[Resuscitative endovascular balloon occlusion of the aorta in haemodynamically unstable patients with bleeding (webinar review)]. / Primenenie éndovaskuliarnoi ballonnoi okkliuzii aorty u gemodinamicheski nestabil'nykh patsientov pri krovotecheniiakh (obzor vebinara).

This article reviews a webinar of the European Society for Vascular Surgery and the Endovascular Trauma and Resuscitation Management Society, dedicated to using endovascular balloon occlusion of the aorta in haemodynamically unstable patients, briefly covering the main conclusions of the reports and underlining prospects of this method. Possibilities of using aortic balloon occlusion arise interest of various-specialty medical experts, and the number of scientific works in this field has increasingly been growing, thus explaining the need for measures and studies on the subject concerned.

[Modern strategy to improve remote results of surgical treatment of peripheral artery disease]. / Sovremennaia strategiia uluchsheniia otdalennykh rezul'tatov khirurgicheskogo lecheniia zabolevanii perifericheskikh arterii.

Treatment of patients presenting with peripheral artery disease requires a comprehensive approach: correction of risk factors, drug therapy and, if necessary, an endovascular/hybrid/open intervention. Reconstructive operation may effectively improve a patient's quality of life in intermittent claudication, save the limb and life in case of severe ischaemia. Discussed in the article are advantages and disadvantages of various types of surgical interventions for peripheral artery disease, the concept PLAN (Patient risk, Limb severity, and ANatomic complexity) and the new Global Anatomic Staging System (GLASS). Good remote results may be ensured by adequate medicamentous therapy. Variations of antithrombotic therapy are versatile and debatable. Long-term dual antithrombotic or systemic anticoagulant therapy with administration of vitamin K antagonists are not indicated for peripheral artery disease. In this connection, the findings of the COMPASS and VOYAGER PAD studies are analysed. The VOYAGER PAD trial showed that in patients with peripheral artery disease who underwent revascularization of lower limbs, the addition of rivaroxaban at a dose of 2.5 mg twice daily to aspirin decreased the risk of lower-extremity unfavourable ischaemic events and major adverse cardiovascular events by 15%. The obtained findings open new possibilities of conservative therapy having a significant role in decreasing the risk for development of limb-threatening conditions.

[Antithrombotic therapy in patients with peripheral artery diseases]. / Antitromboticheskaia terapiia u bol'nykh s zabolevaniiami perifericheskikh arterii.

Complications of cardiovascular diseases whose substrate is atherothrombosis continue to occupy leading positions in the structure of mortality worldwide. Peripheral artery diseases (PAD), in particular, are characterized by an especially unfavourable life prognosis for patients with cardiovascular diseases. In order to decrease the risks of ischaemic complications in patients with PAD, various approaches to antithrombotic therapy have over the last two decades been studied, with the resulting standard of therapy continuing to be acetylsalicylic acid. Even more difficult today is the task of selecting antithrombotic therapy in patients having endured revascularization.

[The efficacy of mexidol in carotid endarterectomy procedure in patients with cerebral atherosclerotic stenosis].

OBJECTIVE: To determine the antihypoxic efficacy of mexidol in carotid endarterectomy (CE) procedure in patients with cerebral atherosclerotic stenosis using cerebral oximetry. MATERIAL AND METHODS: Clinical/psycho/neurological monitoring was performed in 109 patients with internal carotid artery stenosis of 69±7.0% and neurological symptoms of cerebral ischemia, 2-3 degree, in pre- and postoperative periods. Cerebral oximetry was carried out perioperatively. Fifty-four patients were treated with mexidol in a dose of 1000 mg/day for 14-15 days and 55 patients did not received mexidol. RESULTS AND CONCLUSION: The difference in initial brain oxygenation (rSO2) between the main and comparison groups was shown (60.8±5.0 and 47.29±5.5%, respectively). During operation, the degree of blood oxygenation in these groups decreased by 57% and 41%, respectively. On day 7, sinificant differences in the Schulte test in two groups of patients with similar neurological status were found considering efficiency of work and mental stability before and after operation. No differences were found in the comparison group. Mexidol used for antihypoxic brain protection in carotid endarterectomy of patients with cerebral atherosclerotic stenosis significantly reduces the degree of cerebral hypoxia, decreases the duration of surgery, improves neurological status of patients and performance of psychological tests in postoperative period.

[The modern principles of management of intermittent claudication]. / Sovremennye printsipy lecheniya peremezhayushcheisya khromoty.

Number of patients with peripheral arterial disease, despite various national public health programs, remains high and has no steady downward trend over the past few decades. Despite recent advances in drug therapy, сonservative approach in the management of peripheral arterial disease is often neglected by vascular surgeons. However, vast majority of patients with intermittent claudication, who receive comprehensive conservative treatment, including risk factor modification, exercise and drug therapy, may get significant improvement in quality of life by partial or complete relief of symptoms related to the disease. Patients strictly adhering to medical recommendations has favorable prognosis and progression of disease to the stage of critical limb ischemia is very unlikely. Noncompliant patients and those who continue smoking in particular, often experience progression of symptoms related to the disease. That may result in the need for surgical intervention aiming to prevent or delay the onset of critical limb ischemia.

[Stagewise treatment of a patient with multifocal atherosclerosis, limb ischaemia, and surgical infection]. / Étapnoe lechenie patsienta s mul'tifokal'nym aterosklerozom pri ishemii konechnosti i khirurgicheskoi infektsii.

UNLABELLED: The authors share herein their experience in successful treatment of a male patient with multifocal atherosclerosis and lower-limb critical ischaemia complicated by erysipelas. THE AIM OF THE WORK: to show not only efficacy of iloprost (Ilomedin) used as conservative treatment in patients presenting with critical ischaemia and surgical infection in both pre- and postoperative periods in order to save the limb, but also the possibility of postponing reconstructive intervention, improving the patient's quality of life during this period, as well as shortening the duration of the postoperative period, and also to demonstrate both immediate outcomes of endovascular repair of an abdominal aortic aneurysm and remote results of comprehensive treatment for disseminated multifocal atherosclerosis with severe accompanying pathology.

[Optimization of the technique of the vascular anastomosis formation in reconstructive surgery of lower extremity arteries].

In reconstructive surgery of arteries of the femoro-popliteal-tibial segment the leading role belongs to autovenous bypass surgery. The standard kind of vascular bypass applied during this procedure is bypass "autovein end to the artery side" using the "parachute technique". The classical method means constant help of an assistant, certain inconvenience associated with inadequate fixation and positioning the autovein end, it also does not exclude risk of traumatism of the bypass posterior wall. The article presents an optimized variant of the technique of forming the "autovein end to the artery side" bypass using improved surgical instruments: atraumatic pincers and retractor and a proposed for the first time vascular dilatator.