[Complications of fibrinolytic therapy in thromboses of the major arteries of the lower extremities]. / Oslozhneniia fibrinoliticheskoi terapii trombozov magistral'nykh arterii nizhnikh konechnostei.

Fibrinolytic therapy with streptokinase preparations was administered to 79 patients. Hemorrhagic, embolic, thrombotic, and allergic complications were observed over the course of therapy. Massive bleedings occurred in 3 (4%) patients, two of them died. Negligible hematomas at the site of vessel puncture were seen in 11 (14.4%) cases. Distal arteries embolization developed in 6 (7.6%) patients. Nine patients (11.4%) developed early re-thromboses soon after therapy was over. Allergic reactions presenting as hyperthermia and short-term chill were observed in one third of the patients. Measures to prevent possible complications of fibrinolytic therapy are strict adherence to thrombolysis methods and a dynamic laboratory monitoring over the course of therapy.

[Regional thrombolytic therapy of thrombosis of arteries of the pelvis and lower extremities]. / Regionarnaia tromboliticheskaia terapiia v lechenii trombozov arterii taza i nizhnikh konechnostei.

Regional thrombolysis was performed in 62 patients with thrombosis of the aorta and arteries of the pelvis and lower extremities. The thrombolytics used were avelysin (20 patients) and celiase (42 patients). Complete lysis of the thrombi was recorded in 49 cases. After successful thrombolytic therapy balloon angioplasty of the revealed stenoses was carried out in 39 patients. After thrombolysis was completed 15 patients underwent various reconstructive operations which failed to produce an effect in 4 patients and the extremity was amputated. The complications of thrombolysis included hematomas at the site of catheterization of the arteries in 5 patients, distal embolism in 7, and an allergic reaction in one patient. The authors appraise the dependence of thrombolysis efficacy on the level, extent, and duration of the thrombotic occlusion.

[Embolization of gastric veins in patients with esophageal hemorrhage during laparotomy]. / Embolizatsiia zheludochnykh ven u bol'nykh pishchevodnymi krovotecheniiami pri laparotomii.

The authors discuss the possibility of a laparotomy approach for endovascular embolization of the gastric veins in patients with portal hypertension and gastroesophageal bleeding. This approach was used in four patients in whom transhepatic catheterization of the portal channel was impossible. After laparotomy, catheterization of the portal vein system was conducted through one of the veins of the small intestine. The effect of embolization in two of three patients who were subjected to the operation consisted in correction of esophagitis and complete cessation of esophageal bleeding. In view of the danger of the development of operative and postoperative complications due to the specific features of the pathological condition, the authors recommend using laparotomy endovascular embolization of the gastric veins only in the presence of strict indications.

[Thrombolytic therapy of acute thrombosis of the major arteries in the legs with streptokinase preparations]. / Tromboliticheskaia terapiia ostrogo tromboza magistral'nykh arterii nizhnikh konechnostei preparatami streptokinazy.

Thrombolytic therapy was used in treatment of 40 patients with acute thromboses of the aorta, major arteries of the pelvis and lower extremities. Complete lysis of the thrombus was achieved in 21 patients, partial lysis in 13 patients, 6 patients had no effect. The authors consider that the effectiveness of the treatment of acute thrombosis of major arteries is dependent on duration of the disease, character, level and distance of the occlusion, degree of ischemia of the extremity. It is stressed that the method of choice is the selective administration of streptokinase drugs (Awelysin, Celiase).

[The use of digital subtraction angiography in diseases of the arteries of the pelvis and lower limbs]. / Primenenie digital'noi subtraktsionnoi angiografii pri zabolevaniiakharterii taza i nizhnykh konechnostei.

The diagnostic potentialities of digital subtraction angiography (DSA) in diseases of the pelvic arteries and lower limbs were studied. Intravenous (iv) and intraarterial (ia) DSA were performed in 613 patients, among them were patients with obliterating atherosclerosis and endarteritis, thromboembolism, aneurysms and arteriovenous fistulas. Iv DSA provided good information for the solution of therapeutic and tactical problems in pelvic, femoral and popliteal arterial lesions but in 16% of the cases it gave no opportunity to assess the status of the crural arteries. Ia DSA was shown to be no inferior to routine arteriography in the visualization of the lower limb arteries. This method is economical, well tolerated by patients, permits the intensification of examination of patients with acute and chronic arterial pathology. It can be employed under outpatient conditions and in the early postoperative period.