[Elimination of late endoleak after endovascular repair of a dissecting thoracoabdominal aortic aneurysm]. / Likvidatsiia pozdnego éndolika posle éndoprotezirovaniia rassloivsheisia torakoabdominal'noi anevrizmy aorty.

Described herein is a clinical case report regarding treatment of a 70-year-old male patient presenting with a late complication following endoprosthetic repair for a Stanford type B dissecting thoracic aortic aneurysm. The man was admitted to our hospital for persistent type IIb endoleak and an increased diameter of the aorta in its thoracic and thoracoabdominal portions. Two years previously, he had endured endoprosthetic repair of the thoracic aorta. The findings of computed tomography revealed negative dynamics manifesting as an increase in the diameter of the false channel of the arch and descending thoracic aorta with persistent type IIb endoleak. He was subjected to elimination of abdominal aortic dissection and type IIb endoleak with partial prosthetic repair of the descending thoracic portion of the aorta by means of prosthetic repair of the lower thoracic portion of the aorta between the stent graft and linear vascular Dacron prosthesis. The postoperative period was complicated by transient acute renal failure and paraparesis of the lower limbs. The patient was discharged on POD 14, with no endoleaks revealed on control computed tomography 3 months thereafter.

[Treatment of abdominal aortic aneurysms in patients older than 70 years of age].

The investigation has shown that patients with the diagnosed abdominal aortic aneurysms must be operated, the age being not considered a contraindication to surgical treatment. Five years survival of the patients after resection of the abdominal aortic aneurysm and its prosthesis does not depend on the age and is higher than 70%, while the expectant management leads to rupture of the aneurysm and death of 70% of the patients. A medical algorithm has been developed allowing reduction of lethality of elderly patients with abdominal aortic aneurysms and less frequency of complications.

[Application of different textile vascular grafts in the aorto-femoral location and ways for their improvement]. / Primenenie razlichnykh tekstil'nykh sosudistykh transplantatov v aortobedrennoi pozitsii i puti ikh sovershenstvovaniia.

A comparative analysis of 220 reconstructions of the aortofemoral segment with the application of vascular prostheses of firms "Sever" and "Vascutek" was made. It was established that in patients with obvious anemia and hemodilution (hematocrit less than 25%, hemoglobin less that 80 g/l) an important condition for less total blood loss was to impart the zero surgical porosity to the graft wall at the preoperative stage. However, the biological impregnation used for these purposes reinforces the inflammatory component in the implantation of the vascular graft. The authors propose to use a more inert polytetrafluoroethylene film to impart the zero surgical porosity to the graft wall.