Abstract:

Introduction: coronavirus (COVID) pandemic has caused temporary changes in work algorithms of different hospitals, that have not previously provided care for infectious patients. However, the consequences of COVID go beyond infectious pathology. Widespread use of therapeutic doses of anticoagulants as a necessary treatment option and resistant to treatment, cough as a typical symptom, led to an increase in spontaneous ruptures of epigastric arteries with hematomas of abdominal wall, which was an undesirable complication of the main disease.

Aim: was to demonstrate possibilities of endovascular methods in treatment of patients with spontaneous rupture of epigastric arteries on the background of COVID-19 and anticoagulant therapy.

Material and methods: at joinant infectious hospital, inpatient care was provided to 421 patients with coronavirus infection. At the same time, during treatment 9 patients had hematomas of abdominal wall and two of them had spontaneous rupture of rectus abdominis muscle and branches of inferior epigastric artery were damaged. In this article, we present both observations demonstrating the potential of endovascular surgery in treatment of such lesions in patients with COVID-19. Both patients, on the 6 and 10th day of inpatient treatment (severity of lung involvement was Grade 1 and Grade 2) during intense coughing, noted pain and swelling of anterior abdominal wall, accompanied by clinical and laboratory signs of blood loss. Computed tomography angiography (CT-A) revealed extravasation from small branches of inferior epigastric artery with an extensive hematoma that spread into the retroperitoneal space. In a hybrid operating room, a selective embolization of inferior (in one case, due to the high localization of the hematoma, inferior and superior) epigastric artery with an adhesive composition (N-butyl cyanoacrylate with iodolipol) was performed with successful angiographic and clinical results. Patients were discharged without complications on the 7th and 9th days of the postoperative period.

Conclusion: timely CT-diagnostic of severe bleeding, even in cases with atypical localization, and its management by selective embolization of damaged artery is the basis in treatment of spontaneous (cough-associated) ruptures of rectus abdominis muscle in patients with new coronavirus infection.

Abstract:

Aim: was to evaluate the effectiveness of the complex use of MRI and high-resolution ultrasound for the diagnostics of fillers.

Material and methods: in presented case report, the study was carried out using a SOMATOM Aera SIMENS 1.5 Т tomograph in T1, T1 Dixon, T1 Fs, T2, T2 STIR modes, the slice thickness was 3 mm. Ultrasound was performed with a MyLab Alpha, Esaote device, linear sensors with a frequency of 6 - 18 MHz and 10 - 22 MHz were used in B-mode, Color Doppler Imaging mode.

Results: case report demonstrates possibilities of complex use of ultrasound and MRI in patients with atypical ultrasound pattern for hyaluronic acid-based fillers. When choosing treatment tactics, data obtained during the examination, indicating the presence of a filler in soft tissues of the chin that does not correspond to the ultrasound and MRI signs of hyaluronic acid, were taken into account.

Conclusions: complex diagnostics of dermal fillers using high-resolution ultrasound and MRI is indicated for patients with complications of contouring, for differential diagnostics of hyaluronic acid with fillers of non-hyaluronic nature.

Abstract: 

Aim: was to present the experience of using blockers of IIb/IIIa glycoprotein receptors in treatment of thromboembolic complications of endovascular treatment of cerebral aneurysms.

Materials and methods: from December 2007 to June 2021, 695 patients underwent embolization of cerebral aneurysms. Thromboembolic complications were observed in 45 patients (6,5%), blockers of IIb/IIIa glycoprotein receptors were used in 32 patients (4,6%).

Results: blockers of IIb/IIIa glycoprotein receptors were used in 10,1% of patients with embolization of aneurysms and stent implantation, in 9,2% of cases with implantation of flow-diverters, and in 1% of patients with embolization of aneurysms using only coils. Effective restoration of blood flow was observed in 90,6% of patients. Intracranial hemorrhagic complications were not observed. The incidence of bleeding from the gastrointestinal tract was 6,3%, the incidence of puncture hematomas was 12,5%.

Conclusion: blockers of glycoprotein IIb/IIIa receptors can be effectively and safely used in treatment of thromboembolic complications of endovascular treatment of cerebral aneurysms.

References

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2.     Kiselev VS, Gafurov RR, Sosnov AO, Perfil’ev AM. Using of low-profile stents in the endovascular treatment of complex aneurysms of the brain. Neyrokhirurgiya. 2018; 20(1): 49-55 [In Russ].

https://doi.org/10.17650/1683-3295-2018-20-1-49-55

3.     Dornbos D, Katz JS, Youssef P, et al. Glycoprotein IIb/IIIa Inhibitors in Prevention andиRescue Treatment of Thromboembolic Complications During Endovascular Embolization of Intracranial Aneurysms. Neurosurgery. 2017; 0: 1-10.

https://doi.org/10.1093/neuros/nyx170J

4.     Kansagra AP, McEachern JD, Madaelil ThP, et al. Intra-arterial versus intravenous abciximab therapy for thromboembolic complications of neuroendovascular procedures: case review and meta-analysis. NeuroIntervent Surg. 2017; 9: 131-136.

https://doi.org/10.1136/neurintsurg-2016-012587

5.     Brinjikji W, Morales-Valero SF, Murad MH, et al. Rescue treatment of thromboembolic complications during endovascular treatment of cerebral aneurysms: a meta-analysis. Am J Neuroradiol. 2015; 36: 121-5.

https://doi.org/10.3174/ajnr.A4066

6.     Lin L-M, Jiang B, Campos JK, et al. Coon Strategy for the Management of Acute Intraprocedural Thromboembolic Complications during Pipeline Flow Diversion Treatment of Intracranial Aneurysms. Intervent Neurol. 2018; 7: 218-232.

https://doi.org/10.1159/000486458

7.     Cheung NK, Carr MW, Ray U, et al. Platelet Function Testing in Neurovascular Procedures: Tool or Gimmick? Intervent Neurol 2019; 8: 123-134.

https://doi.org/0.1159/000496702

8.     Zelenskaya EM, Slepuhina AA, Koch NV, et al. Genetic, pathophysiological and clinical aspects of antiplatelet therapy (review). Pharmacogenetics and Pharmacogenomics. 2015; 1:12-19 [In Russ].

