Abstract:

Introduction: the problem of the shortage of donor organs can be partially solved by expanding the donor selection criteria. The consequence of this is an increase in the risk of transmission of atherosclerotic lesions of the coronary arteries from the donor to the recipient. According to current publications, endovascular correction is the preferred treatment. Assessment of the hemodynamic significance of borderline stenosis of the coronary arteries in recipients, detected at the first coronary angiography in the early postoperative period, remains a topical issue.

Case report: article presents case report of results of endovascular correction of donor-associated lesion of coronary arteries in recipient under control of iFr.

Conclusion: due to the severity of patient's condition, the use of non-invasive methods for verifying myocardial ischemia is sharply limited, which determines the high importance of endovascular technologies for the physiological assessment of stenosis.

References

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3.     Sakhovsky SA, Izotov DA, Koloskova NN, et al. Angiograficheskaya otsenka ateroskleroticheskogo porazheniya koronarnikh arterii serdechnogo transplantata. Vestnik transplantologii i iskusstvennih organov. 2018; 20(4): 22-29 [In Russ].

https://doi.org/10.15825/1995-1191-2018-4-22-29

4.     Chestukhin VV, Ostroumov EN, Tyunyaeva IYu, et al. Bolezn’ koronarnikh arterii peresazhennogo serdtsa. Vozmozhnosti diagnostiki i lecheniya. Ocherki klinicheskoi transplantologii pod redakciei Got’e SV. M. 2009; 88-93 [In Russ].

5.     Darenskii DI, Gramovich VV, Zharova EA, et al. Diagnosticheskaya tsennost izmereniya momental’nogo rezerva krovotoka po sravneniyu s neinvazivnimi metodami viyavleniya ishemii miokarda pri otsenke funktsionalnoi znachimosti pogranichnikh stenozov koronarnikh arterii. Terapevticheskii arkhiv. 2017; 4: 15-21 [In Russ].

6.     Gramovich VV, Zharova EA, Mitroshkin MG, et al. Opredelenie porogovikh znachenii momental’nogo rezerva krovotoka pri otsenke funktsionalnoi znachimosti stenozov koronarnish arterii pogranichnoi stepeni tyazhesti s ispolzovaniem neinvazivnikh metodov verifikatsii ishemii miokarda v kachestve standarta. Evraziiskii kardiologicheskii zhurnal. 2016; 4: 34-41 [In Russ].

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https://doi.org/10.1056/NEJMoa0807611

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https://doi.org/10.1056/NEJMoa1205361

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https://doi.org/10.1056/NEJMoa1803538

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https://doi.org/10.1016/j.jacc.2016.08.055

11.   G?tberg M, Christiansen EH, Gudmundsdottir IJ, et al. Instantaneous Wave-free Ratio versus Fractional Flow Reserve to Guide PC. The New England Journal of Medicine. 2017; 376: 1813-23.

https://doi.org/10.1056/NEJMoa1616540

12.   Andell P, Berntorp K, Christiansen EH, et al. Reclassification of Treatment Strategy With Instantaneous Wave-Free Ratio and В Fractional Flow Reserve: A Substudy From the iFR-SWEDEHEART Trial. JACC: Cardiovascular Interventions. 2018; 11(20): 2084-2094.

https://doi.org/10.1016/j.jcin.2018.07.035

13.   Davies JE, Sen S, Dehbi HM, et al. Use of the Instantaneous Wave-free Ratio or Fractional Flow Reserve in PCI. The New England Journal of Medicine. 2017; 376: 1824-1834.

https://doi.org/10.1056/NEJMoa1700445

14.   Neumann FJ, Sousa-Uva M, Ahlsson A, et al. ESC Scientific Document Group; 2018 ESC/EACTS Guidelines on myocardial revascularization. European Heart Journal. 2019; 40(2): 87-165.

https://doi.org/10.1093/eurheartj/ehy394

Abstract

Aim: was to study features of the clinical course, instrumental and biochemical parameters of patients with atherosclerotic aneurysmal expansion of the abdominal aorta on the base of retrospective analysis and prospective observation to determine indications for timely surgical correction.

Materials and methods: patients with the maximum diameter of the infra-renal abdominal aorta from 26 to 50mm (n=60) without primary indications for surgical treatment (endovascular abdominal aortic aneurysm repair) were selected for the prospective follow-up group. For the period of 2 years, all patients from prospective group underwent duplex scanning of the abdominal aorta every 6 months and multislice computed tomography (MSCT) of the aorta – once a year. The retrospective analysis included results of preoperative clinical-instrumental and laboratory examination of patients (n=55) who underwent endovascular aneurysm repair (EVAR) of the abdominal aorta with a maximum diameter of the infra-renal abdominal aorta more than 50mm.

