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Abstract:

Introduction: in recanalization of chronic total occlusions (CTO), contralateral injection is the most important stage, significantly increasing chance of technical success and reducing the incidence of complications.

Materials and methods: 60-year old male patients, with angina pectoris, 3 functional class. After the examination, decision was made to conduct coronary angiography. According to coronarography, occlusion of proximal third of right coronary artery (RCA) was revealed, with collateral filling from the left coronary artery (LCA) R2 and the development of collaterals CC0. According to the scintigraphy data, a «viable myocardium» was detected behind the occlusion zone. Patient underwent mechanical recanalization of RCA with contralateral contrast-agent injection, balloon angioplasty, drug-eluting stents (DES) 3,5?38 mm and 3,5?24 mm were sequentially implanted with a good angiographic result.

Result: contralateral contrast-agent injection during this recanalization helped to avoid complications associated with perforation of lateral branches and greatly facilitated the positioning of guidewire into true lumen of artery. Patient continued military service under the contract.

Conclusion: in case of proper examination, management, and selection of patients, recanalization of chronic occlusion can significantly improve patient's quality of life. It is worth noting that for many patients, social indications are also important, such as the possibility to continue military service or work in a specialty. However, medical indications should be considered first, since unjustified recanalization of chronic occlusion will not improve patient's condition, and a number of serious complications may occur during the operation.

 

  

Abstract:

Background: the use of vascular closure devices (VCD) reduces the time of hemostasis, accelerates activation and discharge of the patient. Suture-mediated closure devices are closest in it's structure to the traditional surgical method of hemostasis. Advantages and disadvantages of these devices are mainly associated with design features. Stenoses, atherosclerosis, calcification and scars at the site of access are predictors of complications in the use of suturing devices. Although the effectiveness of these devices has been proven in several foreign studies, their data are not sufficient to draw clear conclusions.

Aim: was to evaluate advantages and disadvantages of using the suture-mediated closure devices after PCI.

Material and methods: study enrolled 208 adult patients, who underwent PCI in City Clinical Hospital named after M.P Konchalovsky, Moscow; FSBI «3 Central clinical military hospital n.a. A. A. Vishnevsky» Defense Ministry RF and SMRC preventive medicine of Department of Healthcare. Study group, where hemostasis after PCI was achieved by means of suture-mediated closure devices Perclose Pro Glide (Abbott Vascular), consisted of 90 patients, control group - 118 patients with manual hemostasis. Subjective feelings (pain, numbness, etc.) were assessed using a rating scale. The incidence of complications in the study group was 5.56%, in the control group - 6.78%. The comfort level of patients was higher in the study group

Results of the study: showed that the use of the Perclose device to achieve hemostasis after PC does not increase the frequency of regional vascular complications in compatison with manual hemostasis. But, at the same time, the use of VCD is an effective way to reduce the time of hemostasis, reduces the period of immobilization of the patient, which increases the patient's comfort and reduces patient's hospital stay.

 

 

References

1.      Caputo RP: Currently approved vascular closure devices. Card Interv Today: 70-76, 2012.

2.      Bechara CF, Annambhotla S, LinP H:Access site management with vascular closure devices for percutaneous transarterial procedures. J VascSurg 2010; 52:1682-1696. http://dx.doi.org/10.1016/j.jvs. 2010. 04.079.

3.      Sheth RA, Walker TG, Saad WE, et al: Quality improvement guidelines for vascular access and closure device use. J Vasc Interv Radiol. 2014; 25: 73-84. http://dx.doi.org/10.1016Zj.jvir.2013.08.011.

4.      Haas PC, Krajcer Z, Diethrich Edward B: Closure of large percutaneous access sites using the Prostar XL percutaneous vascular surgery device. J Endovasc Surg. 1999; 168-170.

5.      Barbetta I, van den Berg J: Access and hemostasis: femora and popliteal approaches and closure devices — Why, what, when, and how? Semin Interv Radiol 2014; 31:353-360. http://dx.doi.org/10. 1055/s-0034-1393972.

6.      Boschewitz J M, Pieper CC, Andersson M, et al: Efficacy and time-to-hemostasis of antegrade femoral access closure using the exoseal vascular closure device: A retrospective single-center study. Eur J Vasc Endovasc Surg 2014; 48:585-591. http://dx.doi.org/10.1016/ j.ejvs.2014. 08.006.

7.      Gutzeit A, van Schie B, Schoch E, et al: Feasibility and safety of vascular closure devices in an antegrade approach to either the common femoral artery or the superficial femoral artery. 2012; Cardiovasc Intervent Radiol 35:1036-1040. http://dx.doi.org/10.1007/s0 0270012-0454-5.

8.      Ward TJ, Weintraub J L: Vascular closure device update. Endovasc Today: 2015; 54-60.

9.      Hon LQ, Ganeshan A, Thomas SM, et al: An overview of vascular closure devices: What every radiologist should know. Eur J Radiol. 2010; 73:181-190,. http://dx.doi.org/10.1016/j.ejrad.2008.09.023.

10.    Krajcer Z: The preclose technique for AAA repair. Endovasc Today: 2011; 46-54.

11.    Gerckens U, Cattelaens N, Lampe EG, Grube E. Management of arterial puncture site after catheterization procedures: evaluating a suture-mediated closure device. Am J Cardiol. 1999; 83:1658-63.

