[Malignant stenosis of the superior vena cava]. / Maligní stenóza horní duté zíly.

Superior vena cava syndrome is a distressing manifestation of a benign or malignant disease that obstructs the blood flow in the superior vena cava. Radiation and chemotherapy are often used to treat malignant forms of the disease. However, this therapy brings slow and sometimes incomplete regression of symptoms. Percutaneous administration of the metallic intravascular stents appears to be effective therapy. It offers immediate resolution and long-term relief of symptoms. Paper describes two patients with superior vena cava syndrome of a malignant aetiology where the incomplete but hemodynamicaly significant stenosis was successfully treated by percutaneous stenting.

[Reconstruction of the femoro-popliteal and peripheral portion in saphenous insufficiency]. / Náhradní rekonstrukce femoropopliteálního a periferního úseku pri nedostatku safény.

Implantation of a venous bypass is the best method of infraarticular and crural reconstructions. In 30%, however, a suitable saphenous vein is not available. If on account of severe ischemia revascularization is necessary, an alternative method must be selected. From a total number of 326 peripheral reconstructions with a distal anastomosis into the distal popliteal artery or crural artery the authors had to use instead of a long venous bypass a subsidiary reconstruction in 145 patients (44.6%). The authors implanted composite venous bypasses in 36 patients (24%), in 93 patients (64%) they combined a venous bypass with desobliteration of the superficial femoral artery and in 16 patients (11%) with an artificial prosthesis. For the end-to-end anastomosis of the prosthesis and vein the authors suggested a plastic operation by means of a venous patch which makes a short anastomosis possible with a smooth transit from a wide prosthesis into a narrow vein. The authors assume that in future ever more frequently the combination prosthesis and vein in the shape of a jump bypass will be preferred to other reconstructive methods, as it is relatively simple and rapid. Their hitherto assembled experience with this methods is favourable.

[The role of computer tomography in the diagnosis of aneurysms of the abdominal aorta]. / Uloha computerové tomografie v diagnostice aneurysmatu abdominální aorty.

The advantages of computer tomography are obvious. They include the non-invasive character of examination, the detection of aneurysms with a small diameter and the opportunity to check them systematically. Computer tomography is in the authors' opinion most effective in the differential diagnosis and for the assessment of the character of aneurysms--stable or unstable, and in particular in the diagnosis of initial stages of ruptures.

Significance of pedal arch for femoropopliteal vein bypass patency.

There are different opinions about the usefulness of preoperative arteriography. Therefore we resolved to show its importance for the distal runoff evaluation as well as for the indication and results of femoropopliteal vein bypasses. There were controlled 149 patients 1-5 years after femoropopliteal vein bypass implantations. Seventy six vein bypasses proved to be patent and seventy three were closed. The findings of preoperative arteriographies visualizating the whole arterial periphery, including the pedal arch arteries, were compared in both groups of patients. It was proved that the evaluation of the distal runoff by means of preoperative arteriography may be reliable and correct under condition of tibial and pedal arch arteries visualization. According to our experience, the preoperative arteriography can be performed in such a way to fulfil this indispensable condition. In rare case of preoperative arteriography repeated failure, it is the peroperative prebypass arteriography, which always is successful. In evaluating the distal runoff, there must be taken into consideration the whole arterial complex: tibial + pedal arch arteries. The patency of pedal arch seems to be more important than the number of patent tibial arteries. According to preoperative arteriographic findings, there is possible to distinguish three main types of distal runoff: (1) Sufficient runoff: whole pedal arch and 1-3 tibial arteries patent; (2) satisfactory runoff: partial pedal arch patency and 1-3 tibial arteries patent; (3) Unsufficient runoff: total pedal arch obliterations and 1-3 tibial arteries patency.

[Treatment of fracture of the talar joint using the malleolar transtibial traction loop]. / Lécení zlomenin hlezenného kloubu maleolární transtibiální taznou klickou.

The authors submit their own experience with the treatment of malleolar fractures by means of a transtibial traction malleolar loop of their own modification which makes it possible by means of a minimal amount of osteosynthetic material to fix all three fragments of the malleolar fracture, incl. the tibiofibular syndesmosis. The authors applied this method in 20 patients with good results.

[Significance of the pedal arch for patency of femoropopliteal bypasses]. / Význam pedálního oblouku pro pruchodnost femoropopliteálních bypassu.

The authors pay attention to the evaluation of drainage in indications of femoropopliteal reconstructions with regard to the patency of the peripheral circulation. Based on comparison of preoperative arteriographic findings regarding the patency of venous femoropopliteal bypasses in 149 operated patients the authors were able to confirm their previous assumption that when evaluating the drainage it is necessary to take into consideration not only the number of patent arteries on the leg but also the patency of their continuation in the area of the sole where they form the plantar arch. When evaluating the drainage it is thus necessary to evaluate the patency of the entire complex: arteries of the leg+plantar arch. From this ensues the authors' demand to use in indications of femoropopliteal reconstructions as a basis arteriography which visualizes the entire peripheral arterial circulation incl. the plantar arch.