Results: when comparing clinical, instrumental and biochemical parameters in patients with abdominal aortic aneurysm (AAA) before surgery and atherosclerotic aneurysmal abdominal aortic expansion of different degrees, not requiring surgical correction at the time of inclusion, it was shown that patients with AAA, statistically significantly differed from patients with AAA in clinical symptoms (pulsation and abdominal pain), burdened heredity, the number of smokers. There were no statistically significant differences in the severity of coronary and peripheral atherosclerosis. When comparing results of ultrasound duplex scanning and MSCT to estimate linear dimensions of the abdominal aorta in the group of patients with aneurysmal dilation and in the group of patients with abdominal aortic aneurysm, the comparability of results has been revealed. Prospective observation of patients with abdominal aortic aneurysmal dilation revealed predictors of disease progression: age less than 65 years, diameter of the upper third of the abdominal aorta more than 23mm, maximum diameter of the abdominal aorta more than 43mm, length of aneurismal dilation more than 52mm.

Conclusion: obtained results allowed to determine most informative indicators and criteria for the progression of atherosclerotic aneurysm expansion of the abdominal aorta, to determine further tactics of treatment, including the need for surgical correction of this pathology.

References

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7.     Moll FL, Powell JT, Fraedrich G, Verzini F, Haulon S, Waltham M, van Herwaarden JA, Holt PJ, van Keulen JW, Rantner B, Schlosser FJ, Setacci F, Ricco JB; European Society for Vascular Surgery. Management of abdominal aortic aneurysms clinical practice guidelines of the European Society for Vascular Surgery. Eur J Vasc Endovasc Surg. 2011; 4: 1-58.

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9.     National recomendations on management of patient with abdominal aorta aneurysms. Angiology and vascular surgery. 2013; 19(2) (appendix) [In Russ].

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12.   Lindholt JS, Bjorck M, Michel JB. Anti-platelet treatment of middle-sized abdominal aortic aneurysms. Curr Vasc Pharmacol. 2013; 11(3): 305-13.

13.   Chaikof EL. The Care of Patients with an Abdominal Aortic Aneurysm: The Society for Vascular Surgery Practice Guidelines. EL Chaikof, DC Brewster, RL Dalman [et al.] J. Vasc. Surg. 2009; 50(4): Suppl. 2-49.

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15.   Johnston KW, Rutherford RB, Tilson MD. Suggested Standards for Reporting on Arterial Aneurysms. Subcommittee on Reporting Standards for Arterial Aneurysms, Ad Hoc Committee on Reporting Standards, Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery. J. Vasc. Surg. 1991; 13 (3): 452-458.

16.   Ashton HA, Buxton MJ, Day NE, Kim LG, Marteau TM, Scott RA, et al., Multicentre Aneurysm Screening Study Group. The Multicentre Aneurysm Screening Study (MASS) into the effect of abdominal aortic aneurysm screening on mortality in men: a randomised controlled trial. Lancet. 2002;360(9345):1531-9. doi: http://dx.doi.org/10.1016/S0140-6736(02)11522-4. PubMed.

17.   Johansson M, Zahl PH, Volkert Siersma V, Jorgensen KJ, Marklund B, Brodersen J. Benefits and harms of screening men for abdominal aortic aneurysm in Sweden: a registry-based cohort study. Lancet. 2018; 391(10138): 2441-2447.

18.   Anjum A, Powell JT Is the incidence of abdominal aortic aneurysm declining in the 21st century? Mortality and hospital admissions for England & Wales and Scotland. Eur J Vasc Endovasc Surg. 2012; 43: 161-166.

Abstract

This study presents an overview of modern methods of surgical and endovascular treatment of atherosclerotic lesions of the superficial femoral artery

Aim: was to analyze the state of surgical and endovascular treatment of atherosclerotic lesions of the superficial femoral artery according to the modern literature in the field of vascular surgery

Results: this review analyzes more than 30 relevant publications presented in both domestic anc foreign press over the past 20 years, taking into account a variety of meta-analyses.

Conclusions: this topic is very relevant today, as the increase in the number of surgical and endovascular interventions in lesions of the superficial femoral artery dictates new research to develop optimal tactics of treatment of this category of patients.