12.    Baim DS, Knopf WD, Hinohara T, et al. Suture-mediated closure of the femoral access site after cardiac catheterization: results of the suture to ambulate and discharge (STAND I and STAND II) trials. Am J Cardiol. 2000; 85:864-9.

13.    Fram D.B., Giri S., Jamil G., et al. Suture closure of the femoral arteriotomy following invasive cardiac procedures: a detailed analysis of efficacy, complications, and the impact of early ambulation in 1200 consecutive, unselected cases. Cathet Cardiovasc Interv. 2001; 53:163-73.

14.    Balzer J.O., Scheinert D., Diebold T., et al. Postinterventional transcutaneous suture of femoral artery access sites in patients with peripheral arterial occlusive disease: a study of 930 patients. Cathet Cardiovasc Interv. 2001;53.

 

Abstract:

Aim: was to improve diagnostics of neck vessels' damage, by methods of traditional and CT-angiography

Material and methods: 65 injured patients with suspected damage of neck major vessels underwent examination. 52 persons had open traumas of the neck, 13 persons had closed traumas of the neck. Radiological diagnostics included CT-angiography and traditional angiography Main aim of examination was in determination of damage including both vessels and other structures of the neck, their localization and the nature of damage.

Results: CT-angiography gave possibilities:

           to give exact characterictics of all traumatic injures of the neck and to choose the group of patients with vessel traumas (23 patients)

           to define exactly the nature of the damage of neck vessels (aneurysm, thrombosis, rupture);

           to control the effectiveness of the surgical intervention.

Traditional angiography was applied in 10 observations of the traumatic aneurysm of neck vessel, for search of the additional diagnostic information. In comparison with results of CT- angiography any other precise information was not received.

Conclusions: analysis of the traditional and CT-angiography diagnostic possibilities of vessels damage, accompanying cervical trauma demonstrated high effectiveness of both methods. Traditional angiography should be used in absence of CTA in diagnostic arsenal. 

 

Referenses

1.      Korzhuk M.S., Kozlov K.K., Tkachev A.G. at al. Problems of medical care for injuries of major vessels of the neck. Sovremennye problemy nauki i obrazovaniya. 2014; 6: 1039 [In Russ].

2.      Mosyagin V.B., Slobozhankin A.D., Chernysh A.V et al. Experience in surgical treatment of closed lesions of major vessels of the neck. Vestnik Rossijskoj voenno-medicinskojakademii. 2013; 1 (41): 80-83 [In Russ].

3.      Vereshchagin S.V., Ahmad M.M.D., Kucher V.N. et al. The first experience of endovascular treatment of posttraumatic false aneurysms of aortic arch branches. Endovaskulyarna nejrorentgenohirurgiya. 2014; 2 (8): 64-70 [In Russ].

4.      Abakumov M.M. Multiple and combined wounds of the neck, chest, abdomen. Rukovodstvo dlya vrachej. 2013; 688 [In Russ].

5.      Mosyagin V.B, Chernysh A.V, Ryl'kov V.F. et al. Experience of surgical treatment of wounds of the neck. Vestnik Rossijskoj voenno-medicinskoj akademii. 2012; 3 (39): 86-90 [In Russ].

6.      Shabonov A.A., Trunin E.M. Treatment of wounds and injuries of major vessels of the neck. Vestnik Avicenny. 2011; 2 (47): 135-141 [In Russ].

7.      Sayyed Ehtesham Hussain Naqvi, Eram Ali, Mohammed Haneef Beg et al. Successful Resuscitation of a Cardiac Arrest following Slit Neck and Carotid Artery Injury: A Case Report. Journal of Clinical and Diagnostic Research. 2016; 10 (6): 25-27.

8.      Halimova A.A. Post-traumatic dissection of vertebral and major arteries as a complication of mechanical injury of the carotid artery on the background of a light traumatic brain injury. Nejrohirurgiya i nevrologiya Kazahstana. 2012; 4 (29): 29-32 [In Russ].

9.      Komelyagin D.Yu., Dubin S.A., Vladimirov F.I. et al. Clinical case of treatment of a patient with post-traumatic arteriovenous fistula in the neck. Detskaya hirurgiya. 2015;19 (5): 50-53 [In Russ].

10.    Griessenauer C.J., Foreman P.M, Deveikis J.P. et al. Optical coherence tomography of traumatic aneurysms of the internal carotid artery: report of 2 cases. J Neurosurg. 2016; 124 (2): 305-9.

11.    Shtejnle A.V., Alyab'ev F.V., Duduzinskij K.Yu. at al. History of surgery damages blood vessels of the neck. Sibirskij medicinskij zhurnal. 2008; 23 (2): 87-97 [In Russ]

 

Abstract:

19 males with unilateral symptomatic internal carotid artery stenosis were stented in 2007 using Mo.Ma cerebral protection device (Invatec, Italy). Angiographic success rate was 100%, average procedure time 53,7±9,9 min, ICA occlusion time 53,7±19,9 min. 2 patients presented transitory ischemic attack. Clinical improvement achieved in all cases. Our experience demonstrates that the Mo.Ma device effectively prevents intraprocedural cerebral embolism in carotid stenting, and the idea of proximal protection seems to be safe, user-friendly and very promising. 

