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:

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:

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.

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.