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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

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Abstract:

A reduced level of female sex hormones at menopause leads to development of atherosclerotic manifestations as well as to reduction of bone mineral density The total estimation of changes in blood vessels and bone tissue on the basis of comparison of SCORE scale and FRAX® program ir a single two-dimensional coordinate system makes it possible to determine degree of risks of cardiovascular complications and fractures in the near future of each individual patient.

Aim: was to assess risks of cardiovascular complications and fractures in women in the early postmenopausal period based on the data of SCORE scale and FRAX® program.

Materials and methods: research included 25 women in the variable menopause period without a previous cardiovascular disease (CVD) and osteoporosis (OP). A standard clinical examination, laboratory tests of lipid spectrum, determination of pulse wave velocity, doppler ultrasound of main arteries of the head with the definition of the thickness of the intima-media complex (IMC) of common carotid arteries(CCA), dual energy X-ray absorptiometry were carried out, risk calculations on the basis of SCORE scale and FRAX® computer program were studied. Re-examination of 25 patients was carried out not less than 12 months after the cessation of menses.

Results: baseline characteristics: low risk (less than 1%) was observed in 72% of women on SCORE scale, and 100% of women (less than 10%) was observed on FRAX®. An increasing number of risk factors enhances the performance of «early» markers of atherosclerosis (CPV-13,0 + 3,4 m/s; thickness IMA of CCA-0.95+0,11 mm) and statistically significant (p <0,05) decrease of mineral bone density (BMD). In the early stage of menopause, an increase in the total risk of cardiovascular complications and fractures in coming 10 years was observed. So poor performance risk was observed in 64% of women on SCORE scale, and risk of fractures was observed in 96% of patients on FRAX®.

Conclusion: distribution of studied parameters in a two-dimensional table in accordance with results of the SCORE scale and FRAX® program revealed the prevalence of patients with low values. After 12 months, the growth of BMD was noted in the decrease of number of patients (64%) with low risks and the occurrence of women (8%) with moderate risk of fractures and no cardiovascular risk. BMD study in the early postmenopausal period found a slight decrease in BMD in 48% of women, osteopenia - 44%, osteoporosis - 8%. The comparison of results of both methods makes it possible to assess objectively risks of cardiovascular disease and risk of fractures in each individual patient in next 10 years of their lives. 

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8.     Skripnikova I. A. Osteoporosis and osteopathy. Abstracts of the IV Russian Congress on osteoporosis «Chto svyazyvaet osteoporoz i serdechno-sosudistyye zabolevaniya, obuslovlennyye aterosklerozom (CCZ-AS)?»[What connects osteoporosis and cardiovascular disease caused by atherosclerosis (CVD-al)?]. Moscow. 2010; (1):66. [In Russ].

9.     Ershova O. B. Kommentarii k prakticheskomu ispol'zovaniyu Rossiyskikh klinicheskikh rekomendaciy po osteoporozu. [Comments to the practical use of the Russian clinical recommendations for osteoporosis]. Osteoporosis and osteopathy. Scientific-practical journal. 2010; (1):34-46 [In Russ].

10.   Skripnikova I. A., Oganov R.G. Osteoporoz i serdechno-sosudistyye zabolevaniya, obuslovlennyye aterosklerozom, u zhenshchin postmenopauzal'nogo perioda: obshchnost' povedencheskikh i social'nykh faktorov riska. [Osteoporosis and cardiovascular diseases caused by atherosclerosis, postmenopausal women: a community behavior al and social risk factors]. Osteoporosis and osteopathy. 2009; (2):5-9 [In Russ].

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. 

References 

1.      Norgren L., Hiatt W., Dormandy J. et al. Inter Society Consensus for the Management of peripheral Arterial Disease (TASC II). J. Vasc. Surg. 2007; 1:1-75.

2.      Покровский А.В., Алекян Б.Г., Аралекян В.С. и соавт. Диагностика и лечение больных с заболеваниями периферических артерий. (Рекомендации Российского общества ангиологов и сосудистыххирургов) Москва 2007.

3.      King S., Smith S., Hirshfeld J. et al. 2007 focused update of the ACC/AHA/SCAI 2005 guideline update for percutaneous coronary intervention: a report of the American College of Cardiology/American Heart Association Task Force on Practice guidelines. J. Am. Coll. Cardiol. 2008; 51(2): 172-209.

4.      Abstracts of CIRSE (Cardiovascular and Interventional Radiological Society of Europe) 2010.Cardiovasc Intervent Radiol. 2010; 33(2):14-313.