Abstract:

Introduction: arterial complications after orthotopic liver transplantation are common cause of graft loss (10-40%).

Aim: was to estimate efficiency of endovascular interventions in correction of revealed arterial complications in patients after OLT.

Material and methods: for the period of 2015-2020, arterial complications after 104 OLT were revealed in 24(23%) pts and were divided into 4 groups: «steal»-syndrome (n=8), hepatic artery thrombosis (n=7), combination of hepatic artery stenosis and «steal» syndrome (n=6), hepatic artery stenosis (n=3). Endovascular interventios such as splenic artery embolization, direct thrombolysis, stenting and balloon plastic were performed for correction of these complications.

Results: using of endovascular treatment, we successfully identified and correct complications with saving of the graft in 14 pts (58%), 10 pts died because of biliary necrosis, sepsis and graft loss.

Conclusion: early detection and elimination of emerging arterial complications after OLT play a keyrole in saving of organs and patients’ life.

References

1.     Gautier SV, Khomyakov SM. Organ donation and transplantation in the Russian Federation in 2018 году. 11th report from the registry of the Russian Transplant Society. Russian journal of transplantology and artificial organs. 2019; 21(3): 7-32 [In Russ].

2.     Buck DG, Zajko AB. Biliary complications after orthotopic liver transplantation. Tech Vasc Interv Radiol. 2008; 11(01): 51-59.

3.     Seehofer D, Eurich D, Veltzke-Shlieker W, et al. Biliary complications after liver transplantation: old problems and new challenges. Am J Transplant. 2013; 13(02): 253-265.

4.     Ingraham C, Montenovo M. Ishemic complications after liver transplantation. Dig Dis Interv. 2018; 2: 244-248.

5.     Goldsmith LE, Wiebke K, Seal J, et al. Complications after endovascular treatment of hepatic artery stenosis after liver transplantation. J Vasc Surg. 2017; 66(5): 1488-1496.

6.     Prieto M, Gastaca M, Valdivieso A, et al. Does low hepatic artery flow increase rate of biliary strictures in deceased donor liver transplantation? Transplantation. 2017; 101(9): 311.

7.     Chen J, Weinstein J, Black S, et al. Surgical and endovascular treatment of hepatic arterial complications following liver transplant. Clin Transplant. 2014; 28(12): 1305-1312.

8.     Kim PT, Fernandez H, Gupta A, et al. Low measured hepatic artery flow increases rate of biliary strictures in deceased donor liver transplantation: an age-dependent phenomenon. Transplantation. 2017; 101(2): 332-340.

9.     Galperin EI, Kunichan MD. Manometric and debitometric study in bile ducts. Surgery. 1969; 8: 74-78 [In Russ].

10.   Polikarpov АА, Tarazov PG, Polekhin AS, et al. Biliary manometric test (BMT) to assess the effectiveness balloon plasty of strictures of the bile ducts after orthotopic liver transplantation (OLT). Modern technologies in medicine. 2017; 9(4): 60-65 [In Russ].

11.   Buis CI, Verdonk RC, Van der Jagt EJ, et al. Nonanastomotic biliary strictures after liver transplantation, part 1: Radiological features and risk factors for early vs late presentation. Liver Transpl. 2007; 13: 708-718.

12.   Moiseenko AV, Polikarpov АA, Tarazov PG, et al. Method for invasive graft perfusion determination. Russian patent № 270496: 23.10.2019 2019. № 30 [In Russ].

13.   Pinto S, Reddy SN, Horrow MM, et al. Splenic artery syndrome after orthotopic liver transplantation: a review. Int J Surg. 2014; 12(11): 1228-34.

14.   Mogl N, N?ssler N, Presser S, et al. Evolving experience with prevention and treatment of splenic artery syndrome after orthotopic liver transplantation. Transpl. Int. 2010; 23(8): 831-841.

15.   Dokmak S, Aussilhou B, Belghiti J. Liver transplantation and splenic artery steal syndrome: the diagnosis should be established preoperatively. Liver Transpl. 2013; 19(6): 667-668.

16.   Grieser С, Denecke T, Steffen I, et al. Computed tomography for preoperative assessment of hepatic vasculature and prediction of splenic artery steal syndrome in patients with liver cirrhosis before transplantation. Eur. Radiol. 2010; 20(1): 108-117.

17.   Li H, Gao K, Huang Q, et al. Successful management of splenic artery steal syndrome with hepatic artery stenosis in an orthotopic liver transplant recipient. Ann. Transplant. Q. Pol. Transplant. 2014; 145-148.

18.   Strain D, Brady P, Matalon T, et al. Splenic artery embolization as treatment for splenic artery steal syndrome after liver transplantation. J. Vasc. Intervent. Radiol. 2013; 24(4): 159-160.