 

 

Reference

 

1.     Brown M., Rogers J., Bland J. et al.Endovascular versus surgical treatment inpatients with carotid stenosis in the Carotidand Vertebral Artery Transluminal Angioplasty Study (CAVATAS): a randomised trial.The Lancet. 2001; 357: 1729-1737.

2.     Brooks W., McClure R., Jones M. et al. Carotidangioplasty and stenting versus caroti-dendarterectomy: randomized trial in a comnity hospital.J. Am. Coll. Cardiol. 2001; 38 (6):1589-1595.

3.     Wholey M.H., Al-Mubarek N., Wholey M.H.Updated review of the global carotid arterystent registry. Catheter. Cardiovasc. Interv. 2003.60 (2): 259-266.

4.     Roubin G., New G., Iyer S. et al. Immediateand late clinical outcomes of carotid artery stenting in patients with symptomatic and asymptomatic carotid artery stenosis: a 5-yearanalysis. Circulation. 2001; 103 (4): 532-537.

5.     McKevitt F.M., Macdonald S., Venables S. Et al. Complications following carotid angioplasty and carotid stenting in patients with symptomatic carotid artery disease. Cerebrovasc. Dis. 2004; 17 (1): 285-34.

6.     Ahmadi R., Willfort A., Lang W. et al. Carotidartery stenting: effect of learning curve and intermediate-term morphological outcome./Endovasc. Ther. 2001; 8 (6): 539-546.

7.     Reimers B., Schluter M., Castriota F. et al.Routine use of cerebral protection duringcarotid artery stenting: results of a multicenterregistry of 753 patients. Am. J. Med. 2004;116 (4): 217-222.

 

8.     Cremonesi A., Manetti R., Setacci F. et al.Protected carotid stenting: clinical advantagesand complications of embolic protectiondevices in 442 consecutive patients. Stroke.2003; 34 (8): 1936-1941.

 

9.     Aronow Н., Yadav J. Embolic Protection forCarotid Artery Stenting. A 'No Brainer'.Actachir. belg. 2004; 104: 65-70.

 

 

Abstract:

On the base of a case report article shows the role of interventional and diagnostic radiology in treatment of patients with multifocal atherosclerosis. Application of modern interventional cardiology methods expands the possibilities in treatment of patients with multifocal atherosclerosis, often in severe condition, and in senile group. Article provides literary data on the prevalence of multifocal atherosclerosis.

 

References

 1.    Bjerrum I.S., Sand N.P., Poulsen M.K., et al. Non-invasive assessments reveal that more than half of randomly selected middle-aged individuals have evidence of subclinical atherosclerosis: a DanRisk substudy. Int. J. Cardiovasc. Imaging. 2012. [Epub ahead of print].

2.     Sumin A.N., Gaifulin R.A., Bezdenezhnykh A.V., Mos'kin M.G., Korok E.V., Karpovich A.V., Ivanov S.V., Barbarash O.L., Barbarash L.S. Rasprostranennost multifokalnogo ateroskleroza v razlichnyh vozrastnyh gruppah. [Prevalence of multifocal atherosclerosis in different age groups] Кардиология. Kardiologiia. 2010; 52(6): 28-34 [In Russ].

3.     Belov U.V., Carchan E.R., Krasnikov M.P. Odnomomentnoe hirurgicheskoe lechenie porazhenia voshodiaschej dugi aorty, koronarnyh i sonnyh artetij u bolnogo s multifokalnym aterosklerozom) [Single-step surgical management of lesions of the ascending aorta and aortic arch, coronary and carotid arteries in a male patient with multifocal atherosclerosis]. Angiol. Sosud. Khir. 2012;18(1): 131-135[In Russ].

4.     Helgadottir A., Gretarsdottir S., Thorleifsson G., et al. Apolipoprotein(a) Genetic Sequence Variants Associated With Systemic Atherosclerosis and Coronary Atherosclerotic Burden But Not With Venous Thromboembolism. Am. Coll. Cardiol. 2012; 60(8): 722-729.

5.     Lammeren G.W., Catanzariti L.M., Peelen L.M., et al. Clinical prediction rule to estimate the absolute 3-year risk of major cardiovascular events after carotid endarterectomy. Stroke. 2012; 43(5): 1273-1278.

6.     Giugliano G., Di Serafino L., Perrino C., et al. Effects of successful percutaneous lower extremity revascularization on cardiovascular outcome in patients with peripheral arterial disease. Int. J. Cardiol. 2012. [Epub ahead of print].

7.     Matsuo Y, Takumi T, Mathew V, et al. Plaque characteristics and arterial remodeling in coronary and peripheral arterial systems. Atherosclerosis. 2012; 223(2): 365-371.

8.     Karimov Sh.I., Sunnatov R.D., Ganiev A.M., Keldierov B.K., Irnazarov A.A., Asrarov U.A., Iulbarisov A.A., Alidzhanov Kh. Diagnostika i taktika hirurgicheskogo lechenia bolnyh s multifokalnym aterosklerozom) [Diagnostics and strategy of surgical treatment of multifocal atherosclerosis]. Vestn. Ross. Akad. Med. Nauk. 2011; 1:14-18 [In Russ]. 