5.      John L. Limitations of Percutaneous Transluminal Angioplasty and Stenting for the Treatment of Disease of the Superficial Femoral and Popliteal Arteries. Journal of Endovascular Therapy. 2006; 13(2): 30-40.

6.      Thomas Z. Current state of endovascular treatment of femoro-popliteal artery disease. Vasc Med. 2007; 12: 223.

7.      Adam D., Beard D., Cleveland T. et al. Bypass versus angioplasty in severe ischaemia of the leg (BASIL): multicentre, randomised controlled trial. Lancet. 2006; 367(9525): 14.

8.      Schillinger M, Minar E. Past, present and future of femoropopliteal stenting. J Endova,sc Ther. 2009; 16(1): 52-147.

9.      Cotroneo A., Pascali D., Santoro M. et al. Endovascular treatment of femoropopliteal steno-obstructive disease with percutaneous transluminal angioplasty: midterm results. Radiol. Med. 2008; 113(7): 1043-55.

10.    Furuichi S., Sangiorgi G., Colombo A. Early Occlusive Restenosis Due to Self- Expandable Stent Squeeze in the Popliteal Artery. J. Invasive Cardiol. 2007; 19(10): E300-2.

11.    Laird J., Katzen B., Scheinert D. et Al. Nitinol stent implantation versus balloon angioplasty for lesions in the superficial femoral artery and proximal popliteal artery: twelvemonth results from the RESIL

Abstract:

Aim: was to compare fabric mineral density in women after bilateral ovarioectomy with hormonal replacement therapy and without it after 10 years of monitoring.

Materials and methods: we have examined 87 women after bilateral ovarioectomy with hysterectomy Patients were divided into 2 groups: 50 women with hormonal replacement therapy (1st group) and 37 patients without it (2nd group). All the patients were comparable by age at the moment of operation. Patients from the 1st group underwent examination twice: before operation and 13,1+5,6 years after the operation. Patients from the first group were examined once -11,4±4,1 yrs after the operation. Bone fabric mineral density was measured in 3 regions: lumbar department of a backbone, in a neck of a hip and in proximal department of a femur.

Results: on the base of obtained data it was found out that decreasement of bone fabric mineral density is different due to region of skeleton. Hormonal replacement therapy can decrease the speed of osteoporosis in women after hysterectomy, and that leads to decreased level of fractures in the postoperative period. 

References 

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2.      Руководство по остеопорозу. (Под ред. Боневоленской Л.И.) М.: Бином. Лаборатория знаний. 2003; 523.

3.      Руководство по климактерию. (Под ред. Кулакова В.И., Сметник В.П.) М.: Мед. информ.издат. 2001; 685.

4.      Лесняк О.М., Боневоленская Л.И. Остео- пороз. Диагностика, профилактика, лечение. Клинические рекомендации. М.: «ГЭОТАР». 2009; 219.

5.      Jilka R.L., Cytokines, bone remodeling and estrogen deficiency: a 1998 update. Bone. 1998; 23: 75-81.

6.      Riggs B. The mechanisms of estrogen regulation of bone resorption. J.Clin. Invest. 2000; 106: 120-126.

7.      Kimble R.B., Matayoshi A.B., Vannice J.L., et al. Simultanious block of interleikin-1 and tumor necrosis factor is reguered to completely prevent bone loss in the early postovarioectomy period. Endocronol. 1995; 136: 3054-61.

8.      Кулаков В.И., Юренева С.В., Майчук Е.Ю. Постовариоэктомический синдром. Клиническая лекция. М.: Орион корпорейшн. 2003; 15.

9.      Рябцева И.Т., Шаповалова К.А. Заместительная гормональная терапия при синдроме постовариэктомии. Вестник Росс. Ассоц. акушеров-гинекологов. 2000; 2: 92-94.

10.    Шварц ГЯ. Фармакотерапия остеопороза. М.: МИА. 2002; 53-64.

11.    Ершова О.Б. Комментарии к практическому использованию Российских клинических рекомендаций по остеопорозу. Остеопороз и остеопатии. 2010; 1: 34-46.

12.    Аметов А.С. Избранные лекции по эндокринологии. М.: МИА. 2009; 475-495.

13.    Castelo-Branco C., Figueras F., Sanjuan A. et al. Long-term compliance with estrogen replacement therapy in surgical postmenopausal women: benefits to bone and analysis of factors associated with discontinuation. Menopause: The J. of the North Am.Menop.Soc. 1999; 6(4): 307-311.