19.   G?m?n G, Gelley F, Doros A, et al. Biliary complications after orthotopic liver transplantation: The Hungarian Experience. Transplantation Proceedings. 2013; 45: 3695-3697.

20.   Lee IJ, Kim SH, Lee SD, et al. Feasibility and midterm results of endovascular treatment of hepatic artery occlusion within 24 hours after living-donor liver transplantation. J Vasc Interv Radiol. 2017; 28(2): 269-275.

21.   Fujiki M, Hashimoto K, Palaios E, et al. Probability, management, and long-term outcomes of biliary complications after hepatic artery thrombosis in liver transplant recipients. Surgery. 2017; 162(5): 1101-1111.

Abstract:

Article presents a case report of a 38-year-old patient who was admitted to our hospital with symptoms of acute appendicitis, she was examined and then urgently operated.

Postoperative period was complicated by clinical picture of colonic bleeding. During 1 st day of postoperative period, patient underwent a diagnostic search of bleeding source, conservative hemostatic therapy, transfusion of blood components, however, taking into consideration negative dynamics of patient's condition, laboratory test indicators, the next day, she was urgently operated: lower midline laparotomy, suturing of cecum hematoma, drainage of the abdominal cavity. Eight hours after repeated surgical treatment, against the background of transfusion of blood components, further negative dynamics of patient's condition, laboratory test indicators also worsened, medical concilium decided to perform angiography, followed by a decision on the amount of treatment intraoperatively. Selective angiography of branches of the mesenteric artery was performed, the source of bleeding was diagnosed, and a successful temporary pharmacologic endovascular hemostasis of the branch of the superior mesenteric artery was performed. Post-hemorrhagic anemia in the patient was corrected on the 3rd day after endovascular intervention, 10 days after, patient was discharged in a satisfactory condition.

The choice of the method of endovascular intervention was carried out taking into consideration the ineffective of reoperation, patient's condition, as well as peculiarities of the blood supply to the area of the alleged source of bleeding.

The study also discusses indications and methods of endovascular treatment of colonic bleeding.

References

1.     Avdos'ev JuV, Belozerov IV, Kudrevich AN. Endovascular methods for the diagnosis and treatment of acute bleeding into the lumen of the gastrointestinal tract. Novostihirurgii. 2018; 26 (2): 169-178 [In Russ].

2.     Soh B, Chan S. The use of super-selective mesenteric embolisation as a first-line management of acute lower gastrointestinal bleeding. Annals of Medicine and Sur­gery. 2017; 17: 27-32.

3.     Avdos'ev JuV, Bojko W. Angiography and endovascular abdominal bleeding. Ukraina: Savchuk. 2011; 648. [In Russ].

4.     Tan К К, Wong D, Sim R. Superselective Embolization for Lower Gastrointestinal Hemorrhage: An Institutional Review Over 7 Years. World J Surg. 2008; 32:2707-2715.

http://doi.org/10.1007/s00268-008-9759-6

5.     Annamalai G, Masson N, Robertson I. Acute gastrointestinal haemorrhage: investigation and treatment. Imaging. 2009; 21(2): 142-151.

6.     Urbano J, Manuel Cabrera J, Franco A, Alonso-Burgos A. Selective arterial embolization with ethylenevinyl alcohol copolymer for control of massive lower gastrointestinal bleeding: feasibility and initial experience. J Vase I nterv Radiol. 2014; 25: 839-846.

7.     Walker TG, Salazar GM, Waltman AC. Angiographic evaluation and management of acute gastrointestinal hemorrhage. World J Gastroenterol. 2012;18 (11): 1191-1201.

http://doi.org/10.3748/wjg.v18.i11.1191

8.     Jang Bl. Lower gastrointestinal bleeding: is urgent colonoscopy necessary for all hematochezia? Clinical Endosc. 2013; 46: 476-479.

9.     Green ВТ, Rockey DC, Portwood G et al. Urgent colonoscopy for evaluation and management of acute lower gastrointestinal hemorrhage: a randomized controlled trial. Am J Gastroenterol. 2005; 100: 2395-2402.

10.   Loffroy R, Falvo N, Nakai M et al. When all else fails - radiological management of severe gastrointestinal bleeding. Best Practice & Research Clinical Gastroenterology. 2019; 1-9.

http://doi.org/10.1016/j.bpg.2019.04.005

11.   Shi Z X, Yang J, Liang H W et al. Emergency transcatheter arterial embolization for massive gastrointestinal arterial hemorrhage. Medicine. 2017; 96(52): 9437.

http://doi.org/10.1097/md.0000000000009437

12.   Nanavati S M. What if endoscopic hemostasis fails? Alternative treatment strategies: interventional radiology. Gastroenterol Clin North Am. 2014;43(4): 739-752.

http://doi.org/10.1016/i.gtc.2014.08.013

Abstract:

Introduction: vascular closure devices (VCD) for over 20 years have been used as an alternative to manual compression to achieve hemostasis. Despite the fact that clinical efficacy and safety of occlusive type VCD have been confirmed in a number of studies, their use remains controversial due to the formation of complications at the access site when using these devices.

Aim: was to estimate possible advantages and limitations of vascular closure devices of occlusive type (Angio-Seal) in patients, who had underwent percutaneous coronary interventions (PCI) via femoral access in comparison with traditional manual hemostasis.

Material and methods: data of 231 adult patients who underwent therapeutic endovascular procedures in the City Hospital named after M.P. Konchalovsky, Research and Development Center for Preventive Medicine were selected for retrospective research. The main group, with hemostasis after PCI with Angio-Seal (Terumo) obturating device, consisted of 113 patients, control group - included 118 patients with manual hemostasis. Subjective sensations (pain, numbness, etc.), complication rate, hemostasis time, immobilization and hospitalization duration were evaluated.

