[Carotid endarterectomy with stent removal in a patient with early bilateral restenosis of the internal carotid arteries in the acute period of recurrent ischemic stroke]. / Karotidnaya endarterektomiya s udaleniem stentov u patsienta s rannim dvustoronnim restenozom vnutrennikh sonnykh arterii v ostrom periode povtornogo ishemicheskogo insul'ta.

We present a rare clinical observation of a patient with an early reoperation performed up to 2 weeks after a recurrent stroke. Carotid endarterectomy with removal of previously installed stents for critical stenoses of the internal carotid arteries after the first stroke was performed. Early bilateral restenosis up to 80-90% of the lumen in the stents of both internal carotid arteries was observed 6 months after stenting. Open interventions were performed in the acute period of recurrent ischemic stroke in two stages with a favorable outcome. No data on the increase of neurological symptoms were obtained for 2 years of observation. Treatment and application of early rehabilitation methods, improved the patient's general condition, strength in the left extremities increased up to 4.5 points, left-sided hemihypesthesia decreased, speech disorders regressed. The patient walks and serves himself independently.

[Modern look at endovascular treatment bleeding the gastrointestinal tract in elderly patients.]

A literature review of the publications of foreign authors on the treatment of non-varicose bleeding from the upper gastrointestinal tract of elderly and senile patients is presented. The authors showed a modern view of the possibilities of endovascular hemostasis in comparison with a surgical operation with inefficiency of endoscopic hemostasis and characterized patients in whom it is possible this will be most effective.

[Roentgenosurgery for aortic coarctation and open arterial duct with intravascular ultrasonic examination]. / Rentgenokhirurgicheskie operatsii po povodu koarktatsii aorty i otkrytogo arterial'nogo protoka s ispol'zovaniem vnutrisosudistogo ul'trazvukovogo issledovaniia.

Forty-five patients (32 with open arterial duct and 13 with aortic coarctation) were examined. Forty-nine intravascular ultrasonic examinations were performed, qualitative and quantitative analysis of 139 vascular segments was carried out. Despite the fact that mean morphometric indices of open arterial duct and aorta in angiography and intravascular ultrasonic examination had no significant difference, real confidence of the o data was seen only in 13.3% cases for open arterial duct an in 16.7% cases--for aortic coarctation. In 37.5 and 50% patients, respectively, difference in the dimensions was so significant that dictated choice of instruments with difference size. Roentgenoendovascular surgeries were performed in 23 patients with open arterial duct and in 12--with aortic coarctation. Choice of instruments parameters based on data of intravascular ultrasonic examination provided safer and more efficient procedures.

[Rheolytic thrombectomy using the "Angiojet" complex in treating arterial thrombosis]. / Reoliticheskaia trombéktomiia s ispol'zovaniem kompleksa "Angiodzhet" v lechenii arterial'nykh trombozov.

Results of roentgenendovascular treatment of arterial thrombosis by rheolytic thrombectomy with "Angiojet" are presented. 18 patients (1 woman, 17 men) underwent 19 rheolytic thrombectomies from peripheral arteries. Mean age of patients was 53.3 +/- 3.0 years, time of thrombosis--from 20-30 min to 60 days (mean 121 +/- 17 hours). Thrombectomy was performed from superficial femoral, popliteal or tibial arteries, or from all these vessels simultaneously. In one case thrombus was removed from femoro-popliteal graft. Rheolytic thrombectomy was combined with balloon angioplasty of hemodynamicaly important stenosis, 5 patients underwent implantation of 9 stents. Good and satisfactory results were achieved in 77.8% patients; thrombectomy as the stage of operation was ineffective in one case only. Rheolytic thrombectomy from coronary arteries was performed 3 times, with complete effect in 1 and with partial--also in 1 patient.