 

Abstract:

Choice of treatment strategy in patients with recurrent angina after coronary artery bypass graft surgery (CABG) is still an actual question. Repeat CABG is associated with an increased risk of mortality and large cardiovascular events, so percutaneous coronary intervention (PCI) is the main strategy in these patients. Criteria for choosing between the bypass and the native vessel stenting are not fully understood, as well as not resolved the question of the differentiated approach to the choice of defeat for stenting

Aim: was to compare long-term results of stenting of bypass and native coronary arteries in patients with recurrent angina after CABG using the algorithm proposed in the study.

Materials and methods: study was conducted in 2010-2014 years. in «3rd Central Military Clinical Hospital named after A.A.Vishnevsky of Ministry of Military Defence». A total of 168 patients with the defeat of coronary bypass graft were operated: revascularization of the native vessel - 80 patients, stenting of coronary bypass graft was performed in 88 patients.

Treatment groups were comparable in all major clinical characteristics of patients, as well as on the number of affected arteries, the total number of bypasses, the number of working bypasses, and diffuse lesion of the native channel.

The degree of stenosis of the native vessel was significantly higher in the second group, and the degree of stenosis of bypasses was significantly higher in the first group. Diffuse lesions of coronary bypasses were significantly more frequent in the first group.

Long-term results of the study were followed up in patients in the observation period of 3 to 36 months (mean follow-up was 21(14-27) months). The average duration was not significantly different between treatment groups.

Results: the incidence of myocardial infarction was comparable between groups. In group of coronary bypass graft stenting, revascularization procedures frequency was higher than in the native vessel revascularization (20,45% and 16,25%, respectively, p = 0,0045), and also had a higher incidence of target lesion revascularization (11.36% and 6.25%, respectively, p = 0,0045).

The cumulative rate of major cardiovascular events did not differ significantly, but there was a certain tendency toward a lower incidence of major cardiovascular events in the group of revascularization of the native vessel. 

 

References 

1.    Goldman S., Zadina K., Moritz T., et al. Long-term patency of saphenous vein and left internal mammary artery grafts after coronary artery bypass surgery: results from a Department of Veterans Affairs Cooperative Study. J. Am. Coll. Cardiol. 2004; 44:2149 -56.

2.    Бокерия Л.А., Алекян Б.Г. Руководство по рентгеноэндоваскулярной хирургии сердца и сосудов. Москва. Издательство НЦССХ им. А.Н. Бакулева РАМН. 2008. том 3; 592с.

Bokerija L.A., Alekjan B.G. Rukovodstvo po rentgenojendovaskuljarnoj hirurgii serdca i sosudov [Guideline for endovascular surgery of vesels and heart]. Moskva. Izdatel'stvo NCSSH im. A.N. Bakuleva RAMN. 2008. tom 3; 592s [In Russ].

3.    Brilakis E.S., de Lemos J.A., Cannon C.P., et al. Outcomes of patients with acute coronary syndrome and previous coronary artery bypass grafting (from the Pravastatin or Atorvastatin Evaluation and Infection Therapy [PROVE IT-TIMI 22] and the Aggrastat to Zocor [A to Z] trials). Am.J. Cardiol. 2008;102:552-8.

4.    Brilakis E.S., Wang T.Y, Rao S.V., et al. Frequency and predictors of drug-eluting stent use in saphenous vein bypass graft percutaneous coronary interventions: a report from the American College of Cardiology National Cardiovascular Data CathPCI registry. JACC Cardiovasc Interv. 2010; 3:1068-73.

5.    Brodie B.R., Wilson H., Stuckey T., et al. Outcomes with drug-eluting versus bare-metal stents in saphenous vein graft intervention results from the STENT (strategic transcatheter evaluation of new therapies) group. JACC Cardiovasc Interv. 2009; 2:1105-12.

6.    Brilakis E.S1, Rao S.V., Ba

Abstract:

Percutaneous coronary intervention is a method of choice in patients with recurrence of angina after aorto-coronary bypass. Endovascular interventions after aorto-coronary bypass are associated with a high risk of distal embolism and technical difficulties. On the other hand, revascularization of native coronary arteries in patients after aorto-coronary bypass, leads to worse results than PCI in patients without prior cardiac operations.

Aim: was to compare results of stenting of coronary bypass graft and native artery stenting in patients with recurrence of angina after aorto-coronary bypass, with use of proposed algorithm.

Materials and methods: for the period 2010-2014, in 3rd Central Military Clinical Hospital named after A.A.Vishnevsky of Ministry of Military Defence, 168 patients with coronary bypass defeat underwent operation: in 80 patients native artery reconstruction and in 88 - aorto-coronary bypass graft stenting were performed.

Due to impossible endovascular revascularization, 14 patients underwent repeated aorto-coronary bypass; after that they were excluded from research.

Included into research patietns were treated by different stents: drug-eluting stents (DES), bare metal stents (BMS) and combination BMS+DES. In first group the rate of DES implantation was higher (60% vs 37,5%); in the second group stent placement was comparable (DES 46,6% vs BMS 50%).

The results of this study show that the choice of revascularization strategy according to the presented algorithm, the short-term outcomes of both tactics are comparable.  

 

References 

1.    Epstein A.J., Polsky D., Yang F., Yang L., Groeneveld P.W. Coronary revascularization trends in the United States, 2001-2008. JAMA 2011; 305:1769-76.

