[Positional deformity of the subclavian artery as a possible cause of subclavian steal syndrome]. / Pozitsionnaia deformatsiia podkliuchichnoi arterii kak vozmozhnaia prichina podkliuchichnogo steal-sindroma.

Using the method of duplex scanning, we examined a total of 123 patients presenting with a deformity of the subclavian artery (SCA). We assessed the Doppler spectrum of blood flow in the zone of the SCA deformity, as well as in V2 and V4 segments of the ipsilateral vertebral artery (VA) at rest and in breath holding on inspiration. Deformity of the SCA was observed on the right in 91% of cases, on the left in 5%, and on both sides in 4%. Haemodynamic disorders in the ipsilateral VA as a change of the shape of the Doppler spectrum according to the type of steal syndrome were noted in 10.8% of cases, with a more pronounced impairment of blood flow at the intracranial level - in 78.6% of cases. It was determined that a deformity of the SCA was characterised by a decrease in angulation (up to complete straightening) and a reduction of the peak systolic velocity on deep inspiration, thus reflecting its positional nature. Patients with initial impairment of the Doppler spectrum in the VA demonstrated normalization of the spectrum on an intake of breath. Hence, the index of the peak systolic velocity of blood flow in the zone of the SCA deformity in combination with assessment of the Doppler spectrum in the ipsilateral VA on inhalation may be used for determining the haemodynamic significance of a deformity of the SCA.

[Improvement of ultrasound study in the diagnosis of pleurisies of various etiologies].

The study was undertaken to improve ultrasonography using needle biopsy under ultrasound control in the diagnosis of pleurisies of various etiologies. The patients of the Department of Thoracic Surgery, who had been divided by the nosological principle (nonspecific pleurisy, tuberculosis effusions, and tumorous and posttraumatic pleurisies), were followed up. The study and statistical processing yielded major ultrasound criteria for pleural effusions and a final diagnosis was made on the basis of needle biopsy under ultrasound control with subsequent morphological verification.