[Endografting of a true aneurysm of the internal carotid artery].

Aneurysms of the internal carotid artery are a rarely encountered nosological entity, with only sporadic clinical cases being reported in both Russian and foreign literature. In the majority of instances, this pathology is removed by means of prosthetic repair of the internal carotid artery. However, recent trends are toward increased use of endovascular endografting. Described in the article is a case of an internal carotid artery aneurysm successfully treated by a self-opening stent graft.

[Comparison of remote results outcomes of stenting and eversion endarterectomy from internal carotid arteries].

Presented in the article are comparative results of carotid angioplasty with stenting (CAS) and eversion carotid endarterectomy (ECEA) in the remote period of follow up. The study included a total of 92 patients. Of these, 33 were subjected to CAS (Group I) and 59 underwent a total of 63 ECEAs (Group II). Depending upon the presence or absence of symptoms of cerebrovascular insufficiency (CVI), as well as based on assessment of risk factors for surgical intervention, the patients were subdivided into four subgroups: a) low-risk asymptomatic b) low-risk symptomatic, c) high-risk asymptomatic and d) high-risk symptomatic. We followed up remote results in 31 Group I patients (94%) up to 70 months (mean period of follow up amounted to 25±17 months), and in 36 Group II patients up to for up to 65 months (mean duration of the follow up amounting to 37±20 months). There was no statistically significant difference (P >0.05) between subgroups of patients along such parameters as severe or mild stroke, myocardial infarction, stroke-related death, or myocardial infarction related death. CAS and ECEA are equally highly efficient techniques of preventing acute cerebral circulation impairments in the remote period of follow up in patients of both high and low risk of surgical intervention.

[Long-term outcomes of balloon angioplasty for aortic coarctation]. / Otdalennye rezul'taty ballonnoi angioplastiki koarktatsii aorty.

From 1994 to 2001 balloon angioplasty was fulfilled for 19 patients aged from 4 to 28 (mean 11.0+/-7.0) with discrete type aortic coarctation. Early outcomes were satisfactory in all cases. Catheterization showed 10 mm Hg decrease in systolic pressure gradient (SPG). Long-term results (from 6 months to 8 years, mean 3.0+/-2.5) were evaluated with transthoracic EchoCG, Doppler ultrasound, duplex scanning of iliofemoral segment and CT-angiography with 3D reconstruction. Surgical outcomes were considered good when SPG did not exceed 20 mm Hg for Doppler ultrasound and 25 mm Hg for Doppler EchoCG. In the study group there was statistically significant decrease in arterial pressure in right upper limb and SPG (measured with both Doppler EchoCG and Doppler ultrasonography) and rise of ankle-brachial index. Beneficial hemodynamic effect was detected in 15 from 19 patients (79%). Recoarctation has developed in 4 (21%) patients, in 1 (5.3%) case it was combined with true posttraumatic aortic aneurysm. Three patients underwent open surgical intervention with uneventful postoperative period. Aneurysmal dilatation of thoracic aorta has developed in 1 patient (5.3%), non-progressive intimal dissection - in another one (5.3%), 2 patients (10.5%) experienced ipsilateral 40-60% stenosis of right external iliac and femoral arteries. Thus good long-term outcomes of balloon angioplasty in patients with discrete type aortic coarctation were achieved in 79% cases. Patients after balloon angioplasty must be assessed regularly with non-invasive diagnostic methods such as Doppler ultrasonography, Doppler EchoCG, CT-angiography.