[Sequence of stages of hybrid operations in patients with Leriche syndrome and critical limb ischaemia].

Presented in the article are the results of treating a total of 108 patients with chronic critical lower limb ischaemia (CCLLI) confirmed according to the recommendations of the Transatlantic Inter-Society Consensus (TASC) 2007 [1]. All patients were diagnosed as having combined lesions of the aortoiliac and femoropopliteal segments of the arterial bed of the lower limbs. All patients underwent simultaneous hybrid operations: open reconstructive interventions in the infrarenal zone and stenting of iliac arteries. In the comparison group (n=14) the first stage consisted of restoration of the inflow pathways followed by open reconstruction of the femoropopliteal segment. In the Study Group (n=94) the first stage was infrainguinal reconstruction by the open technique followed by stenting of the arteries of the aortoiliac segment. It was shown that restoration the outflow pathways as the first stage was associated with a considerable decrease in the risk of intraoperative complications.

[Surgical treatment of a patient with occlusion of the main trunk of the renal artery of the solitary kidney].

Presented herein is a clinical case report of successful stagewise surgical treatment of a patient with atherosclerotic occlusion of the main trunk of the renal artery of the single kidney. Clinically, the patient had signs of ischaemic renal disease in the form of pronounced azotemia being characteristic of the terminal stage of renal insufficiency, as well as malignant arterial hypertension. Besides, the patient had previously endured ischaemic stroke in the vertebrobaslar basin. The patient was subjected to stagewise surgical intervention, i.e., stenting of the upper-pole renal artery followed by open operation--prosthetic repair of the left renal artery with a synthetic prosthesis. Three months thereafter, the patient underwent carotid endarterectomy and operation of transposition of the subclavian artery. The postoperative period turned out uneventful. Currently, no progression of azotemia is observed, neither are there any indications for carrying out restorative therapy of the renal function.

[Hybrid operations in high-operative risk patients with limb critical ischaemia and lesion of the aortoiliac segment].

The article deals with outcomes of managing a total of twenty-nine patients of high operational risk with TASK II type С and D lesions of the aortoiliac segment. All patients were subjected to single-stage hybrid operations: open reconstructive interventions on the infrainguinal zone and stenting of iliac arteries. High risk of coronary complications these patients were running was confirmed in accordance with the European guidelines on perioperative assessment of the patients being elected for extracardiac operative treatment. Critical ischaemia was in all cases reliably relieved. Two patients during predilatation developed haemorrhage due to iliac artery rupture which was the cause of changing over to open operation. No lethal outcomes were observed.

[Endovascular treatment of a female patient with resistant arterial hypertension secondary to a renal artery aneurysm].

Described herein is a successful therapeutic outcome in a female patient presenting with resistant arterial hypertension secondary to a gigantic intraorganic aneurysm of the right renal artery. Treatment consisted of intravascular prosthetic repair of the parenchymatous portion of the renal artery, eventually making itpossible to entirely bypass the aneurysmatic sac and to restore the lumen of the renal artery, followed by normalization of arterial pressure.

[Surgical management of a hypertensive young adult suffering from nonspecific aortoarteritis accompanied by renal arterial lesions].

Presented herein is a successful outcome of stagewise surgical management of a young adult suffering from nonspecific aortoarteritis accompanied renal artery lesions. The patient was subjected to a stagewise intervention consisting of stenting of the renal arteries and an open operation, i.e. bilateral aortorenal bypass grafting performed with the synthetic stent B-Braun.

[Treatment of injuries and scar strictures of extrahepatic bile ducts]. / Lechenie povrezhdenii i rubtsovykh striktur vnepechenochnykh zhelchnykh protokov.

Results of treatment of 118 patients with trauma of bile ducts during cholecystectomy are analyzed. Rate of this complication ranges from 0.25 to 0.68%. Reconstructive surgeries on bile ducts were performed in 111 of 118 patients. Non-drainage variant of reconstruction of bile ducts was used only in 18 patients. Hepaticojejunostomy on removable transhepatic drainage was performed in the majority of cases. It is demonstrated that reconstructive surgeries on bile ducts must be performed early after trauma, just after arrest of bile peritonitis and other purulent complications. The best long-term results were achieved in patients who underwent reconstruction of bile ducts just after diagnosis of their iatrogenic injury on operation table. Postoperative lethality was 8.5%. Good long-term results were achieved in 81.4% patients. Repeated surgeries due to recurrences of bile ducts strictures were performed in 11.9% patients with good short-term results.

[Embolization of cerebrovascular aneurysms with controlled microspirals (complications and technical problems)]. / Embolizatsiia arterial'nykh anevrizm golovnogo mozga upravliaemymi mikrospiraliami (oslozhneniia i tekhnicheskie trudnosti).

The paper summarizes five-year experience with mechanically detachable microspirals for embolization of 62 arterial aneurysms in 59 patients. The complications and technical problems associated with both the specific features of this technology and anatomic types of the structure of vessels and aneurysms are described. Methods for the prevention and treatment of these complications are proposed.

[Intravascular embolization of cerebral aneurysms by mechanically detachable micro-spirals]. / Vnutrisosudistaia émbolizatsiia arterial'nykh anevrizm golovnogo mozga pri pomoshchi mekhaniceski otdeliaemykh mikrospiralei.

The paper presents experience in embolizing arterial aneurysm, which of great value for interventional radiology. Endovascular embolization is a low-traumatic intervention, which reduces the time of rehabilitation in a patient and makes him active much earlier. The paper uses a sufficient body of data to provide evidence for the efficiency and safety of this technique in the treatment of aneurysms. The authors' experience allows one to expand indications for endovascular treatment of arterial aneurysm and to create a mechanism of embolization in practice, by applying the mechanically detachable spirals.

[Significance of a complex of laboratory methods of study in the differential diagnosis of various forms of bronchial asthma]. / Znachenie kompleksa laboratornykh metodov issledovaniia v differentsial'noi diagnostike razlichnykh form bronkhial'noi astmy.

The changes of serum crystallograms and peripheral erythrocytes morphology were studied in 104 patients. Nonspecific immunity was evaluated by means of monocytes count, succinate dehydrogenase and acid phosphatase activities in peripheral lymphocytes. The revealed differences in crystallograms, erythrocytes morphology can be applied as other laboratory methods to differential diagnosis of various forms of bronchial asthma and to assessment of remission and exacerbation of the disease.