[Tactics of the surgical treatment of combined occlusive diseases of the coronary arteries, the abdominal aorta and the arteries of the lower extremities]. / Taktika khirurgicheskogo lecheniia sochetannykh okkliuziruiushchikh porazhenii koronarnykh arterii, briushnoi aorty i arterii nizhnikh konechnostei.

On the basis of experience in reconstructive operations on 250 patients with combined affection of the coronary arteries, abdominal aorta, and arteries of the lower limbs the authors discuss the diagnostic and tactical features of surgical management of these patients. The article dwells upon the necessary preoperative diagnostic algorithm as well as that in tactical variants of surgical treatment: (1) one-stage reconstructive operations on several vascular beds; (2) successive stage-by-stage treatment of patients with combined vascular pathology; (3) reconstructive vascular intervention on only one of the vascular beds. Correct practical solution of all these problems allowed the authors to reduce postoperative lethality to 5.4% among this grave contingent of patients with combined vascular pathology.

[Tissue oxygen metabolism, hemodynamics and microcirculation in vasorenal hypertension in patients with different types of blood circulation]. / Kislorodnyi rezhim tkanei, sostoianie gemodinamiki i mikrotsirkuliatsii pri vazorenal'noi gipertenzii u bol'nykh s razlichnymi tipami krovoobrashcheniia.

The authors examined 68 patients with vasorenal hypertension (VRH). In hyperkinetic type of VRH, the tissue hypoxia is caused by the increase in the cardiac index and rate of blood flow, changes in the microcirculation; in hypokinetic type--by decrease in the cardiac index, sharp increase in the specific peripheral vascular resistance and pronounced changes in all the links of microcirculatory channel as well is observed. Timely correction of the hyperkinetic type of VRH in patients leads to normalization of hemodynamics and elimination of tissue hypoxia. After correction of the hypokinetic type of VRH in patients, neither hemodynamics, nor impairment in the oxygen regimen of the tissues normalizes, even if the positive effect of treatment is noted.

[Surgical treatment of recurrent thrombosis after aorto-femoral reconstruction]. / Khirurgiia mnogokratnykh retrombozov posle aortobedrennykh rekonstruktsii.

The article describes an experience with the surgical treatment of repeated re-thromboses after aorto-femoral reconstructions with a bifurcation explant in 34 patients with the Leriche syndrome of atherosclerotic etiology who were subjected to 110 reoperations. Different kinds of reconstructions for revascularization of extremities are considered. Favorable results were obtained in 76.5% of the cases. Lethality was 2.73% per 110 operations. Long-term results were studied during 13 years. The bifurcation explant was found to be functioning in 30% of the cases observed.

[Effectiveness of the modified Linton operation in post-thrombophlebitic syndrome in the light of remote results and medical, social and vocational rehabilitation]. / Effektivnost' modifitsirovannoi operatsii Lintona pri posttromboflebiticheskom sindrome v svete otdalennykh rezul'tatov i mediko-sotsial'no-trudovoi reabilitatsii.

The results of surgical and conservative treatment of 207 patients with the post-thrombophlebitic syndrome in pedal veins suggested that modified Linton's operation produced very good long-term effect in late postoperative period. Therefore it can be used as an operation of choice in surgical treatment for this pathology. The efficiency of the operation is improved significantly, if postoperative medical, social and occupational rehabilitation is conducted on a consistent basis.

["Chronic thrombophlebitis" and its modern problems]. / "Khronicheskii tromboflebit" i ego sovremennye problemy.

The most urgent problems of the terminology, diagnosis and treatment of the post-thrombophlebitic syndrome are discussed. The author believes, in particular, that clinical tests and methods which do not require any special expensive equipment constitute a diagnostic complex that is quite sufficient in the practice of health care. Phlebography should be undertaken when there are definite indications. From experience in the performance of more than 500 operations by Linton's method, the author claims that this operation is most indicated in the post-thrombophlebitic syndrome of the lower extremities; in localization of the pathologic process in the ilio-femoral segment, plastic surgery is indicated, autovenous shunt of the type of Palm's operation in particular. In some cases Palm's and Linton's operations may be combined. Patients with the post-thrombophlebitic syndrome require rehabilitation after surgery.

[Repeated plastic operations on the abdominal aorta and main arteries of the pelvis and lower limbs in arteriosclerotic occlusion]. / Povtornye plasticheskie operatsii na briushnoi aorte, magistral'nykh arteriiakh taza i nizhnikh konechnostei pri ikh ateroskleroticheskikh okkliuziiakh

Among 600 patients operated on primarily for atherosclerotic lesions of the aorto-iliac-femoral zone (various plastic operations) secondary interventions were undertaken in 140 persons with re-occlusions of the operated segments. All patients were subjected to secondary reconstructive-plastic operations that gave good results--elimination of ischaemia and preservation of the extremity--in 77.2% of the cases. In 12.8% of them the extremity was amputated. Postoperative mortality comprised 10%.