Abstract:

Traumas, complicated with the injury of blood vessels are the most grave situations in traumatology. Occurrence rate of such complicated traumas increased two or three times within past decade. The experience of angiographic evaluation of blood vessels injuries is represented in this article. 208 patients with vascular injuries underwent angiography within the period since 2003 till 2006. There were 177 men and 31 women. Angiographic findings were: false aneurism (pseudoaneurism) in 38% of cases, arteriovenous communication (fistula) in 7,2% of cases, occlusion of arterial lumen in 28,8% of cases, soft tissue hematoma in 6,2%, full transversal rupture of vessel in 1,5%, intimal dissection in 0,96% and absence of angiographic findings in 17,3% of cases. Angiography is the most informative diagnostic option in vascular trauma, which provides the possibility to determine the most optimal treatment option immediately.

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Abstract:

Aim: was to evaluate efficiency of stents-grafts in treatment of cerebral aneurysms.

Materials and methods: for the period of 2001-2012 implantation of stent-grafts was performedm 10 patients with cerebral aneurysms. Indications for implantation: huge or giant aneurysms; wide«neck» of aneurysm; difficult localization for neurosurgical techniques; absence of significant tortuosity of artery that could interfere successful stent delivery All patients underwent examination:

MSCT-angiography, MRI, cerebral angiography To predict possible stent thrombosis we performed angiographic tests with pinching of pathological artery and contrasting of opposite artery Then we assessed blood-flow of anterior and posterior communicating arteries and also changes in neurological status. Unsatisfactory condition of collateral blood-flow - was not a contraindication for stenting. In 8 patient, aneurysms were localized in internal carotid artery, and in 2 patients in the vertebrobasilar artery In 3 cases implantation of stent-graft was proceeded in acute period of hemorrhage; that caused late disaggregant therapy (immediately after implantation, drugs were injected through nasogastric tube instead of 4-5 days of preoperative treatment).

Results: exclusion of the aneurysm from the blood-flow was reached 100% of cases. In one case, implantation of micro-coils was necessary due to inability to cover the whole neck of the aneurysm because of tortuosity of artery In 1 case we had thrombosis of stent in vertebral artery with spreading of thrombosis on basilar artery with development of ischemic stroke and further death.

Conclusion: use of stent-grafts for exclusion of huge and giant aneurysms from cerebral blood- flow is a highly effective method.

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