14.    Chittacharoen A., Theppisai U., Sirisriro R. et al. Pattern of bone loss in surgical menopause: a preliminary report. J. Med. Assoc. Thai. 1997; 80 (1):731-737.

15.    Hreshchychyn M., Hopkins A., Zystra S. et al. Effect of natural menopause, hysterectomy and oophorectomy on lumbar spine and femoral neck bone densities. Obstet Gynecol. 1998; 8: 631-638.

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:

Purpose. Оf the study was to determine abilities of multislice spiral tomography (MSCT) in detection coronary artery disease (CAD) in patients with atypical angina..

Material and methods. Sixty patients (39 men) with atypical chest pain and suspected ischemic heart disease underwent complex diagnostic strategy. Value of MSCT in detection of significant (more than 50%) coronary artery stenoses was assessed by segmental analysis, vascular bed involvement, and patient analysis.

Results. Significant CAD in 8% of patients with atypical angina was revealed. In 98,7% (58 of 60 cases) MSCT allowed to specify coronary anatomy. In 53 (88,3%) of patients no significant CAD was found, in 5 cases (8,3%) MSCT confirmed significant coronary artery stenoses. Sensitivity, specificity, positive and negative prognostic value of MSCT were correspondingly 100%, 99,3%, 71,4%, 100% in segmental analysis (n = 295). Vascular territory involvement analysis (n = 91) showed 100% sensitivity, 97,7% specificity, positive prognostic value 71,4% and negative prognostic value 100%.

Conclusions. High prognostic value, as well as high sensitivity and specificity of MSCT allow us to include this method into the CAD diagnostic algorithm in patients with atypical chest pain. This method is highly reliable in eliminating of significant CAD and detecting coronary artery stenoses.

References 

1.      Синицын В.Е., Устюжанин Д-В. КТ-ангио-графия коронарных артерий. Кардиология. 2006; 1: 20-25.

2.      Терновой  С.К.,  Синицын В.Е.,  Гагарина Н.В. Неинвазивная диагностика атеросклероза и кальциноза коронарных артерий.М.: Атмосфера. 2003; 144.

3.      Hoffman M.H. et al. Noninvasive coronary angiography with multislice computed tomography. JAMA. 2005; 293: 2471-2478.

4.      Leber A.W. et al. Quantification of obstructive and nonobstructive coronary lesions by 64-slice computed tomography. A comparative study with quantitative coronary angiography and intravascular ultrasound. J. Am. Coll. Cardiol. 2005; 46: 147-154.

5.      Leschka S. et al. Accuracy of MSCT coronary angiography with 64-slice technology: first experience. Eur. Heart. J. 2005; 26: 1482-1487.

6.      Mollet N.R. et al. Highresolution spiral computed tomography coronary angiography in patients referred for diagnostic conventional coronary angiography. Circulation. 2005; 112: 2318 -2323.

7.      Raff G.L. et al. Diagnostic accuracy of noninvasive coronary angiography using 64-slice spiral computed tomography. J. Am. Coll. Cardiol. 2005; 46: 552-557.

8.      Kopp A.F. et al. Coronary arteries: retrospectively ECG-gated multi-detector row CT angiography with selective optimization  of the image reconstruction window. Radiology. 2001; 221:683-688.

9.      Austen W.G. et al. A reporting system on patients evaluated for coronary artery disease. Report of the Ad-Hoc Committee for Grading of Coronary Artery Disease, Council on Cardiovascular Surgery.   Circulation.   1975;  51:5-40.

10.    Patel M.R. et al. Low diagnostic yield of elective coronary angiography. N. Engl.J. Med. 2010; 362: 886-895.

11.    Leber A.W. et al. Diagnostic accuracy of dual-source multi-slice CT-coronary angiography in patients with an intermediate pretest likelihood for coronary artery disease. Eur. Heart. J. 2007; 28: 2354-2360.

12.    Hausleiter J. et al. Non-invasive coronary computed tomographic angiography for patients with suspected coronary artery disease. Тhe Coronary Angiography by Computed Tomography with the Use of a Submillimeter resolution (CACTUS) trial. Eur. Heart. J. 2007; 28: 3034-3041.

13.    Goldstein J.A. et al. A randomized controlled trial of multi-slice coronary computed tomography for evaluation of acute chest pain. J. Am. Coll. Cardiol. 2007; 49: 863-871.

