Abstract:

Treatment of massive hemoptysis represents a major and important medical problem in surgery. Development of endovascular surgery allows to introduce principle new methods of minimally invasive treatment of this pathology Current review represents information about bronchial artery anatomy, pathologic features of the bronchial artery, material used during embolization procedure and possible complications of treatment.

Abstract:

We have analyzed long-term results of different revascularization strategies in 171 patients with multivessel coronary artery defeat. Duration of follow up observation ranged from 12 to 18 months. Complete revascularization of the myocardium was performed in 63 pts, culprit vessel revascularization - in 86 and incomplete revascularization - in 22 patients. All patients undervwent SYNTAX scoring analysis to find out possible risks of transcutaneus coronary interventions. Survival rate, incidence of myocardial infarction, repeat myocardial revascularization procedures and major adverse cardiac events were comparable among the patients with low and intermediate SYNTAX Score. Among the patients with high SYNTAX Score the incidence of myocardial infarction (8,82%, р = 0,002), repeat PCI procedure (32,35%, р = 0,001) and major adverse cardiac events (32,35%, р = 0,002) was reliably higher compared to patients with low and intermediate SYNTAX Score. The mpact of the SYNTAX Score rate on the long-term results in the different revascularization strategy groups was also analyzed. In the 1st group the incidence of major adverse cardiac events among the patients was comparable. In the 2nd group patients with the high SYNTAX Score rate had reliably higher rate of major adverse cardiac events (43,75%, р = 0,002). The rate of major adverse cardiac events were higher in the 3rd group of patients with the high SYNTAX Score rate compared in patients with low and intermediate SYNTAX Score rate, but this difference didn't reach statistically reliable difference. Use of the strategy of culprit vessel revascularization in the patients with high SYNTAX Score rate, leads to increased rate of major adverse cardiac events and repeat PCI procedures in the long-term follow up period.

References 

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Abstract:

Comparative analysis of transradial and transfemoral approach for uterine artery embolization is presented.

Materials and methods: for the period from september 2013 to december 2014, 58 women underwent uterine artery embolization (UAE). Age varied from 25 to 49. Transradial approach (TRA) was used in 26 patients (44,8%), transfemoral approach (TFA) - in 32 patients (55,2%).

Results: uterine artery embolization was successful in all patients in both groups. Operation duration was 20,7 minutes in TRA group and 26,3 in TFA group (p>0,05). Mean number of used catheters was lower in TRA group (1,2 and 2,3 respectively p>0,02). In early post-operative period there was no complication in access place in TRA group, in 2 cases (7,7%) small subcutaneous hematomas were noted. They didn't require any special treatment. In TFA group, in 1 case (3.1%) it was noted the presence of hematoma, 5 cm in diameter, and in 4 cases (12,5%) - there were small subcutaneous hematomas that didn't require any special treatment. The usage of TRA is associated with a statistically significant reduction in the incidence of all parameters of discomfort, associated with UAE and improving the quality of life of patients in the early post-operative period compared with TFA. Significantly more often in patients with TRA group compared to the group TFA completely absent from the discomfort associated with the procedure (61.5% and 6.25%, respectively, p <0,001).

Conclusions: the use of TRA allowed to decrease an average of 29.6% of total duration of the intervention, decrease up to 51.5% of time spent on the uterine artery catheterization and 40.8% patient radiation dose. In addition, TRA allowed early mobilization of patients and reduced by 59% the incidence of discomfort associated with the UAE.  

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