[Variants of surgical management for severe arterial hypertension combined with type 2 diabetes mellitus].

Based on studying venous trunks and their syntopia, previously performed on a total of 160 cadavers we elaborated" methods of "cross" shunting. Clinical application thereof in ten patients presenting with severe arterial hypertension accompanied by type 2 diabetes mellitus made it possible to decrease both mortality and complication rates.

[Feasibility study of perftoran for protection of the brain from ischaemia in operations on extracranial arteries].

AIM: To substantiate administration of <> for prevention of cerebral ischemia in operations on extracranial arteries. MATERIAL AND METHODS: The present prospective randomized trial included a total of 50 patients having endured various operative interventions on extracranial arteries. Of these, 24 subjects were additionally given <> in order to prevent ischaemic complications. Conventionally accepted methods of protection were used in 26 patients. The degree of cerebral ischaemia during surgery was assessed by means of monitoring the lactate content in the blood from the internal carotid artery and internal jugular vein on the side of the operation performed. Also, as an indirect method aimed at evaluating intraoperative cerebral ischaemia we used monitoring of transcutaneous oxygen tension (TcPO2) on the side of the surgical intervention with the placement of the appropriate sensor in the temporal region. RESULTS: The patients receiving perftoran additionally in order to prevent cerebral ischaemia showed a statistically reliable decrease in the blood lactate level at all stages of the operation. Besides, with the statistically similar levels of TcPO2 in the both groups at the stage prior to pinching the major arteries amongst the patients given perftoran the decrease in TcPO2 at the subsequent stages was significantly lower. CONCLUSION: Administration of perftoran during surgery on the extracranial arteries made it possible to substantially improve cerebral oxygenation, rendering it stable at all stages of the surgical intervention. Combining this method with other techniques aimed at protecting the brain makes it possible to increase safety of the operations by promoting additional protection from circulatory hypoxia in multifocal lesions of the carotid arteries and arteries of the circle of Willis.