[The risk prediction of erectile failure developing after the reconstruction of the aortoiliac segment]. / Prognozirovanie riska razvitiia érektsionnoi nedostatochnosti posle rekonstruktsii aortopodvzdoshnogo segmenta.

The authors suggest their method for prognosticating the risk of formation of erectile incompetence after reconstruction of the aortoiliac segment. In 78 patients with Leriche's syndrome and maintained erectile function 13 qualitative parameters were determined before the operation (the degree of intermittent claudication, the duration of the disease of the lower limbs, the results of ultrasonic dopplerography and angiography), which were then converted to quantitative discrete characteristics. The obtained set of characteristics was used for prognosticating the condition of the sexual function after the operation by means of the familiar methods of regressive analysis on a personal PS/XT computer according to a program of multidimensional regression in the packet of programs. Clinical tests confirmed the high accuracy of the prognosis of the value characterizing the condition of the sexual function by this method. Such prognostication makes it possible to substantiate with high authenticity the expediency of combined revascularization of the lower limbs and cavernous bodies of the penis and opens real prospects of improving its results.

[The prognosis of the efficacy of revascularization of the penile corpora cavernosa in the surgical treatment of Leriche's syndrome]. / Prognozirovanie éffektivnosti revaskuliarizatsii kavernoznykh tel polovogo chlena pri khirurgicheskom lechenii sindroma Lerisha.

The authors have developed a procedure for predicting the efficiency of penal spongy body revascularization in surgical management. Thirteen qualitative parameters, such as duration of sexual dysfunction, libido, having a sexual intercourse partner, degree of intermittent claudication, duration of lower extremity diseases, penal erection angle after drug test and ultrasound Doppler echography with drug test, were evaluated in 36 patients with Leriche's syndrome and erectile dysfunction. The qualitative parameters obtained were converted to quantitative discrete characteristics. The set of characteristics was used to predict the postoperative parameter--the value characterizing the sexual function by using the well-known methods of regression analysis on a PS/XI personal computer by the multiple regression programme in the Statgraphics program package. The high accuracy of prediction of the value characterizing the sexual function by this method makes it possible to substantiate the expediency of penal spongy body revascularization and opens up new ways for improving its outcomes.

[Experimental premises and 1st experiences in the clinical use of antibacterial vascular prostheses under circumstances of increased risk of suppuration]. / Eksperimental'nye predposylki i pervyi opyt klinicheskogo primeneniia antibakterial'nykh sosudistykh protezov v usloviiakh povyshennogo riska nagnoeniia.

It was shown on the basis of laboratory and experimental data that created antibacterial vascular prostheses are marked, on the main, by local bacteriostatic and anticoagulative effect. It was found that heparin concentration of 3 to 500 U per 1 kg collagen causes a hyperadhesive effect on blood platelets and facilitates the formation of the primary thrombocytic thrombus. The free surface energy grows in this case from 34 +/- 0.8 to 66.3 +/- erg/cm2. The optimal thromboresistant effect occurs in heparin content of 1 U per 1 mg collagen. That this choice is correct is confirmed on examination of the inner surface of the prostheses with an electron microscope after being in the blood flow for 45 minutes. Bifurcation and linear antibacterial prostheses were used in 9 patients with a high risk of suppuration verified by cultures of discharge from ulcers and lymph nodes, and the presence of lymphangitis and lymphadenitis. The effect was positive in 8 patients, 2 of them had superficial suppuration of the operative wounds.

Surgical treatment and prevention of vasculopathic impotence in conjunction with revascularisation of the lower extremities in Leriche's syndrome.

The results are presented of combined revascularization of the lower extremities and the penis in 29 patients with Leriche's syndrome. This was effected by placing an autogenous venous shunt between the branch of a prosthesis or the common femoral artery and one of the dorsal arteries of the penis. Preoperatively lost sexual function was restored in 6 patients, while in 16 the sexual function was maintained at the preoperative level or improved in the late postoperative period. A comparison of the results obtained with the sexual performance of patients who had undergone bifurcated aortofemoral shunting only, prompted the conclusion that this surgical procedure was effective in the prevention and treatment of vasculopathic impotence in Leriche's syndrome.

[The clinical aspects of using Vazaprostan in patients with atherosclerotic involvement of the vessels of the extremities]. / Klinicheskie aspekty primeneniia vazaprostana u bol'nykh s ateroskleroticheskim porazheniem sosudov konechnostei.

A study was made of the clinical efficacy of vasaprostane and its influence on peripheral hemodynamics, microcirculation and hemostasis. The results of the studies made it possible to ascertain that the drug is highly effective, which enables the abatement of the ischemic syndrome to be attained. Vasaprostane was found to improve regional hemodynamics and microcirculation. In addition, it corrected hemostatic disorders.

