Extracellular Matrix Remodeling Factors as Markers of Carotid Artery Atherosclerosis.

MATERIALS AND METHODS: 20 patients undergoing routine carotid endarterectomy and 40 healthy volunteers were enrolled in this study. MMPs activity and OPG and FN concentrations were measured in atherosclerotic plaques and nonchanged contiguous tissue after homogenization as well as in plasma from patients and reference group. The activity of MMPs was evaluated by gelatin zymography, and the concentration of OPG and FN was assessed by ELISA. RESULTS: OPG concentration and MMP-9 activity showed differences between plaque and nonchanged tissue; OPG was higher in adjacent tissue (P=0.0009), whereas MMP-9 was higher in plaque (proMMP-9 P=0.0003; MMP-9 P < 0.0001). The OPG plasma concentration and both MMPs plasma activity were higher in patients (OPG P < 0.001; proMMP-2 P=0.0292; and proMMP-9 P=0.0374), while FN plasma concentration was lower in patients than in the reference group (P=0.0004). The ROC curves analysis showed the highest AUC for OPG (0.943) with 85.0% sensitivity and 92.1% specificity. CONCLUSIONS: The atherosclerotic plaque and the contiguous artery wall are biochemically different. OPG shows the highest potential to be a marker of advanced carotid atherosclerosis.

[Modern treatment of rupturted abdominal aortic aneurysms with the use of synthetic endovascular prostheses]. / Leczenie peknietych tetniaków aorty brzusznej z uzyciem syntetycznych protez wewnatrznaczyniowych.

AIM OF STUDY: We analyzed the case of two patients with ruptured aortic aneurysm treated with the usage of the endowascular method. MATERIALS AND METHODS: Treatment of ruptured abdominal aortic aneurysms is burdened with a high mortality rate during the perioperative period. The implantation of forked stent-grafts and uni-grafts significantly reduced the mortality rate in this group of patients. Usage of this treatment requires the hybrid operating room. An essential element is to have the appropriate amount of equipment available to find a suitable intravascular prostheses. Uni-grafts are a good alternative for smaller divisions and for physicians with less experience in endovascular surgery. CONCLUSION: Endowascular procedures have a great chance to became a golden treatment standard.

[The treatment of dissected thoraco-abdominal aorta aneurysm with the use hybrid procedure]. / Zaopatrzenie tetniaka aorty piersiowo-brzusznej przy uzyciu procedur hybrydowych.

AIM OF STUDY: We analyzed the case of a patient treated in Vascular Surgery Department with the use of the hybrid procedure with a good results. MATERIALS AND METHODS: Acute cases of dissected aortic aneurysm are commonly known as an immediate danger of human live and determinate a big challenge for physicians. The collaboration of classic and endovascular methods (hybrid procedures) gives much more chances to improve patient's survival and resumption to normal life activity. Endovascular procedures are limiting the operation shock, improving recovery time. That means rising the chances of survival so advanced surgical procedure. CONCLUSION: Hybrid procedures are a modern technic that gives good results.

[The use of the heparin-bonded ePTFE grafts for needs of the hemodialysis]. / Zastosowanie protez naczyniowych politetrafluoroetylenowych pokrytych heparyna dla potrzeb hemodializy.

Chronic dialysis in case of patients with extreme renal insufficiency frequently leads to loss of vascular access for hemodialysis. The only alternative for such patients is a transplantation of a kidney. The time of expectation may extend because of many reasons and a patient requires permanent and systematic dialysis. Then there is no option of maintaining a permanent access to dialysis but to artery-arterial by-pass with the usage of vascular prosthesis as an access to dialysis. Recent researches recommend prostheses covered with heparin. Such prosthesis are less of thrombosis and they curb processes connected to the height of the number of cells. At the same time they retain their patency for longer, especially in region of anastomosis. It permits to lengthen time of dialysis and also time of expectation for a kidney transplant. Our experiences are confirmed by other authors' observations and they also prove usefulness of heparin bonded prosthesis Propaten for producing artery-arterial by-pass as the only alternative of treating patients with chronic renal insufficiency in cases of whom all possibilities of vascular access for hemodialysis were depleted.