[The use of vascular prothesis Gore Viabahn in the managment of the lower limbs ischemia]. / Zastosowanie protezy Gore Viabahn w leczeniu przewleklego niedokrwienia konczyn dolnych.

The chronic lower limbs ischaemia is caused mainly by arteriosclerosis. After insufficient conservative treatment only the surgical intervention can salvage the limb. The revascularisation surgery can be performed by open surgery with implantation of the prosthetic bypass or by endovascular angioplasty with stent. This second method seems to be the best alternative for the patients with several concomitant systemic diseases. Nevertheless it is limited by presence of the long-distance arteriosclerotic lesions. The resolve of that problem is use of new generation of long endovascular covered stents. They can be succesfuly used in aorto-femoral and femoro-popliteal segment. Their efficiacy is simmilar to traditional prosthetic grafts.

The heparin-bonded ePTFE grafts in revascularisation of the lower limbs.

The critical limb ischemia is diagnosed when the rest pain and/or distal necrosis or ishemic ulceration occur and last for more than two weeks. Critical limb ischemia requires immediate revascularisation due to the risk of amputation. The most common cause of this state is the arteriosclerosis located on femoropopliteal level. The surgery consists of endarterectomy or implantation of the bypass graft or the percutaneous, intravascular procedure. The best material for the graft is the autologous saphenous vein but sometimes the artificial graft should be used. Some trials have proven that the heparin-bonded polytetrafluoroethylene graft could be the best resolution for patients without possibilities of use of the autologous vein.

[The use of silver/collagen coated vascular prostheses in the treatment of critical limbs ischemia]. / Stosowanie protez naczyniowych impregnowanych solami srebra i uszczelnianych kolagenem w krytycznym niedokrwieniu konczyn dolnych.

Critical lower limb ischemia is a term used to define those patients with chronic ischemic pain at rest, ulcerations or limb necrosis caused by confirmed atherosclerotic lesions of the arteries. In this paper to evaluate of the clinical usefulness of silver coated prostheses in critical lower limb ischemia was presented. The use of the vascular artificial prostheses (dacron, dacron with velour, dacron albumin coated, polytetrafluoroethylene, dacron gentamicin/ryfampicin coated) in the critical ischemia limbs threatened is her contagion. In cases of potentially threatened a contagion is indicated the use of vascular prostheses about enlarged resistance on the contagion, e.g. the silver/collagen coated prosthesis. A foundation of the use of such prostheses are antibacterial proprieties of polyester fibers salts of the silver. An aim of many works is estimation of healing of the silver prostheses of grafted in lower limb at ill with the critical ischemia where infecting of the synthetic material is extremely probable. The healing of the silver prosthesis rated is most often at the use of the scintigraphy with Technetium 99. One attends that such research will make possible the estimation of the usefulness of the vascular silver prostheses in reconstructive operations in the vascular surgery, particularly in cases threatened with the infection of used synthetic material.

[Mallory-Weiss syndrome after the use of biliary prosthesis]. / Zespól Mallory-Weiss po zastosowaniu protezy dróg zólciowych.

The Mallory-Weiss Syndrome is a rare complication of endoscopic examination. Upper gastrointestinal bleeding due to the Mallory-Weiss Syndrome usually stops spontaneously. The gastroscopy is an effective procedure (method) of diagnosis and treatment of the syndrome. Presented in this paper is a case of 49-year old woman with an upper gastrointestinal bleeding due to the Mallory-Weiss after biliary prosthesis removal. The choledocholithiasis was the primary reason for the initial insertion of prostheses. The cause of gastrointestinal bleeding was determined on the basis of performed gastroscopy in the early stage of prostheses removal forced by bleeding. The bleeding was effectively stopped with endoclips.