[Endovascular surgery for complications after open surgery of abdominal aorta]. / Vozmozhnosti endovaskulyarnoi khirurgii bryushnoi aorty pri vozniknovenii oslozhnenii posle otkrytykh vmeshatel'stv.

Abdominal aortic aneurysm rupture (AAAR) is a fatal complication and results high mortality rate (40-70%). To date, open surgery remains the method of choice for AAAR in the Russian Federation. Various complications can occur after surgery for RAAA. Typical adverse events are hemorrhagic complications. The authors describe open surgical treatment of RAAA. In postoperative period, hypertensive crisis was followed by distal anastomosis failure and bleeding into the cavity of sutured aneurysmal sac. This complication was successfully eliminated by installation of stent graft.

[Use of a filtering protective device during angioplasty and stenting of the brachiocephalic trunk]. / Primenenie fil'truiushchego zashchitnogo ustroistva pri angioplastike i stentirovanii brakhiotsefal'nogo stvola.

The authors carried out a pilot study aimed at assessing the possibility and efficacy of using filtering systems for protection of cerebral arteries from distal embolism during angioplasty and stenting of the brachiocephalic trunk. A total of five patients presenting with lesions of the brachiocephalic trunk underwent 5 roentgenoendovascular interventions with the use of the filtering protective device Spider FX. Angiographic and clinical success was achieved in 100% of cases. Particles of debris were obtained from the protective device in all cases. All the five patients were found to have symptoms of vertebrobasilar insufficiency. During follow-up in the medium-term period at check examinations the implanted stents were patent, with neither major nor minor neurological complications observed. The patients turned out to be free from cerebrovascular insufficiency relapses. Presented herein are clinical case reports describing technical peculiarities of using the protective device in different variants of the anatomy and vascular lesion.

[Roentgen endovascular treatment of common carotid artery dissection after eversion carotid endarterectomy]. / Rentgenendovaskulyarnoe lechenie dissektsii obshchei sonnoi arterii posle eversionnoi karotidnoi endarterektomii.

The article deals with the use of self-expanding stents for endovascular treatment in patients presenting with dissection of the common carotid artery, exemplified by two clinical case reports. In both cases, dissection of the common carotid artery developed after eversion carotid endarterectomy. Intimal detachment was eliminated in both cases by implanting self-expanding stents. These cases demonstrated possibilities of roentgen endovascular methods of treatment making it possible to successfully replace a repeat, technically difficult surgical intervention for iatrogenic dissection of the common carotid artery.

[Experience with the ovations stent graft system for totally percutaneous endovascular repair of the infrarenal portion of the abdominal aorta].

Presented in the article are clinical cases of successful totally percutaneous endovascular repair of the infrarenal portion of the abdominal aorta using the Ovation Prime ultra-low profile stent graft in high-surgical-risk patients, yielding good immediate and short-term results, thus demonstrating new possibilities in endovascular treatment of aneurysms of the infrarenal portion of the abdominal aorta.

[Endovascular treatment of traumatic arteriovenous fistulas of the vertebral artery].

The authors describe herein the use of balloon-distensible stent grafts for endovascular treatment of patients presenting with traumatic arteriovenous fistulas in the first segment of the vertebral artery, exemplified by two clinical case reports. In both cases, the arteriovenous fistula formed after a stab-and-slash wound in the neck area. In order to exclude the arteriovenous aneurysm from the blood flow in the first case we performed endoprosthetic repair of the first segment of the subclavian artery with shutting off of the ostium of the vertebral artery carrying the aneurysm. In the second case, in order to remove the arteriovenous shunt we carried out performed endoprosthetic repair of the first segment of the vertebral artery. These cases show possibilities of roentgenoendovascular methods of treatment, making it possible to successfully replace technically complicated surgical interventions in traumatic arteriovenous fistulas of vertebral arteries.

[Endovascular treatment of post-traumatic arteriovenous fistulae].

AIM: To summarize the experience of endovascular treatment of traumatic arteriovenous fistulae. MATERIAL AND METHODS: Endovascular interventions for arteriovenous fistulae of different locations were applied in 16 patients aged 19 to 83 years (mean 50.4±14.3) in A.V. Vishnevskiy Institute of Surgery from 2003 to 2014. Among causes there were stab wounds, gunshot wounds, blunt trauma, iatrogenic. Different endovascular methods including stenting with self-opening and balloon-expanding stent-grafts, embolic coils and occluders implantation were used. RESULTS: Pain syndrome, disorders of support function and trophic changes were observed in patients with arteriovenous fistulae more localized more distal than lower one third of the thigh. More proximally located arteriovenous fistulae regardless of their diameter resulted severe heart failure and portal hypertension. Angiographic and clinical success was achieved in 100% of cases. Manifestations of heart failure and portal hypertension disappeared in all patients after endovascular interventions. Also support function restored, pain and trophic disorders were cured. CONCLUSION: Arteriovenous fistulae regardless of their size, location and time of existence must be dissociated. Prolonged arteriovenous shunting leads to severe heart failure. Current technologies and tools used in endovascular interventions provide reliable dissociation of arteriovenous fistulae even in case of difficult anatomical features.

[Use of balloon-expandable stent graft for treatment of a false pseudoaneurysm of the proximal anastomosis of the iliac-femoral bypass graft].

The authors present in the article a case report of successful use of a balloon-expandable stent graft for endovascular prosthetic reconstruction of an aneurysm of the proximal anastomosis of the iliac-femoral bypass graft by puncture approach through the brachial artery. We implanted a balloon-expandable stent graft measuring 6.0-12.0 mm in diameter and 58-mm long with good immediate and short-term results in the anastomosis with large alteration in the diameter along the length.