].

The results of examination and complex treatment of 230 patients, suffering purulent-septic complications of reconstructive operations on abdominal aorta and peripheral arteries, were analyzed. The terms of diagnosis of the infected soft tissues and transplants had constituted 4.7 years at average. There was performed complex prophylaxis and diagnosis of complications, using invasive and noninvasive methods of investigation. An important role of early diagnosis of the vascular transplant infectioning (VTI), using radionuclide scanning and leukocytes, traced with 99mTc, determination of proinflammatory interleukin-6 and anti-inflammatory interleukin-4 content while radical treatment of purulent-septic complications before arrosive hemorrhage and fistula occurrence was substantiated. The advantages of extraanatomic shunting in total VTI and sepsis, using autovenous transplants and the autologous tissue defense of the anastomoses area were shown. In 90.5% patients, in whom reoperations were performed, the results were good, the transplants passability without their reinfectioning was secured in 12 months after the operation in 71% patients.

[Choice of surgical strategies in aorto-femoral transplant infections]. / Vybor taktiki khirurgicheskogo lecheniia pri infitsirovanii aorto- bedrennogo transplantata.

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.

[Pathophysiology, prophylaxis and treatment of reperfusion syndrome in the surgery of abdominal aorta aneurysm]. / Patofiziologiia, profilaktika i lechenie reprefuzionnogo sindroma v khirurgii anervrizmy briushnoi chasti aorty.

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.

[Reconstructive surgery on the major vessels. The results of work over 25 years]. / Rekonstruktivnaia khirurgiia magistral'nykh sosudov. Itogi raboty za 25 let.

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.

[The surgical procedure in treating vascular thrombosis after performing aortofemoral reconstruction]. / Khirurgicheskaia taktika pri lechenii tromboza sosudov posle vypolneniia aorto-bedrennoi rekonstruktsii.

Experience of vascular thrombosis prophylaxis and treatment after reconstructive operation conduction on abdominal aorta and peripheral arteries in 244 patients, including 112 of them immediately after the operation, 32-up to one year time, 100-in long-term follow-up period was summarized. Main aetiological cause for thrombosis occurrence immediately after the operation were technical and tactical failures committed during its conduction, in the early postoperative period-the neointima hyperplasia in the anastomosis area, in late terms-the blood outflow disorder from the reconstructed segment due to the atherosclerosis progression. Original methods of reoperation conduction for the transplant thrombosis and the outflow arteries reconstruction were proposed. Mortality lowering from 8.8 to 5.3% and the extremity revascularization occurrence, in 75% of patients immediately after the operation and in 84%-in long-term period was promoted owing to tactics of postoperative thrombosis treatment elaborated.

[The choice of surgical strategies in bacterial infections of the transplants after the reconstructive surgery of the aorto-femoral segment]. / Bybor khirurgicheskoi taktiki pri infitsirovanii transplantata posle vypolneniia rekonstruktsii sosudov aorto-bedrennogo segmenta.

The experience of the purulent complications treatment occurring while synthetic prosthesis application in the aorto-femoral region and venous shunts-in femoral-popliteal zone is presented. Reconstructive procedures on the abdominal aorta and peripheral arteries were conducted in 4462 patients of whom in 158 (3.5%) the transplant infecting occurred. All the patients were divided conventionally on three groups: with local and total infecting of the transplant and with angiogenic sepsis. New methods of reoperative procedures depending on the infecting kind were proposed. Application of the surgical tactics elaborated for the transplant infecting on aorto-ileal and femoral-popliteal levels have permitted to reduce the lethality from 49.8 to 13.2%, to save the life in 158 (75.5%) patients and to achieve the lower extremities revascularization.

[Emergency reoperations in the reconstructive surgery of abdominal aorta and major arteries of the lower extremities]. / Neotlozhnye povtornye operatsii v rekonstruktivnoi khirurgii briushnoi chasti aorty i magistralnykh arterii nizhnikh konechnostei.

The experience with treatment of 564 patients who underwent 642 reoperations on the arterial vessels, including 281 emergency operation, are presented. The causes of the development of pronounced ischemia of the lower extremities and that of the extreme situation are considered. The surgical tactics for the treatment in cases of transplant infection, erosive bleeding from aortal anastomosis etc. have been developed. The original methods for surgical correction in performance of a reoperation have been suggested, the analysis of the results of treatment has been performed.

[Surgical treatment of atherosclerotic occlusion of the femoral, popliteal and tibial arteries]. / Khirurgicheskoe lechenie ateroskleroticheskikh okkliuzii bedrennoi, podkolennoi i bertsovykh arterii.

An analysis of results of the treatment of 182 patients with atherosclerotic occlusions of femoral, popliteal and tibial bones has shown the necessity of an individual approach to choosing the method of restorative operation on the vessels. More favourable remote results were obtained after autovenous shunting "in situ" and by the method of vein reversion.