Results: success of using VCD was 98.23%, complication rate in the main group was 4.37%, in the control group - 6.78% (however, it was not reliable). The time of hemostasis (2.1 min versus 22.25 min), immobilization (3.5 hours versus 20.6 hours) and hospitalization (4 days versus 8 days) significantly decreased, and the patient comfort level was significantly higher in the main group.

Conclusions: the use of Angio-Seal VCD in patients after percutaneous transfemoral therapeutic endovascular procedures is an effective way to reduce hemostasis time in comparison with using of manual compression; allows to reduce patient's immobilization period, significantly increases patient comfort, and reduces patient's hospital stay.

Along with this procedure, it should be considered as an independent surgical intervention and surgeon should follow all necessary rules and stages of its implementation, should control result of hemostasis.

References

1.     Bockeria LA, Alekyan BG. State of endovascular diagnosis and treatment of cardiac and vascular diseases in the Russian Federation (2014). Russian Journal of Endovascular Surgery 2015; 2(1-2):5-20 [In Russ].

2.     Byrne RA, Cassese S, Linhardt M, Kastrati A. Vascular access and closure in coronary angiography and percutaneous intervention. Nat Rev Cardiol. 2013; 10(1):27-40.

3.     Semitko SP, Gubenko IM, Analeev AI, Azarov AV, Maiskov VV, Karpun NA, Iosseliani DG. Vascular complications of percutaneous coronary interventions and clinical results of the use of various devices providing hemostasis. Consilium medicum 2012; 14(10): 51-57 [In Russ].

4.     Dauerman HL, Applegate RJ, Cohen DJ. Vascular closure devices: the second decade. J Am Coll Cardiol. 2007; 50(17):1617-1626.

5.     Biancari F, D’Andrea V, Di Marco C, Savino G, Tiozzo V, Catania A. Meta-analysis of randomized trials on the efficacy of vascular closure devices after diagnostic angiography and angioplasty. Am Heart J. 2010; 159(4): 518-531.

6.     Ndrepepa G, Berger PB, Mehilli J et al. Periprocedural bleeding and 1-year outcome after percutaneous coronary interventions: appropriateness of including bleeding as a component of a quadruple end point. J Am Coll Cardiol 2008; 51:690.

7.     Rao SV, Kedev S. Approaching the post-femoral era for coronary angiography and intervention. JACC Cardiovasc. Interv. 2015; 8: 524–526.

8.     Lo TS et al. Radial artery anomaly and its influence on transradial coronary procedural outcome. Heart 2009; 95(5): 410–415.

9.     Sciahbasi A et al. Transradial approach (left versus right) and procedural times during percutaneous coronary procedures: TALENT study. Am. Heart J. 2011; 161: 172–179.

Abstract:

Background: the use of vascular closure devices (VCD) reduces the time of hemostasis, accelerates activation and discharge of the patient. Suture-mediated closure devices are closest in it's structure to the traditional surgical method of hemostasis. Advantages and disadvantages of these devices are mainly associated with design features. Stenoses, atherosclerosis, calcification and scars at the site of access are predictors of complications in the use of suturing devices. Although the effectiveness of these devices has been proven in several foreign studies, their data are not sufficient to draw clear conclusions.

Aim: was to evaluate advantages and disadvantages of using the suture-mediated closure devices after PCI.

Material and methods: study enrolled 208 adult patients, who underwent PCI in City Clinical Hospital named after M.P Konchalovsky, Moscow; FSBI «3 Central clinical military hospital n.a. A. A. Vishnevsky» Defense Ministry RF and SMRC preventive medicine of Department of Healthcare. Study group, where hemostasis after PCI was achieved by means of suture-mediated closure devices Perclose Pro Glide (Abbott Vascular), consisted of 90 patients, control group - 118 patients with manual hemostasis. Subjective feelings (pain, numbness, etc.) were assessed using a rating scale. The incidence of complications in the study group was 5.56%, in the control group - 6.78%. The comfort level of patients was higher in the study group

Results of the study: showed that the use of the Perclose device to achieve hemostasis after PC does not increase the frequency of regional vascular complications in compatison with manual hemostasis. But, at the same time, the use of VCD is an effective way to reduce the time of hemostasis, reduces the period of immobilization of the patient, which increases the patient's comfort and reduces patient's hospital stay.

References

1.      Caputo RP: Currently approved vascular closure devices. Card Interv Today: 70-76, 2012.

2.      Bechara CF, Annambhotla S, LinP H:Access site management with vascular closure devices for percutaneous transarterial procedures. J VascSurg 2010; 52:1682-1696. http://dx.doi.org/10.1016/j.jvs. 2010. 04.079.

3.      Sheth RA, Walker TG, Saad WE, et al: Quality improvement guidelines for vascular access and closure device use. J Vasc Interv Radiol. 2014; 25: 73-84. http://dx.doi.org/10.1016Zj.jvir.2013.08.011.

4.      Haas PC, Krajcer Z, Diethrich Edward B: Closure of large percutaneous access sites using the Prostar XL percutaneous vascular surgery device. J Endovasc Surg. 1999; 168-170.

5.      Barbetta I, van den Berg J: Access and hemostasis: femora and popliteal approaches and closure devices — Why, what, when, and how? Semin Interv Radiol 2014; 31:353-360. http://dx.doi.org/10. 1055/s-0034-1393972.

