[Experience in treatment of critical lower limb ischaemia on the background of diffuse arterial lesions].

The article deals with general statistical data on surgical treatment of chronic critical lower limb ischaemia on the background of diffuse arterial lesions. Also presented herein is an interesting clinical example of revascularization of a lower limb in diffuse arterial lesions by means of atypical bypass grafting.

[Successful outcome of treatment for a ruptured abdominal aortic aneurysm accompanied by inguinal hernia: a clinical case report].

The article deals with a clinical case report concerning surgical management of a male patient presenting with a ruptured abdominal aortic aneurysm. The postoperative period was complicated by strangulation of inguinal hernia inadvertently neglected during prior surgery, however then treated successfully by tension-free hernioplasty, with due conclusions eventually drawn.

[Simultaneous multi-storey bypasses in a poly-segmental lesion of lower-limb arteries in patients with critical ischaemia].

The article deals with therapeutic outcomes obtained in treating patients diagnosed with chronic critical ischaemia of the lower extremities, who were subjected to multi-storey shunting with the restoration of the major blood flow in the distal vascular bed and with the inclusion of the collateral bloodstream into the unaltered portions of the arterial segments. Also established was a distal anastomosis with the formation of an arteriovenous fistula. In the operated on patients, the manifestations of critical ischaemia of the lower limbs were coped with intraoperatively, and the check-up Dopplerograms taken during the follow-up period showed the presence of the major blood flow along the bypasses and more distally along the anterior tibial artery.

[Comparative assessment of different methods of treatment of chronic critical ischemia of lower extremities in elderly and senile patients]. / Sravnitel'naia otsenka razlichnykh sposobov lecheniia khronicheskoi kriticheskoi ishemii nizhnikh konechnostei u bol'nykh pozhilogo i starcheskogo vozrasta.

Results of using different methods of treatment of chronic critical ischemia of lower extremities were analyzed in 267 elderly and senile patients. Ischemia of the lower extremities of the III degree was noted in 83% of the patients, the IV degree ischemia--in 17%. In 86 patients who underwent primary high amputation of the lower extremity 2 years survival was noted in 33.7%. In 89 patients treated conservatively during 12-14 days good and satisfactory results were obtained in 58.4%, amputations were made in 41.6%. The 2 years survival was 66.3%. In 92 patients primary reconstructive operations resulted in good and satisfactory outcomes in 75 (81.5%) out of them with the 2 years survival in 88.0%.

[Application of xenogeneic bioprostheses in reconstruction of the arteries of infrainguinal localization]. / Primenenie ksenogennykh bioprotezov v rekonstruktsii arterii infraingvinal'noi lokalizatsii.

The application of 37 xenogenous bioprostheses was carried out in reconstruction of the arteries of infrainguinal localization in 37 patients (34 men and 3 women). Patients older than 60 years made up 67.2%. Most of the patients had occlusion of the femoral artery and lesions of the tibial arteries: one artery in 26 (70.2%), two arteries in 3 (8.1%) patients. The femoro-proximal-popliteal shunt was performed in 15 (40.5%) patients, in 22 (59.5%) patients long shunts were implanted (in 9--femoro-proximal-popliteal shunting, in 13--femoral-tibial). During the shunting operations a reconstruction of the inflow pathways was carried on (aorto-femoral shunting, endarterectomy from the iliac-femoral segment). The results of the reconstructive operations on the lower extremities with the application of xenoprostheses were estimated as good in 28 (75.6%) patients, in 6 (16.2%) patients--as satisfactory, in 3 (8.2%)--as bad. There were no lethal outcomes.

[Reconstructive surgeries on deep femoral artery in chronic critical limb ischemia]. / Rekonstruktivnye operatsii na glubokoi arterii bedra pri khronicheskoi kriticheskoi ishemii konechnostei.

Possibilities of revascularisation of the lower extremity through the deep femoral artery in elderly and aged patients with chronic critical limb ischemia were evaluated. Forty-nine patients with high surgical risk were studied. Safety of the extremity, decrease of ischemia degree and level of amputation were the main problems in surgical treatment. Deep-femoral-popliteal index was very important. If this index was less 0.3 surgeries on deep femoral artery were effective. If index was 0.3-0.5 results of surgery were questionable. Index more than 0.5 is the factor of unsuccessful revascularisation through the deep femoral artery.

[Prevention of purulent complications after reconstructive vascular operations in elderly and aged patients]. / Profilaktika gnoinylh oslozhnenii posle rekonstruktivnykh operatsii na sosudakh u bol'nykh pozhilogo i starcheskogo vozrasta.

Results of surgical treatment of 382 patients with III-IV stages critical limb ischemia and concomitant diseases were analyzed. The mean age of the patients was 67.7 years. All the patients underwent reconstructive operations on lower limbarteries. Three variants of antibiotic therapy were compared: 1) antibiotics were administered parenterally; 2) they were injected endolymphatically; and 3) they were used parenterally and endolymphatically. Combined antibiotic, i.e. a combination of parenteral and endolymphatic routes of administration was most effective.