[A new method of surgical treatment of vasculogenic impotence]. / Novyi sposob khirurgicheskogo lecheniia vaskulogennoi impotentsii.

The authors describe a method of surgical management of vasculogenic impotence consisting in the formation of an anastomosis of an autovenous shunt with the dorsal artery of the penis. To prevent revascularization of the cavernous bodies of the penis with the restoration of erection, the dorsal artery of the penis is divided transversely at the root of the penis, the distal end of the autovenous shunt is given the shape of a trapezium with the upper side sutured, after which the autovenous shunt is anastomosed end to end with both the distal and proximal segments of the dorsal artery of the penis at the lateral sides of the trapezium where the angles were not sutured. The method allows incompetence and thrombosis of the vascular anastomosis to be prevented, raises the efficacy of revascularization of the cavernous bodies of the penis by creating favourable hemodynamic conditions through separation of the blood flow into the distal and proximal segments of the dorsal artery of the penis, which provides retrograde supply of blood into the deep artery of the penis sufficient for adequate revascularization of the cavernous bodies.

[Surgical treatment and prevention of angiogenic impotence in combination with revascularization of the lower extremities in Leriche's syndrome]. / Khirurgicheskoe lechenie i profilaktika vaskulogennoi impotentsii v sochetanii s revaskuliarizatsiei nizhnikh konechnostei pri sindrome Lerisha.

The article deals with the results of combined revascularization of the lower limbs and penis in 29 patients with Leriche's syndrome. It was accomplished by creating an autovenous shunt between the blades of the prosthesis or common femoral artery with the dorsal artery of the penis. In the late-term postoperative period the initially lost sexual function was restored in 6 patients and improved or maintained on the preoperative level in 16 patients. On the basis of comparison of the results with the sexual function in patients who were treated by bifurcation aortofemoral shunting it is concluded that the suggested surgical tactics in the prevention and treatment of vasculogenic impotence in Leriche's syndrome produces a significant clinical effect.

Predicting postoperative arterial pressure in renovascular hypertensive patients.

The authors have developed a method for forecasting the degree of the hypotensive effect of surgery for renovascular hypertension. Fifteen digital parameters were determined in 36 patients with unilateral lesions of the renal arteries by the following methods of preoperative examination: the establishment of the duration of hypertension, radio-isotope renography, determination of renin activity in the peripheral and renovascular (venous) blood, rheonephrography. The obtained set of characteristics was used for the prediction of postoperative arterial pressure values by means of one of the methods of mathematical statistics, the regression analysis in an "SM-4" electronic computer according to a specially created multivariate regression program in the "Fortran-4" language. The high accuracy of predicting the arterial pressure by this method was confirmed by clinical trials. Forecasting postoperative arterial pressure by this method allows us to substantiate with a high degree of fidelity the advisability of reconstructive surgery and opens up realistic prospects for improving its results.

[Importance of morphologic examination of the kidneys of patients with vasorenal hypertension for predicting the results of surgical treatment]. / Znachenie morfologicheskogo issledovaniia pochek bol'nykh vazorenal'noi gipertenziei dlia prognoza rezul'tatov khirurgicheskogo lecheniia.

Light-optical, electron microscopic and morphometric studies of biopsy material from kidneys of 24 patients with vasorenal hypertension were performed. It was determined that sclerosis of the arteries and arterioles on the side of the lesion was more marked, than in the contralateral kidney. At a later stage of the disease (more than 3 yr.) there were occasional signs of increased renin-synthesizing activity of the juxtaglomerular apparatus (JGA) with its simultaneous decrease at the stenotic side. JGA activation in the contralateral kidney can be one of the mechanisms supporting hyperrenin arterial hypertension and can prevent the decrease of the blood pressure after surgery. Studying of the biopsy material with the estimation of the sclerosis degree of the arterial tree vessels, as well as JGA activity, is important for prognosing the results of surgical treatment of vasorenal hypertension.

[Features of renal dynamics among patients with vasorenal hypertension according to rheographic findings]. / Osobennosti pochechnoi gemodinamiki u bol'nykh s vazorenal'noi gipertenziei po dannym reografii.

Preoperative and late postoperative rheonephrographic findings in 23 patients with vasorenal hypertension are reported. Renal rheography was supplemented with a controlled hypotension test. Diagnostic and predictive value of renal rheography and the controlled hypotension test is explained. Indirect evidence of the irreversible nature of renal angiosclerotic changes on the side of occlusive lesion was demonstrated in patients with poor surgical results and a relatively intact contralateral kidney.