2.    Hong M.K., Mehran R., Dangas G., et al. Are we making progress with percutaneous saphenous vein graft treatment? A comparison of 1990 to 1994 and 1995 to 1998 results. J. Am. Coll. Cardiol. 2001; 38:150-4.

3.    Morrison D.A., Sethi G., Sacks J., et al. Percutaneous coronary intervention versus repeat bypass surgery for patients with medically refractory myocardial ischemia: AWESOME randomized trial and registry experience with post-CABG patients. J. Am. Coll. Cardiol. 2002;40:1951-4.

4.    Harskamp R.E., Lopes R.D., Baisden C.E., de Winter R.J., Alexander J.H. Saphenous vein graft failure after coronary artery bypass surgery: pathophysiology, management, and future directions. Ann. Surg. 2013; 257(5):824-833.

5.    Bryan A.J., Angelini G.D. The biology of saphenous vein graft occlusion: etiology and strategies for prevention. Curr. Opin. Cardiol. 1994;9:641-9.

6.    Brilakis E.S., Wang T.Y, Rao S.V., et al. Frequency and predictors of drug-eluting stent use in saphenous vein bypass graft percutaneous coronary interventions: a report from the American College of Cardiology National Cardiovascular Data CathPCI registry. JACC. Cardiovasc. Interv. 2010;3:1068-73.

7.    Brodie B.R., Wilson H., Stuckey T., et al. Outcomes with drug-eluting versus bare-metal stents in saphenous vein graft intervention results from the STENT (strategic transcatheter evaluation of new therapies) group. JACC. Cardiovasc. Interv. 2009;2:1105-12.

8.    Nguyen T.T., O'Neill W.W., Grines C.L., et al. One-year survival in patients with acute myocardial infarction and a saphenous vein graft culprit treated with primary angioplasty. Am. J. Cardiol. 2003;91:1250-4

9.    Serruys P.W., Stoll H.P., Macours N. et al. Multivessel coronary revascularization in patients with and without diabetes mellitus 3-year follow-up of the ARTS-II (Arterial Revascularization Therapies Study-Part II) trial. J. Am. Coll. Cardiol. 2008; 52(24): 1957-1967.

10.  Rodriguez A., Baldi J., Pereira C.F. et al. for the ERACI II Investigators: Five-Year Follow-Up of the Argentine Randomized Trial of Coronary Angioplasty With Stenting Versus Coronary Bypass Surgery in Patients With Multiple Vessel Disease (ERACI II). J. Am. Coll. Cardiol. 2005; 46: 582-588.

11.  Serruys P.W., Donohoe D.J., Wittebols K. et al. The clinical outcome of percutaneous treatment of bifurcation lesions in multivessel coronary artery disease with the sirolimus-eluting stent: insights from the Arterial Revascularization Therapies Study part II (ARTS II). Eur. Heart J. 2007; 28(4): 433-442.

12.  Iakovou I., Schmidt T., Bonizzoni E. et al. Incidence, predictors and outcome of thrombosis after successful implantation of drug-eluting stents. JAMA. 2005; 293: 2126-2130.

13.  Banning A.P, Westaby S., Morice M.C. et al. Diabetic and Nondiabetic Patients With Left Main and/or 3- Vessel Coronary Artery Disease: Comparison of Outcomes With Cardiac Surgery and Paclitaxel-Eluting Stents. J. Am. Coll. Cardiol. 2010; 55: 1067-1075.

14.  Kappetein A.P, Dawkins K.D., Mohr F.W. et al. Current percutaneous coronary intervention and coronary artery bypass grafting practices for three-vessel and left main coronary artery disease.: Insights from the SYNTAX run-in phase. Eur. J. Cardiothorac. Surg. 2006; 29: 486-491.

15.  Serruys P.W., Morice M.C., Kappetein A.P et al. Percutaneous Coronary Intervention versus Coronary-Artery Bypass Grafting for Severe Coronary Artery Disease. N. Engl. J. Med. 2009; 360: 961-972.

16.  Serruys P.W., Ong A.T., Piek J.J. et al. A randomized comparison of a durable polymer everolimus-eluting stent with a bare metal coronary stent: The SPIRIT fist trial. Eurointervention. 2005; 1: 58-65.

17.  Babunashvili A.M. Ivanov V.A.: Hronicheskie okkljuzii koronarnyh arterij: anatomija, patofiziologija, jendovaskuljarnoe lechenie:[ Chronic occlusion of coronary arteries: anatomy, pathophysiology, endovascular interventions.] Monografija. Moskva: Izdatel'stvo ACB. 2012; 487-509 s [In Russ].

18.  Rolf A., Werner G.S., Schuhback A., et al. Preprocedural coronary CT angiography significantly improves success rates of PCI for chronic total occlusion. Int. J. Cardiovasc. Imaging. 2013 29(8):18191827.

Abstract:

Aim: was to assess the efficacy of surgical treatment of post-traumatic arteriovenous fistula with use of stent-grafts.

