Abstract: Purpose. Was to define the capability of multi-slice computed tomography angiography (MSCT-angiography) in diagnostics of arteriove-nosus conflict in patients with primary and recurrent varicocele. Materials and methods. 46 patients with left-side varicocele were underwent MSCT-angiography: 36 had firstly diagnosed disease, 10 had recurrent types. Capability of MSCT-angiography in the zone of possible arteriovenosus conflicts was estimated on the base of imaging analysis: axial, multiplanar and 3D-imaging of left renal vein (LRV), a.mesenterica superior (AMS) in aortomesenterical zone, and crossing place of left iliaca communis vein(LICV) and right iliaca communis artery (LICA). We have investigated structure features of left testiculars vein (LTV) in patients with primary and recurrent varicocele. Results. All the patients during axial imaging analysis we have investigated the crossing place of LRV and LICV with conflict arteries - AMS and LICA. We have revealed featured of LRV, compressed by AMS, on the base of axial and multiplanar imaging changes. Analysis of axial multiplanar and 3D-reconstruction has showed high capability in diagnostics of arteriovenosus conflict on the level LICV Study of multiplanar and CT-imaging in case of LICV valve insufficiency and different types of anatomy is possible Conclusions. Taking into consideration diagnostic capability, technical simplicity and high sensitivity of MSCT-angiography in diagnostics of arteriovenosus conflicts in varicocele, this methodic must be included in algorithm of patients examination in case of primary and recurrent varicocele. MSCT-angiography in definition of haemodynamic types of disorders can promote the right choice of surgical correction. References 1. Kim et al. Hemodynamic Investigation of the Left Renal Vein in Pediatric Varicocele. Doppler US, Venoaphy and Pressure Measurements. Radiology. 2006; 241. 2. Степанов В.Н., Кадыров З.А. Диагностика и лечение варикоцеле. М. 2001; 200. 3. Бавильский В.Ф., Суворов А.В., Иванов А.В. и др. Выбор метода оперативного лечения варикоцеле. Урология. 2003; 6: 40-43. 4. Гарбузов Р.В., Поляев Ю.А., Петрушин А.В. Артериовенозный конфликт и варикоцеле у подростков. Диагностическая и итервенционная радиология. 2010; 4 (3): 31-36. 5. Мазо Е.Б., Тирси К.А., Андранович С.В., Дмитриев Д.Г. Ультразвуковой тест и скротальная допплер-эхография в предоперационной диагностике гемо-динамического типа варикоцеле. Урология и нефрология. 1999; 3: 22-26. 6. Лопаткин Н.А., Морозов А.В., Житникова Л.Н. Стеноз почечной вены. М.: Медицина. 1984. 7. Коган М.И., Афоко А., Тампуори Д., Асанти-Асамани А., Пипченко О.И. Варикоцеле: противоречия проблемы. Урология. 2009; 6: 67-72. 8. Кадыров З.А. Варикоцеле. М.: Медицина. 2006.
Abstract: Aim. Was to estimate the role of transcutaneous interventions under the supervision of radiodiagnostics in the maintenance of all mini-nvasive kinds of operation stages of surgical treatment in patients with pancreatic and duodenal zone tumors Materials and methods. For the period from January 2007 till march 2010, 21 patients, aged 49-75 (10 men, 11 women) - were under aparoscopic pancreaticoduodenectomy (LPDE) Results. The use bile ducts drainage systems before LPDE in 95% cases leads to small hemorrhage (less than 1 liter). The presence of cholangiostomy also leads to early diagnostics of biliodigistive anastamosis (BDA) stenosis, and makes bile peritonitis – impossible. Conclusion. Usage of non-vascular methods of interventional radiology allows to make effective and less traumatic biliar decompression in patients with biliopancreatic and duodenal zone tumors as a stage of LPDE preparations. The presence of decompression cholangiostomy prevents further BDA inconsistency, and makes pacreaticojejunoanastamosis healing faster in case of its' decompression. References 1. Покровский А.В. Клиническая ангиология. Руководство. В двух томах. Т.2. М.: Медицина. 2004; 888. 2. Савельев В.С., Кошкин В.М. Критическая ишемия нижних конечностей. М.: Медицина. 1997; 160. 3. Jeans W.D. et al. Fate of patients undergoing transluminal angioplasty for lover-limb ischemia. Radiology. 1990; 177: 559-564. 4. Hunink M.G. et al. Patency results of percutaneous and surgical revascularization for femoropopliteal arterial disease. Med. Decis. Making. 1994; 14: 71-81. 5. Stokes K.R. et al. Five-year results of iliac end femoropopliteal angioplasty in diabetic patients. Radiology. 1990; 174: 977-982. 6. Минкин С., Рабкин Д. Экспериментально-морфологическое исследование динамики «вживления» рентгеноэндоваскулярных протезов в сосудистую стенку. Материалы 8-го симпозиума по рентгеноэндоваскуляр-ной хирургии. Москва - Ереван. 1987; 12. 7. Maas D. et al. Radiological follow-ap of transluminalli inserted vascular endoprothes-es. An experimental study using expanding spirals. Radiology. 1984; 152: 659-663. 8. Blum U. et al. Percutaneous recanalization of iliac occlusions. Resultsof a prosrective study. Radiology. 1993; 189: 536-540. 9. Henry M. et al. Stenting of femoral and popliteal arteries. Tenth international book of peripheral vascular intervention. 1995; 199: 368-369. 10. Henry M. et al. Palmaz stent placement in iliac and femoropopliteal arteries. Primary and secondary patency in 310 patients 2-4 year follow-up. Radiology. 1995; 197: 167-174. 11. Коков Л.С., Покровский А.В., Балан А.Н. и др. Отдаленные результаты клинического применения отечественного нитинолово-го стента для лечения стенозирующих поражений артерий. Ангиология и сосудистая хирургия. 2002; 8 (1): 41-46. 12. Scheinert D. et al. Stent supported recanaliza-tion of chronic iliac artery occlusions. Tenth international book of peripheral vascular intervention. Edited by M. Hanry. M. Fmor.Paris. 1999; 303-313. 13. Zeller T. Long-term results after recanalisation of thrombotic occlusions of native and stented arteries using a rotationals thrombectomy device. The Paris Course on Revascularization. Paris. 2002; 435-441. 14. White C.J. Peripheral аtherectomi with the рullback аtherectomy сatheter. Procedural safety and efficacy in a multicenter trail. J. of Endovascular. Surgery. 1998; 5: 9-17. 15. Yoffe B. et al. Preliminary experience with the Xtrak debulking device the treatment of peripheral occlusions. J. Endovasc. Ther. 2002; 9: 234-240. 16. Zeller T. et al. Midterm results after atherectomy-assisted angioplasty of below-knee arteries with use of the silverhawk device. J. Intervent. Radiol. 2004; 15: 1391-1397. 17. Ramaiah V. et al. Midterm outcomes from the TALON registry. Treating peripherals with «Silverhawk». Outcomes collection.J. Endovasc. Ther. 2006; 13 (5): 592-602.