[ Thrombolytic therapy in acute occlusions of peripheral arteries].

Atherosclerotic occlusions of the abdominal aorta and arteries of the lower limbs are the commonest pathology of the arterial system. General growth of primary reconstructive operations on the abdominal aorta and peripheral arteries is accompanied and followed by the increased number of patients presenting with various postoperative complications of a specific character, such as early and late re-occlusions of the postoperative segments. Besides, currently important remains the problem concerning effective and safe management of acute occlusions of peripheral arteries not subjected to reconstruction. One of the promising methods of treatment for acute arterial occlusion is thrombolytic therapy. Presented herein is a review of the literature concerning the state of the art of thrombolytic therapy in acute occlusions of peripheral arteries.

[The state of sympathetic-adrenal system in patients with chronic cardiac insufficiency].

Activation of sympato-adrenal system plays an important role in the development of chronic cardiac failure (CCF). However, its relation to morpho-functional state of myocardium in CCF patients is virtually unknown. HPLC with electrochemical detection was used to determine plasma noradrenalin, adrenalin, and their precursors, 3,4-dioxyphenylalanine (DOPA) and dopamine, in patients with different morpho-functional changes in myocardium. The study demonstrated enhanced activity of sympato-adrenal system in patients with CCF. It showed for the first time that activity of sympato-adrenal system in CCF patients depends on the morpho-functional status of myocardium.

[Color duplex scanning in morphological and functional assessment of lower limb arterial occlusions]. / Tsvetovoe dupleksnoe skanirovanie v morfologicheskoi i funktsional'noi diagnostike okkliuziruiushchikh zabolevanii arterii nizhnikh konechnostei.

The paper assesses a potential of color duplex scanning (CDS) in topical diagnosis of atherosclerosis-related lower limb arterial occlusions (LLAO). Benefits and drawbacks of CDS are compared with those of digital subtraction arteriography (DSA). The authors describe objective quantitative measurement of ischemic grade or lower limb chronic arterial insufficiency due to atherosclerosis-related occlusions according to the magnitude of resistance or Pourcelot index (RI). Comparative effectiveness of CDS and DSA are evaluated on the base of 100 patients (791 arterial segments) examination with subsequent calculation of CDS sensitivity, specificity, diagnostic accuracy and validity. Correlation is drawn between ischemic grade and RI in tibial and dorsal metatarsal arteries. It is concluded that CDS plays an important role in topical diagnosis of LLAO, in graft patency evaluation and decision for future interventions. CDS can be used for objective measurement of limb ischemic grade. RI value appears to be a valid criterion for functional assessment of lower limb ischemia. Yielded with the help of CDS anatomic and hemodynamic data restrict indications for invasive, costly and radiation-related DSA.