6.      Boschewitz J M, Pieper CC, Andersson M, et al: Efficacy and time-to-hemostasis of antegrade femoral access closure using the exoseal vascular closure device: A retrospective single-center study. Eur J Vasc Endovasc Surg 2014; 48:585-591. http://dx.doi.org/10.1016/ j.ejvs.2014. 08.006.

7.      Gutzeit A, van Schie B, Schoch E, et al: Feasibility and safety of vascular closure devices in an antegrade approach to either the common femoral artery or the superficial femoral artery. 2012; Cardiovasc Intervent Radiol 35:1036-1040. http://dx.doi.org/10.1007/s0 0270012-0454-5.

8.      Ward TJ, Weintraub J L: Vascular closure device update. Endovasc Today: 2015; 54-60.

9.      Hon LQ, Ganeshan A, Thomas SM, et al: An overview of vascular closure devices: What every radiologist should know. Eur J Radiol. 2010; 73:181-190,. http://dx.doi.org/10.1016/j.ejrad.2008.09.023.

10.    Krajcer Z: The preclose technique for AAA repair. Endovasc Today: 2011; 46-54.

11.    Gerckens U, Cattelaens N, Lampe EG, Grube E. Management of arterial puncture site after catheterization procedures: evaluating a suture-mediated closure device. Am J Cardiol. 1999; 83:1658-63.

12.    Baim DS, Knopf WD, Hinohara T, et al. Suture-mediated closure of the femoral access site after cardiac catheterization: results of the suture to ambulate and discharge (STAND I and STAND II) trials. Am J Cardiol. 2000; 85:864-9.

13.    Fram D.B., Giri S., Jamil G., et al. Suture closure of the femoral arteriotomy following invasive cardiac procedures: a detailed analysis of efficacy, complications, and the impact of early ambulation in 1200 consecutive, unselected cases. Cathet Cardiovasc Interv. 2001; 53:163-73.

14.    Balzer J.O., Scheinert D., Diebold T., et al. Postinterventional transcutaneous suture of femoral artery access sites in patients with peripheral arterial occlusive disease: a study of 930 patients. Cathet Cardiovasc Interv. 2001;53.

Abstract:

To show possibilities to diagnose and treat toxic complications of continuous hepatic artery chemoinfusion using percutaneous implanted catheter-port system.

Materials and methods: Between May 2005 and March 2007, 20 patients (pts) underwent percutaneous transfemoral implantation of the catheter-port system for treatment of unresectable colorectal liver metastases. Toxic complications (gastritis, pancreatits or stomach ulcer) occurred in three pts (each in one). Endoscopy (after arterial injection of methylene blue) and scintigraphy (after arterial injection of technetium-99m macroaggregated albumin) showed abnormal liver perfusion. Visceral angiography was performed for verification and embolization of non-targeted vessels. Angiography with embolization of collateral arteries resulted in normalization of liver perfusion and resolution of complications. At present, all pts continue to receive intraarterial chemotherapy. Transcatheter coil embolization of non-targeted arteries is effective for the management of the catheter-port system misperfusion.

Reference 

1.     Таразов П.Г. Артериальная химиоинфузия в лечении нерезектабельных злокачественных опухолей печени (обзор литературы). Вопр. онкол. 2000; 46 (5): 521-528.

2.     Балахнин П.В., Генералов М.И., Полысалов В.Н. и др. Применение чрескожных имплантируемых инфузионных систем для регионарной химиотерапии метастазов колоректального рака. Анн. хир. гепатол. 2006; 11 (2): 41-48.

3.     Таразов П.Г. Роль методов интервенционной радиологии в лечении больных с метастазами колоректального рака в печень. Практ. онкол. 2005; 6 (2): 119-126.

4.     Herrmann К., Waggershauser Т., Heinemann V, Reiser М. Interventional radiological procedures in impaired function of surgically implanted catheter-port systems. Cardiovasc. Intervent. Radiol. 2001; 24: 31-36.

5.     Venturini M., Angeli E., Salvioni M. et al. Complications after percutaneous transaxillary implantation of a catheter for intraarterial chemotherapy of liver tumors: Clinical relevance and management in 204 patients. Am. J. Roentgenol. 2004; 182: 1417-1426.

6.     Chuang V, Wallace S., Stroehlein J. et al. Hepatic artery infusion chemotherapy: Gastroduodenal complication. Am.]. Roentgenol. 1981; 137: 347-350.

7.     Cohen A., Kemeny N., К hne C. et al. Is intra-arterial chemotherapy worthwhile in the treatment of patients with unresectable hepatic colorectal cancer metastases? Eur.J. Cancer. 1996; 32: 2195-2205.

8.     Doria M., Doria L., Faintuch J., Levin B. Gastric mucosal injury after hepatic arterial infusion chemotherapy with floxuridine: A clinical and pathologic study. Cancer. 1994; 73 (8): 2042-2047.

9.     Bledin A., Kantarjian H., Kim E. et al. 99mTc-labeled macroaggregated albumin in intrahepatic arterial chemotherapy. Am.]. Roentgenol. 1982; 139:711-715.

10.   Kaplan W, Ensminger W, Come S. et al. Radionuclide angiography to predict patient response to hepatic artery chemotherapy. Cancer Treat. Rep. 1980; 64: 1217-1222.

11.   Frye J., Venook A., Ostoff J. et al. Hepatic intra-arterial methylene blue injection during endoscopy: A method of detecting gastroduodenal misperfusion in patients re ceiving hepatic intra-arterial chemotherapy via implan ted pump. Gastrointestinal Endoscopy. 1992; 38 (1): 52-54.