Materials and methods: stent-grafts were successfully used in treatment of 4 patients with post-traumatic arteriovenous fistula (AVF). In 2 cases AVF were located in iliac vessels, in 1 case in shin and in 1 case - thigh. In 3 cases, appearance of AVF was a result of gunshot wound, in 1 case - stab wound

Results: technical success was achieved in all cases. In 1 case after endovascular elimination of AVF on the level of iliac vessels, retroperitoneal hematoma with infection was revealed, that leaded to open surgical operation.

Conclusion: the use of stent-grafts in surgical correction of vessel injury can decrease operational trauma, and can achieve better clinical results and good long-term prognosis.  

 

References

1.    Petrovskij B.V., Milonov O.B. Hirurgija anevrizm perifericheskih sosudov [Surgery of peripheral vessels' aneurysms] M.: Medicina. 1970; 273S [In Russ].

2.    Kugukarslan N.L., Oz B.S., Ozal E.,Yildirim V., Tatar H. Factors affecting the morbidity and mortality of surgical management of vascular gunshot injuries: missed arterial injury and disregarded vein repair. Ulus Travma Acil Cerrahi Derg. 2007;13(1):43-48.

3.    Gavrilenko A.V. Travmaticheskie arteriovenoznye svishhi [Traumatic arteriovenous fistula]. OAO «Izdatel'stvo «Medicina» Klinicheskaja angiologija: Ruk. pod red. A.V. Pokrovskogo. 2004;2: 340-344 [In Russ].

4.    Gavrilenko A.V., Egorov A.A. Tradicionnaja hirurgija sosudov i rentgenjendovaskuljarnye vmeshatel'stva - konkurencija ili vzaimodejstvie, vedushhee k gibridnym operacijam? [Traditional sugery of vessels versus endovascular treatment: competition or cooperation, leading to the hybrid operation?] Angiologija i sosudistaja hirurgija. 2011; 17(4):152-156 [In Russ].

5.    Zotov S.P., Shherbakov A.V., Kugeev A.F., Zajcev S.S., Shakirov R.G., Semashko T.V., Zhabreev A.V., Panov I.O. Klinicheskie osobennosti posttravmaticheskih arterio- venoznyh svishhej [Clinical features of post-traumatic arteriovenous fistula]. Angiologija i sosudistaja hirurgija. 2011; 17(2):133-137 [In Russ].

6.    Li F., Song X., Liu C., Liu B., Zheng Y Endovascular stent-graft treatment for a traumatic vertebrovertebral arteriovenous fistula with pseudoaneurysm. Ann. Vasc. Surg. 2014; 2:489.

7.    Mensel B., Kuhn J.P, Hoene A., Hosten N., Puls R. Endovascular repair of arterial iliac vessel wall lesions with a self-expandable nitinol stent graft system. PLoS One. 2014; 9(8): journal.pone.0103980.

8.    Park H.K., Choe W.J., Koh YC., Park S.W. Endovascular management of great vessel injury following lumbar microdiscectomy. Korean J. Spine. 2013; 4:264-267.

9.    Sin'kov M.A., Murashkovskij A.L., Pogorelov E.A., Golovin A.A., Kalichenko N.A., Haes B.L., Kokov A.N., Heraskov V.Ju., Evtushenko S.A., Popov V.A., Barbarash L.S. Sluchaj uspeshnogo jendovaskuljarnogo zakrytija jatrogennogo arterio-venoznogo soust'ja podvzdoshnoj arterii i veny, projavljajushhegosja venoznym trombojembolicheskim sindromom i pravozheludochkovoj nedostatochnost'ju [Successful endovascular occlusion of iatrogenic arteriovenous fistula of the iliac artery and vein with thromboembolic syndrome and right ventricular insufficiency]. Diagnosticheskaja i intervencionnaja radiologija. 2014; 8(2):98-102 [In Russ].

 

 

Abstract:

In present time coronary angiography remains the "gold standart" in ischemic heart disease diagnostics. The correlation between angiographic or intravascular ultrasound (IVUS) variables and fractional flow reserve (FFR) in patients with intermittent lesion remain unclear. The aim of this article is to demonstrate complimentary use of fractional flow reserve evaluation and intravascular ultrasound for achieving optimal results during PCI.

 

 


 

Article exists only in Russian.

 

Abstract:

Purpose. Was to estimate the efficiency and sensitivity of X-ray-contrast (XRC), CT-angiography (CTAG) and colored duplex scanning (CDS) n diagnostics of patients with chronic abdominal ischemia (CAI)

Materials and methods. We have analyzed 1848 XRC, 436 CTAG and 181 CDS of patients with unpaired visceral artery branches of the abdominal aorta diseases, suffering from CAI.

Results. Due to CTAG, XRC and CDS we have revealed different levels of artery defeats, and also different types of stenotic and occlusion defeat.

Conclusions. CTAG is an effective screening method, and CDS - is an effective method of final diagnostics. Both of these methods should be included into algorithm CAI patients examination. 

 

References 

1.    Покровский А.В., Казанчан П.О., Дюжиков А.А. Диагностика и лечение хронической ишемии органов пищеварения. Ростов-на-Дону: Изд-во РостГУ. 1982; 321.

2.    Гавриленко А.В., Косенков А.Н. Диагностика и хирургическое лечение хронической артериальной ишемии. М.: Москва.2000; 308.

3.    Поташов Л.В., Князев М.Д., Игнашов A.M. Ишемическая болезнь органов пищеварения. М.: Медицина. 1985; 356.

