Abstract:

From January 2003 till January 2008 transhepatic endobiliar stenting was performed in 62 patients with obstructive jaundice due to high post-operative malignant strictures of hepaticocholedochus duct. In 49 cases (79 %) two-step intervention performed (biliary drainage followed by endobiliary stenting), 13 patients (21 %) underwent single-stage intervention. In 60 patients (96,8%) balloon dilatation was done prior to stent implantation. In 59 cases (95,2%) the procedure was completed by control drainage placement. Hospital stay for the endobiliary stenting procedure was 12,7-22,3 days (average hospital stay 17,5 days). Mortality was as high as 12,9% (8 cases). Average post-implantation life span appeared to be 9,7 months. In 5 patients (8,1%) mechanical jaundice relapse occurred, so they needed hospitalization for reintervention. Direct dependence found between the effectiveness of endobiliary stenting and the technical characteristics of stents, anatomy of biliary strictures, as well as the methods and techniques of the intervention. Single-stage endobiliary stenting, without prior drainage, decreases the complication rate, improves the quality of life during the hospital stay, and prolongs the post-implantation life expectancy. Single-stege interventions are also shown to decrease the hospital stay and reduce the costs. Balloon dilatation is the required stage of the intervention, especially if self-expandable stents are used in torturous biliary ducts. Post-implantation drainage placement can be skipped if the wall of the hepatico-choledochus duct is not edematous, there are no signs of tumor prolapse into the lumen, if the stent is completely expanded, and the contrast media evacuates easily into the intestine.

Reference

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Abstract:

The authors report 44 successful implantations of original retrieval Nitinol stent-filters, unique "closed" design of which comprehensively described in the article. All the devices placed for pulmonary embolism (PE) management in patients with lower extremity and pelvic deep vein (DV) thrombosis. Authors announce absolute efficiency of their stent-filters for PE prophylaxis, and the procedure itself declared to be safe and minimally invasive.

Stent-filter implantation into iliac veins compared to standard filter placement in inferior vena cava (IVC) excludes risks of total infrarenal IVC thrombosis - the major complication of such procedures. It is also associated with early DV recanalization, that in sum radically reduces disability rate. Moreover, in case of IVC abnormalities, kinking or external compression stent-filter into iliac position remains the only option for endovascular PE management. All the above can be mentioned as advantages of using stent-filters.

At the same time authors observe that stent-filters quick incorporation into vessel wall prevented endovascular retrieval of the device in quite a number of cases. Persistent PE threat, requiring prolonged antithrombotic therapy under endovascular protection, might also contribute for low retrievability of the device. 

Reference

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Abstract:

By authors it is resulted results of application of system for Angojet rheolytic trombectomy in treatment of acute thromboses of the main veins and pulmonary embolism. On the basis of the data received with use rheolytic trombectomy in system vena cava superior and vena cava inferior and pulmonaty artery thrombosis? Authors conclude, that system Jet-9000 is a modern and highly effective method of treatment of venous tromboses of varios localisation and their complications. Authors specify? That tactic of the use of this method can provide as its isolated, and conjaction application with trombolytic therapy, ballon angyoplasty, stenting and others endovascular techniques. Besides rheolytic trombectomy is an alternative at existence contraindications for standard methods of treatment acute venouse thromboses. At the same time, authors emphasize, that in some cases rheolytic thrombectomy can be main method of treatment of patients with venous patology, before considered incurable (a thrombosis vena cava inferior after cavafilter-implantation, massive pulmonary artery thrombosis).

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Article exists only in Russian.

Abstract:

Endovascular interventions became widespread for last decade. The directional atherectomy with a SilwerHawk device is one of such methods of possible vascular restoration. This method has some advantages than balloon angioplasty or stenting.

Aim: Was to evaluate the efficiency of directional atherectomy with a SilwerHawk device with iliac arteries disease and arteries of legs disease.

Materials and methods: We have included nine patients with peripheral arterial disease in our study the endovascular directional atherectomy with a SilwerHawk device (EV-3) was performed in all patients. We used different accesses to the artery and protocols of interventions. In all cases we used distal embolic protection device «Spider» (EV-3).

Results: The immediate results of intervention were evaluated. We developed operation algorithms in different cases of vessel disease. The article describes the technical aspects and nuances of work with SilwerHawk device. The perioperative tactics of treatment are also considered in it.

Conclusion: Endovascular atherectomy is a new and effective method in treatment of patients with different peripheral arteries disease. It provides allows considerably to expand the field of methodics application. 

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