12.   Tanaka Т., Arai Y, Inaba Y. et al. Radiologic placement of side-hole catheter with tip fixation for hepatic arterial infusion chemotherapy. J. Vase. Interv. Radiol. 2003; 14: 63-68.

13.   Yamagami Т., Kato Т., Iida S. et al. Value of transcatheter arterial embolization with coils and n-butyl cyanoacrylate for long-term hepatic arterial infusion chemotherapy. Radiology. 2004; 230: 792-802.

14.   Herrmann K., Waggershauser Т., Sittek H. et al. Liver intraarterial chemotherapy: Use of the femoral artery for percutaneous implantation of catheter-port systems. Radiology. 2000; 215: 294-299.

Abstract:

Retained cotton foreign bodies (gossypibomas) after abdominal surgery are rare postoperative complication. However gossypiboma can be infected, that leads to pyogenic inflammation, sharply worsens the condition of the patient and requiring re-operation. In late postoperative period gossypibomas can simulate neoplasms of the abdominal cavity In connection with this, the detection of foreign bodies is actual diagnostic problem. MDCT is one of the most effective non-invasive methods in diagnostics of retained foreign bodies. Such diagnostics needs to be careful in examination of the patient's anamnesis and to know variants of computed tomography imaging. The use of radiopaque tags for marking surgical materials, probably, is the optimal solution of gossypiboma disgnostics' problem.

References

1.     Pessaux P., Msika S. Risk Factors for Postoperative Infectious Complications in Noncolorectal Abdominal Surgery. Arch Swrg. 2003; 138: 314-324.

2.     Whang G., Mogel G.T., Tsai J. et all. Left Behind: Unintentionally Retained Surgically Placed Foreign Bodies and How to Reduce Their Incidence Pictorial Review. AJR. 2009; 193: 79-89.

3.     Lauwers P.R, Van Hee R.H. Intraperitoneal gossypibomas: the need to count sponges. World J Surg. 2000; 24: 521-527.

4.     Manzella A., Filho P.B., Albuquerque E., et al. Imaging of Gossypibomas: Pictorial Review. AJR. 2009; 193: 94-101.

5.     Marcy P-Y., Hericord O., Novellas S. Lymph Node-Like Lesion of the Neck After Pharyngolaryngectomy. AJR. 2006; 187: 135-136.

6.     Dux M., Ganten M., Lubienski A. Retained surgical sponge with migration into the duodenum and persistent duodenal fistula. Eur Radiol. 2002; 12 : 74-77.

7.     Gonzalez-Ojeda A., Rodriguez-Alcantar D.A., Arenas-Marquez H., et al. Retained foreign bodies following intra-abdominal surgery. Hepatogastroenterology. 1999;.46 : 808-812.

8.     O'Connor A. R., Coakley F. Imaging of Retained Surgical Sponges in the Abdomen and Pelvis. AJR. 2003; 180: 481-489.

9.     Thurley P. D., Dhingsa R. Laparoscopic Cholecystectomy: Postoperative Imaging. AJR. 2008; 191: 794-801.

Abstract: 

Aim: was to decrease rate of early and late complications after implantaion of venous post-system for long-term infusion therapy in patients with adverse vascular access by estimations of complications and prophylaxis.

Materials and methods: research group included 25 patients with early and late postoperative complications, from data of retrospective analysis of 1690 cancer patients with implanted venous port-system. 15 port-systems (0,9%) were removed because of infection. Pressure sores in the soft tissues because of thinned subcutaneous fatty tissue or incorrect selection of the port-system model were revealed in 3 patients (0,17%), catheter migration to the right atrium or a. pulmonalis (pinch-off syndrome) was observed in 3 cases(0,17%),, 4 patients (0,23%) developed early complications in the form of pneumothorax.

Conclusions: importance of aseptic and antiseptic rules while performing puncture of the port chamber, methods for implantation of venous port systems - should decrease rate of early and late post-operative complications in patients with adverse vascular access. 

References

1.    Jugrinov O.G. Polnostju implantiruemye infuzionnye sistemy central'nogo venoznogo dostupa (porty) [Full-implanted infusion systems in central veins]. Klinicheskaja onkologija. 2011; 2(2): 18-22 {In Russ].

2.     Marcy P.Y, Magne N., Castadot Р. et al. Radiological and surgical placement of port devices: a 4-year institutional analysis of procedure performance, quality of life and cost in breast cancer patients. Breast Cancer Res Treat. 2005; 92:61-67.

3.     Gebauer B., El-Sheik M., Vogt M. et al. Combined ultrasound and fluoroscopy guided port catheter implantation-high success and low complication rate. Eur Radiol. 2009; 69:517-522.

4.     Cil B.E., Canyigit M., Peynircioglu В. et al. Subcutaneous venous port implantation in adult patients: a single center experience. Diagn Interv Radiol. 2006; 12: 93-98.

5.     Orsi F., Grasso R.F., Arnaldi P. et al. Ultrasound guided versus direct vein puncture in central venous port placement. Vase Access 2000; 1:73-77.

6.     Dede D., Akmangit I., Yildirim Z.N., Sanverdi E., Sayin B. Ultrasonography and fluoroscopy-guided insertion of chest ports. Eur. Surg Oncol. 2008; 34:1340-1343.

7.     Ignatov A., Hoffman O., Smith В. et al. An 11 -year retrospective study of totally implanted central venous access ports: complications and patient satisfaction. Eur.Surg Oncol. 2009; 35:241-246.