4.    Ойноткинова О.Ш., Немытин Ю.В. Атеросклероз и абдоминальная ишемическая болезнь. М.: Медицина. 2001; 311.

5.    Шальков Ю.Л. Диагностика и хирургическое лечение хронических нарушений абдоминального артериального кровотока. Дис. д-ра мед. наук. Харьков. 1970; 340.

6.    Mikkelsen W.P., Zaro J.A. Intestinal angina, report of case with preoperative diagnosis and surgical relief. New. Engl. J. Med. 1959; 260 (5): 912-914.

7.    Аракелян В.С., Макаренко В.Н., Прядко С.И., Букацелло Р.Г. Возможности компьютерной томоангиографии в диагностике поражений непарных висцеральных ветвей аорты и определение показаний к их хирургической коррекции при хронической ишемии органов пищеварения. Ангиология и сосудистая хирургия. 2009; 15 (2 - прил.): 21.

8.    Егоров В.И., Яшина Н.И., Кармазановский Г.Г., Федоров А.В. КТ-ангиография как надежный метод верификации заболеваний, вариантов строения целиако-мезентериального бассейна. Медицинская визуализация. 2009; 3: 82-94.

9.    Mitchell E.L. et al. Duplex criteria for native superior mesenteric artery stenosis overestimate stenosis in stented superior mesenteric arteries. J. Vasc. Surg. 2009; 50 (2): 335-340.

10.  Moneta G.L. et al. Mesenteric duplex scanning. A blinded prospective stady. J. Vasc. Surg. 1993; 17: 79.

11.  Власов В.В. Введение в доказательную медицину. М.: Мед. Сфера. 2001; 392.

12.  Реброва О.Ю. Статистический анализ медицинских данных. Применение пакета прикладных программ STATISTICA. М.:Мед. Сфера. 2002; 305.

 


Article exists only in Russian.

 

Abstract:

The article describes results of analysis of five years of experience in the use of magnetic resonance angiography in the diagnosis of lesions of lower limb arteries. This method was used in survey of 489 patients with lesions of the abdominal aorta, arteries of the pelvis and lower limbs. Coverage of this study patients with abnormal lower limb arteries was 14.8%. Features of MR angiographic imaging, advantages and limitations of the method, the relationship with the method X-ray angiography are discussed.

 

 


 

Article exists only in Russian.


 

Article exists only in Russian.

 

 

Abstract:

The article presents the experience of endovascular treatment of abdominal aortic atherosclerotic lesions using different types of stents, performed in the Central Military Clinical Hospital named after A.A.Vishnevskogo.

Materials and methods: nine patients underwent 11 operations - stenting of aorta. Direct stenting of terminal aorta was performed in 5 patients, 4 - bifurcation stenting of aorta and both iliac arteries. Endovascular surgery combined with the "open" reconstruction of arteries below the inguinal ligament (hybrid operation) were performed in 2 cases.

Results: technical perioperative success of interventions with the restoration of the aortic lumen was achieved in all cases. Our experience in endovascular treatment of atherosclerotic lesions of the abdominal aorta, allows to characterize this surgical intervention as a highly effective and low-impact.

 

References

1.     Grollman J.H., Del Vicario M., Mittal A.K. Percutaneous transluminal abdominal aortic angioplasty. Am.J.Roentgenol. 1980; 134(5):1053-1054.

2.     Velasquez G., Castaneda-Zuniga W., Formanek A., Zollikofer C., Barreto A., Nicoloff D., Amplatz K., Sullivan A. Nonsurgical aortoplasty in Leriche syndrome. Radiology. 1980;134(2) 359-360.

3.     Onder H., Oguzkurt L., Gur S., Tekba$ G., Gurel K., Co kun I., Ozkan U. Endovascular treatment of infrarenal abdominal aortic lesions with or without common iliac artery involvement. Cardiovasc Intervent Radiol. 2013; 36(1):56-61.

4.     Ritter J.C., Ghosh J., Butterfield J.S., McCollum C. N., Ashleigh R. Chimney stent technique for treatment of severe abdominal aortic atherosclerotic stenosis. J. Vasc. Interv. Radiol. 2011; 22(3): 391-394.

5.     Sabri S.S., Choudhri A., Orgera G., Arslan B., Turba U.C., Harthun N.L., Hagspiel K.D., Matsumoto A.H., Angle J.F. Outcomes of covered kissing stent placement compared with bare metal stent placement in the treatment of atherosclerotic occlusive disease at the aortic bifurcation. J. Vasc. Interv. Radiol. 2010; 21(7): 995-1003.

6.     Bruijnen R.C., Grimme F.A., Horsch A.D., Van Oostayen J.A., Zeebregts C.J., Reijnen M.M. Primary balloon expandable polytetrafluoroethylene-covered stenting of focal infrarenal aortic occlusive disease. J. Vasc. Surg. 2012; 55(3): 674-678.

7.     Donas K.P, Schonefeld T., Schwindt A., Troisi N., Torsello G. Successful percutaneous endovascular treatment of symptomatic infrarenal aortic stenosis caused by soft-plaque with the Endurant stent-graft. J. Cardiovasc. Surg. (Torino). 2011;52(1): 89-92.