14.    Hoffmann U. et al. Predictive value of 16-slice multidetector spiral computed tomography to detect significant obstructive coronary artery disease in patients at high risk for coronary artery disease. Patient-versus segment-based analysis. Circulation. 2004; 110: 2638-2643.

Abstract:

Aim: was to improve results of a semi-closed loop endarterectomy from the superficial femoral artery (SFA).

Materials and methods: study is based on results of the examination and treatment of 85 patients with obliterating atherosclerosis of lower limbs, who underwent operations in FGBI «Russian Scientific Center of Radiology and Surgical Technologies» Health Ministry from 2008 to 2012.

All patients included in the study were divided into 2 groups :

• Main group - 30 patients operated on by a combination loop endarterectomy with simultaneous implantation of endovascular stent-grafts in SFA .

• The control group - 55 patients operated on a routine procedure loop endarterectomy .

Patients included in the comparison group were matched by gender, age, comorbidity , stage of ischemia and the outflow channel .

Results: The primary patency of the reconstructed area in the main group at 1 year was 73% after 1 years - 63% , cumulative - 76% at 1 year and 70% at 2 years, the limb is stored in 90% of cases (at 1 and 2 years of follow). Patients in the control group remained SFA patency at 1 year in 43% of cases, after 2 years - 32%.

Conclusion: Post-endarterectomy stent placement in SFA significantly improved results of loop endarterectomy

With a diameter of 8 mm and PBA more loop endarterectomy with implantation of stent grafts is a clinically and economically feasible. 

References

1.     Pokrovskiy A.V. Clinical angiology. Part II. M.: Medicina 2004, p.184

2.     National Recommendations for treating patients with Peripheral Arterial Disease. М.: Izdatelstvo NCSSKha im. A.N.Baculeva RAMN, 2010, 78 [In Russ].

3.     Flu H., van der Hage J.H., Knippenberg B. et al. Treatment for peripheral arterial obstructive disease: An appraisal of the economic outcome of complications. J. Vasc. Surg., 2008, 48, 368-376.

4.     TASC Working group. Management of peripheral arterial disease (PAD): TransAtlantic Inter-Society Consensus (TASC). Management Eur. J. Vasc. Endovasc. Surg. 2000; 19 Suppl: 1.

5.     Cotroneo A.R., Iezzi R., Marano G. Hybryd therapy in patients with complex peripheral multifocal stenoobstructive vascular desease: two-year results. Cardio-vasc. Intervent. Radiol., 2007, 30(3), 355-361.

6.     Haimovici H., Ascher E. Haimovici's vascular surgery, fifth ed. Wiley-Blackwell, 2003, 139, 534.

7.     Bockeria L.A., Temrezov M.B., Kovalenko V.I., Chemurziev Surgical treatment of patients with lower limbs arteries atherothrombotic lesions - graft choice for femoral-popliteal anastomosis. Annaly Khirurgii, 2010, 2, 5-8 [In Russ].

8.     Gavrilenko A.V., Skrylev S.I. Surgical management of patients with lower limb critical ischaemia induced by lesions of infrainguinal arteries J.Angiology and vascular surgery, 2008, 14 (3), 111-117 [In Russ].

9.     Morris-Stiff G., D'Souza J., Raman S. Update experience of surgery for acute limb ischaemia in a district general hospital - are we getting any better? Ann. R. Coll. Surg. Engl., 2009, 91(8), 37-40.

10.   Tagelder M.J. Risk factors for occlusion of infrainguinal bypass grafts. Eur. J. Vasc. Endovasc. Surg., 2000, 20(2), 118-124.

11.   Klinkert E.L., Post P.N., Breslau P.J. Saphenous vein versus PTFE for above-knee femoropopliteal bypass. A review of the literature. Eur. J. Vasc. Endovasc. Surg., 2004, 27(4), 357-362.

12.   Rutherford R.B., Baker J.D., Ernst C.J. Recommended standarts for report dealing with lower extremity ischemia: revised version. J. Vasc. Surg., 1997, 26(3), 517-538.

13.   Szilagyi D.E., Smith R.F., Elliott J.P. Infection in arterial reconstruction with synthetic grafts. Ann. Surg., 1972, 176 (3), 321-333.

14.   Pokrovsky A.V., Dan V.N., Zotikov A.E. Femoropopliteal bypass above popliteal fossa with PTFE graft: which graft diameter is better? J. Angiology and vascular surgery, 2008, 14(4), 105-108 [In Russ]. 

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.