8.     Fischer L., Knebel P., Schroder Set al. Reasons for explantation of totally implantable access ports: a multivariate analysis of 385 consecutive patients. Ann Surg Oncol. 2008,15:1124-1129.

9.     Evangelos Perdikakis, Elias Kakhegis, Dimitrios Tsetis. Obshie i spetsificheskie oslozhnenia, voznikaushie pri ispolzovanii polnost’u implantiruemikh tsentralnikh venoznikh portov dostupa. [General and specific complications, occuring during implantation of cental venous port-systemts] J. Vasc Access 2012;13 (3): 345-350 DOI: 10.5301/jva.5000055

10.   Iее I.H., Kim YB., Lee M.K. et al. Catastrophic hemothorax on the contralateral side of the insertion of an implantable subclavian venous access device and the ipsilateral side of the removal of the infected port A case report. Korean Anesthesiol. 2010; 59:214-219.

9.     Teichgra ber U.K., Gebauer B., Benter T. et al. Longterm central venous lines and their complications. Roto 2004; 176:944-992.

10.   Ener R.A., Meglahtery S.B., Styler M. Extravasation of systemic emato-oncological therapies. Ann Oncol. 2004:15:858-862.

11.   Kreis H., Loehberg C.R., Lux M.P. et al. Patients' attitudes to totally implantable venous access port systems for gynecological or breast malignancies. Eur. Surg Oncol. 2007; 33:39-43.

12.   Yildizeli B., Lacin T., Batirel H.F. et al. Complications and management of long-term central venous access catheters and ports.) Vase Access 2004; 5:174-178.

13.   Zhang 0., Liao L., Zhou H. Comparison of implantable central venous ports with catheter insertion via external jugular с ut down and subclavian puncture in children: single center experience. Pediatr Surg Int. 2009; 25: 499-501.

14.   Paoletti F., Ripani U., Antonelli M., Nicoletta С. Central venous catheters. Observations on the implantation technique and its complications. Minerva Anestesiol. 2005; 71: 555-560.

15.   Lorch H., Zwaan M., Kagel С. et al. Central venous access ports placed by interventional radiologists: experience with 125 consecutive patie

Abstract:

Purpose. Define the role of ultrasound diagnostics in preoperative evaluation, surgical approach, and postsurgical assessment in patients with cystous lesions of pancreas underwent various types of pancreatic distal resection (PDR).

Material and methods. Since 1995 till 2008 in Vishnevsky Institute of Surgery (Moscow) 54 patients with distal cystous lesions of pancreas received a course of treatment. Mean age was 50,6+1,2 years, 37 patients (68.5%) were women. Complex pre- and postoperative ultrasound study was performed in all the cases. Morphologically there were true cysts (2 cases), lymphocysts (1 case), postnecrotic cysts (21 patients), serous cystadenoma (9 cases), mucinous cystadenoma (16 cases), and mucinous cystadenocarcinoma (5 cases).

Results. After laparotomy and abdominal revision the following operations were performed:

1. Spleen-preserving distal pancreatic resection;

2. Distal pancreatic resection with splenectomy.

Pancreatic stump assessment revealed 2 possible complications: external pancreatic fistula and sub. phrenic abscess. Spleen-preserving interventions were shown to associate with fewer complication rate, than those with splenectomy.

Conclusions. The cardinal problem is that the PDR associates with repeatedly high complication rate, and the most common complications are external pancreatic fistulas and subphrenic abscesses. As far as the complication rate has the tendency to decrease in spleen-preserving interventions, it is advisable to avoid splenectomy in cases of benign pancreatic lesions.   

References

1.        Fahy B.N., Frey C.F., Ho H.S. et al. Morbidity, mortality and technical factors of distal pancreatectomy. Am. J. Surg. 2002; 183 (3): 237–241.

2.        Andren-Sandberg A., Wagner M., Tihanyi T. et al. Technical Aspects of Left-Sided Pancreatic Resection for Cancer. Dig. Surg. 1999; 16 (4): 305–312.

3.        Шалимов А.А. Хирургия поджелудочной железы. М.: Медицина. 1964.

4.        Mayo W.J. The Surgery of the Pancreas: I. Injuries to the Pancreas in the Course of Operations on the Stomach. II. Injuries to the Pancreas in the Course of Operations on the Spleen. III. Resection of Half the Pancreas for Tumor. Ann. Surg. 1913; 58 (2): 145–150.

5.        Алимов А.Н., Исаев А.Ф., Сафронов Э.П. и др. Обоснование безопасности органосохраняющего метода лечения разрыва селезенки в хирургии изолированной и сочетанной травмы живота. Хирургия. 2005; 10: 55–60.

6.        Lee S.Y., Goh B.K., Tan Y.M. et al. Spleen-preserving distal pancreatectomy. Singapore Maed. J. 2008; 49 (11): 883–885.

7.        Warshaw A.L. Conservation of the spleen with distal pancreatectomy. Arch. Surg. 1988; 123 (5): 550–553.

8         Буриев И.М., Икрамов Р.З. Дистальная резекция поджелудочной железы. Анналы хирургической гепатологии. 1997; 2: 136–138.

9.        Kimura W., Fuse A., Hirai I., Suto K. Spleen-preserving distal pancreatectomy for intraductal papillary-mucinoustumor. Hepatogastroenterology. 2004; 51 (55): 86–90.