8.     Gavrilenko A.V., Egorov A.A. Tradicionnaja hirurgija sosudov i rentgenjendovaskuljarnye vmeshatel'stva - konkurencija ili vzaimodejstvie, vedushhee k gibridnym operacijam? [Traditional angiosurgery and endovascular procedures - competition or cooperation] Angidogija i sosudistaja hirurgija. 2011; 17(4): 152-156 [In Russ].

9.     Masmoudi H., Mordant P, Francis F., Karsenti A., Paraskevas N., Cerceau P, Duprey A., Leseche G., Castier Y Focal atherosclerotic abdominal aortic stenosis. J. Mal. Vasc. 2011; 36(3):196-199.

10.   Schwindt A.G., Panuccio G., Donas K.P, Ferretto L., Austermann M., Torsello G. Endovascular treatment as first line approach for infrarenal aortic occlusive disease. J. Vasc. Surg. 2011; 53(6):1550-1556. 

 

Abstract:

The article is devoted to one of the most modern methods of treatment of benign prostatic hyperplasia (BPH) - endovascular prostatic artery embolization (PAE). This kind of intervention is performed, usually, with approach through the common femoral artery Transradial vascular approach has many advantages over the femoral approach, but its use in this type of intervention is currently limited.

Aim: was to conduct a comparative analysis of the use of transradial and transfemoral vascular approach when performing PAE.

Materials and methods: in a group of transradial approach included 24 patients, and in the femoral approach group - 23 patients

Results: success rate of the procedure and the frequency of complications of vascular approach were comparable between groups. The total duration of the procedure, the time spent on catheterization of internal iliac and prostatic arteries, radiation exposure dose were significantly lower in the group of transradial approach. Using the transradial approach is associated with a significant reduction in the incidence and severity of the discomfort associated with the procedure.

 

References

1.     Lee C., Kozlowski J.M., Grayhack J.T. Intrinsic and extrinsic factors controlling benigh prostatic growth. Prostate. 1997; 31(2):131-138.

2.     American Urological Association: Guideline on the Management of Benigh Prostatic Hyperplasia (BPH). Revised 2010.

3.     Appleton D.S., Sibley G.N., Doyle P.T. Internal iliac artery embolisation for the control of severe bladder and prostate haemorrhage. Br. J. Urol. 1988;61(1):45-47.

4.     Michel F., Dubruille T., Cercueil J.P. et al. Arterial embolization for massive hematuria following transurethral prostatectomy. J. Urol. 2002; 168(6):2550-2551.

5.     Rastinehad A.R., Caplin D.M., Ost M.C. et al. Selective arterial prostatic embolization (SAPE) for refractory hematuria of prostatic origin. Urology. 2008;71(2):181- 184.

6.     DeMeritt J.S., Elmasri F.F., Esposito M.P. et al. Relief of benign prostatic hyperplasia-related bladder outlet obstruction after transarterial polyvinyl alcohol prostate embolization. J. Vasc. Interv. Radiol. 2000;11(6):767-770.

7.     Carnevale F.C., Antunes A.A., da Motta Leal Filho J.M. et al. Prostatic artery embolization as a primary treatment for benign prostatic hyperplasia: preliminary results in two patients. Cardiovasc. Intervent. Radiol. 2010;33(2): 355-361.

8.     Worthington-Kirsch R.L., Andrews R.T., Siskin G.P. et al. Uterine fibroid embolization: technical aspects. Tech. Vasc. Interv. Radiol. 2002;5:17-34.

9.     Carnevale F.C., da Motta-Leal-Filho J.M., Antunes A.A. et al. Quality of life and symptoms relief support prostatic artery embolization for patients with acute urinary retention due to benign prostatic hyperplasia. J. Vasc. Interv. Radiol. 2012;24:535-542.

10.   Bilhim T., Pisco J., Rio Tinto H. et al. Unilateral versus bilateral prostatic arterial embolization for lower urinary tract symptoms in patients with prostate enlargement. Cardiovasc. Intervent. Radiol. 2013;36(2):403-411.

11.   Mclvor J., Rhymer J.C. 245 transaxillary arteriograms in arteriopathic patients: success rate and complications. Clin. Radiol. 1992;45(6):390-394.

12.   Jolly S.S., Yusuf S., Cairns J. et al. Radial versus femoral access for coronary angiography and intervention in patients with acute coronary syndromes (RIVAL): a randomised, parallel group, multicentre trial. Lancet. 2011; 377(9775):1409-1420.

13.   Tavris D.R., Gallauresi B.A., Lin B. et al. Risk of local adverse events following cardiac catheterisation by hemostasis device use and gender. J. Invasive Cardiol. 2004; 16(9):459-464.

14.   Kanei Y, Kwan T., Nakra N.C. et al. Transradial cardiac catheterization: A review of access site complications. Catheter Cardiovasc. Interv. 2011;78(6):840-846.

15.   Caputo R.P, Tremmel J.A., Rao S. et al. Transradial arterial access for coronary and peripheral procedures: Executive summary by the transradial committee of the SCAI. Catheter Cardiovasc. Interv. 2011;78(6):823-839.

16.   Sherev D.A., Shaw R.E., Brent B.N. Angiographic predictors of femoral access site complications: implication for planned percutaneous coronary intervention. Catheter Cardiovasc. Interv. 2005;65(2):196-202. 

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