[Intravenous digital subtraction angiography in the diagnosis of urological diseases]. / Vnutrivennaia digital'naia cubtraktsionnaia angiografiia v diagnostike urologicheskikh zabolevanii.

The diagnostic possibilities of intravenous digital subtraction angiography (DSA) were evaluated in 2393 patients. The diagnostic value was 97.2%. DSA is contraindicated via the subclavian vein in children, inadequate preparation of the patients, vein abnormalities. The informative value was 92% in vasorenal hypertension, 100% in renal abnormalities, 85% in renal tumours. Intravenous DSA may be a screening method in the diagnosis of hypertension of unclear etiology, abnormalities of the upper urinary tract, while in tumours, especially of small size, DSA is a supplementary method to ultrasound and CT. The method is of economic importance.

[The invasion of kidney tumors into the veins]. / Invaziia opukholei pochek v veny.

Comprehensive angiographic examinations of 101 patients operated on for parenchymatous cancer recorded intravenous invasion of the tumour in 29 per cent of the examinees. Roentgenological, macro and microscopic investigations of intraorganic vascular architectonics were studied on 52 removed tumour-affected kidneys. The findings evidenced the outflow of the major blood amount from the tumorous tissue through the collateral collector and subcapsular veins to paranephric ones with a subsequent dilatation of the latters. Arteriographically evidenced tumorous lacunae turned to be muscle-free arterial vessels different from arteriovenous shunts. So the concept of shunt frequency is doubtful and embolism of giant hypervascular tumours of the kidney without embolism of pulmonary arteries is possible. More common passage of tumorous thrombi into vena cava inferior in case of right-sided tumours can be explained by a shorter length of the right renal vein. Besides, the left free growth of the thrombus is hindered by pulsing "aortomesenteric forceps" that enclosed the left renal vein.

[Roentgenoendovascular dilatation of the renal arteries in the treatment of vasorenal hypertension]. / Rentgenoéndovaskuliarnaia dilatatsiia pochechnykh arterii v lechenii vazorenal'noi gipertenzii.

The possibilities of the use of roentgenoendovascular dilatation of the renal artery were studied in 57 patients with stenosis of the renal artery and vasorenal hypertension. The authors managed to perform the manipulation in 48 patients. Occlusion of the renal artery, pronounced atherosclerosis of the iliac and axillary arteries, coarctation of the aorta were the causes of failure. In 52.6% of the patients, the "residue" of stenosis was less than 30% of the normal arterial lumen, in 31.6%--30-50%, in the remaining patients, the dilatation has failed. Stable normotension was achieved in 39.5%, the state improved in 50% of the patients. The absence of hypotensive effect for the first 6 mos after the operation was caused by recurrency of the dilated artery stenosis, which resulted from the improper choice of a balloon catheter. The diameter of such a catheter should be 100-110% of a width of the renal arterial lumen proximally to stenosis. The later recurrency of hypertension was caused by the development of the stenosis of the artery of the contralateral kidney.

[Roentgenoradiologic diagnosis of hydronephrosis]. / Rentgenoradiologicheskaia diagnostika pri gidroneforze.

In order to improve the selection of patients for surgical treatment functional roentgenoradiological diagnostic methods: "diuretic" renography (RRG) and excretory urography (EU) were employed in a group of 126 patients with hydronephrosis, Stages I, II and III, after V. S. Karpenko's classification (1980). Computer-assisted qualitative and quantitative assessment of the results obtained was performed with their further comparison with the results of routine RRG and EU. Regular changes in RRG and EU indices in the presence of diuretic load were shown for each stage of disease, and significant differences were revealed. The authors discussed morphofunctional changes and pathophysiological mechanisms laying the basis of reactions of the cavitary kidney system (CKS) to forced urination and reflected in indices of "diuretic" RRG and EU. A high differential-diagnostic value of the above methods in hydronephrosis was confirmed. Their use made it possible to specify indications for reconstructive operations, especially in controversial cases of the functional obstruction of the ureteropelvic segment. After diuretic RRG and EU one could refrain from surgery in 28% of the patients with obligatory follow-up.