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1.
Angiol Sosud Khir ; 25(4): 131-138, 2019.
Article in Russian | MEDLINE | ID: mdl-31855210

ABSTRACT

Presented in the article are the results of surgical management of a patient with an extremely rare pathology - a saccular arterial aneurysm of the cavernous-ophthalmic segment of the left internal carotid artery. We performed multistage open surgical intervention in the following scope: osteoplastic pterional craniotomy on the left, creation of a wide-lumen anastomosis between the left external carotid artery and M2 segment of the left middle cerebral artery with the use of the radial artery, ligation of the cervical portion of the left internal carotid artery and clipping of its supraclinoid portion. The chosen surgical policy made it possible to create sufficient volumetric blood flow through the shunt, comparable to the blood flow through the internal carotid artery, which helped avoid ischaemic stroke after exclusion of the aneurysm from circulation. A conclusion was drawn on efficacy of this method of treatment.


Subject(s)
Carotid Artery, External/surgery , Carotid Artery, Internal/surgery , Intracranial Aneurysm/surgery , Middle Cerebral Artery/surgery , Anastomosis, Surgical , Brain Ischemia/etiology , Brain Ischemia/prevention & control , Humans , Intracranial Aneurysm/complications , Ligation , Radial Artery/transplantation , Stroke/etiology , Stroke/prevention & control , Vascular Surgical Procedures/methods
2.
Angiol Sosud Khir ; 25(3): 107-112, 2019.
Article in Russian | MEDLINE | ID: mdl-31503254

ABSTRACT

Computer-aided simulation appropriately using the method of computational fluid dynamics (CFD) makes it possible to determine the elevated-risk zones of most probable formation of restenosis. The main idea of the method described in our article consists in a possibility of creating by the model of the geometrical shape of the vessel and characteristics of the flow at inlets and outlets the parameters of flow in each point of a vessel. The curves of velocity are used to create the curves of pressure at inlets and outlets, which are used in a CFD model. The resulting from CFD simulation of blood flow are nonstationary three-dimensional fields of pressure and velocity in the area under study. Visual examination of the dynamics of these fields makes it possible to judge about possible problem zones inside the area of flow and on the internal wall of the vessel. This article also presents a clinical case report illustrating the use of this technique.


Subject(s)
Carotid Arteries , Endarterectomy, Carotid , Blood Flow Velocity , Carotid Arteries/physiopathology , Hemodynamics , Humans , Models, Cardiovascular
3.
Khirurgiia (Mosk) ; (2): 82-88, 2019.
Article in Russian | MEDLINE | ID: mdl-30855596

ABSTRACT

It is presented case report of extremely rare pathology - protoplasmic astrocytoma of sylvian aqueduct involving posterior section of the third ventricle. The main principles of treatment were considered. Dynamics of neurological status was demonstrated. An effectiveness of treatment strategy was assessed.


Subject(s)
Astrocytoma/surgery , Brain Neoplasms/surgery , Cerebral Aqueduct/surgery , Third Ventricle/surgery , Astrocytoma/diagnosis , Brain Neoplasms/diagnosis , Humans , Treatment Outcome
4.
Angiol Sosud Khir ; 23(4): 107-111, 2017.
Article in Russian | MEDLINE | ID: mdl-29240063

ABSTRACT

Presented herein is a clinical case report concerning surgical treatment of a patient with a rare combination of two pathologies, i. e., a haemodynamically significant stenosis of the extracranial portion and a sacciform aneurysm of the communicative portion of the right internal carotid artery on the background of multifocal atherosclerosis. The patient underwent a simultaneous operation consisting in clipping of the sacciform arterial aneurysm of the communicative portion of the right internal carotid artery and carotid endarterectomy on the right. The chosen surgical policy ensured effective prevention of the development of ischaemic stroke and rupture of the arterial aneurysm, whose risks would have been high in staged treatment and sequentially performing two operations.


Subject(s)
Carotid Artery, External , Carotid Artery, Internal , Carotid Stenosis , Endarterectomy, Carotid/methods , Intracranial Aneurysm , Vascular Surgical Procedures/methods , Carotid Artery, External/diagnostic imaging , Carotid Artery, External/pathology , Carotid Artery, External/surgery , Carotid Artery, Internal/diagnostic imaging , Carotid Artery, Internal/pathology , Carotid Artery, Internal/surgery , Carotid Stenosis/diagnosis , Carotid Stenosis/physiopathology , Carotid Stenosis/surgery , Computed Tomography Angiography/methods , Humans , Intracranial Aneurysm/diagnosis , Intracranial Aneurysm/surgery , Male , Middle Aged , Risk Adjustment , Tomography, Spiral Computed/methods , Treatment Outcome
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