10.      Edwin B., Mala T., Mathisen O. et al. Laparoscopic resection of the pancreas: a feasibility study of the short-term outcome. Surg. Endosc. 2004; 18 (3): 407–411.

11.      Vezakis A., Davides M., Larvin M., McMahon M.J. Laparoscopic surgery combined with preservation of the spleen for distal pancreatic tumors. Surg. Endosc. 1999; 13 (1): 26–29.

Abstract:

Purpose. Оf the study was to prevent complications and improve the results of left-sided varicocele treatment.

Material and methods. Severe complications of open surgery (Ivanisevich technique) and endovascular procedures (left internal testicular vein embolization with metal coils) were analyzed.

Results. In all these cases we performed control angiographywas perfomed and the degree of anatomical and functional disturbances was assessed. Ways of complication prevention and countermeasures were offered.

Conclusions. Visualization of testicular venous bed should be made before any surgical or endovascular intervention on left varicocele. A surgeon should be aware of all possible complications. If some complication occurs, urgent visualization of the vascular bed and tissues ought to be performed, angiography being the golden standard. Complications if diagnosed should be eliminated as soon as possible by specialists. 

References 

1.      Ivanissevich O., Gregorini H. Una neuva operation   para curar el varicocele. S.Semana med. (Buenos Aires).   1918;   20:575-576.

2.      Dubin   L., Amelan R.D. Varicocelectomi as   Therapy   in   Male   infertility Stady   of 504 cases.    J.     Urol.    1975;     133 (15):604-641.

3.      Hommonai  Z.T.  et  al.  Tecticula function after herniotomy. Herniotomy and fertility. Andrologia. 1980; 11: 115-120.

4.      Рыжков В.К., Карев А.В., Таразов П.Г. и др. Комбинированные методы внутрисосудистых вмешательств при лечении варикоцеле. Урология и нефрология. 1999; 3: 18-22.

5.      Артюхин А.А. Фундаментальные основы сосудистой андрологии. М.: «Академия».  2008; 222.

6.      Кадыров З.А. Лапароскопическая урологическая хирургия. Урология и нефрология.  1997; 1: 40-44.

7.      Ким В.В., Казимиров В.Г. Анатомо-функциональное обоснование оперативного лечения варикоцеле. М.: ИД «Медпрактика-М». 2008; 112.

8.      Bach D. et al. Spaterqebnise nach Sclerotherapie der Varicocele. Uroloqe. 1984; 23 (6): 338-341.

Abstract:

Aim: was to evaluate morphological features of lesions in lower limb arteries before percutaneous transluminal angioplasty (PTA) and its arterial complications in patients with critical lower limb ischemia (CLI) combined with diabetes mellitus(DM).

Materials and methods: for the period from September 2010 to June 2013, a prospective single-center study was conducted involving 171 patients with CLI and DM (80(47%) men, mean age 64,1[54-68] years, mean HbA1c 8,3[7,4-9,6]%, mean duration of diabetes 16,5[8-23] years, diabetes type 1/2-18/153) who underwent PTA in 193 lower limbs. Myocardial infarction and brain stroke in anamnesis had 53(31%) and 19(11%) patients, respectively Chronic kidney disease (CKD) 3-4 stages had 40 patients(24%), end-stage renal disease - 16 cases (10%). Diagnosis of CLI was based on recommendation of TASC II. Patency of arteries of lower limbs was evaluated by duplex ultrasound (DU) before PTA and during early follow-up period (30 days). PTA in all patients was considered technically successful in restoring continuous arterial flow to the foot of at least one crural artery without residual stenosis >50%.

Results: stenosis>50% and occlusions of tibial arteries were found in all patients. Peripheral arterial disease 4-6 classes according Graziani L. classification was marked in 180(93%) cases. Extensive tibial arterial calcification was found in 123(64%) cases, in patients with residual stenosis (> 50% remaining diameter) -113 (89%). The mean value of transcutaneous oxygen pressure (tcpO2) before PTA was 14,7(8-25) mmHg, after PTA - 35,2 (31-38) mmHg. After PTA , residual stenosis (>50%) in treated arteries was in 125(79,1%) cases, thrombosis in treated arteries - 9(5,7%), intimal dissection - 18(11,4%), incomplete stent disclosure - 3(1,9%), incomplete capture stent area stenosis - 2(1,3%), dislocation of the stent - 1(0,6%). Repeat PTA in the early follow-up period was performed in 15 patients with clinically significant complications (6%).

Conclusion: CLI in diabetic patients is characterized by having severe morphological lesions of lower limb arteries, infrapopliteal arterial calcification. DU plays important role in evaluation of arterial patency and PTA complications in early follow-up period. The high level of residual stenosis of tibial arteries after PTA is associated with chronic complications of diabetes mellitus, including renal insufficiency Timely reintervention in diabetic patients with clinical significant PTA complications promotes optimal arterial patency and permission of CLI in theese cases. 

Reference

1.     Ajubova N.L., Bondarenko O.N., Galstjan G.R., Manchenko O.V., Dedov 1.1. Osobennosti porazhenija arterij nizhnih konechnostej i klinicheskie ishody jendovaskuljarnyh vmeshatel'stv u bol'nyh saharnym diabetom s kriticheskoj ishemiej nizhnih konechnostej i hronicheskoj pochechnoj nedostatochnost'ju [Peculiarities of arteries' lesions of lower limb, and clinical outcomes of PCI in patients with critical ishemia of lower limbs with diabetes mellitus and chronic renal insufficiency]. Saharnyj diabet. 2013; 4:85-94 [In Russ].

2.     TASC. Management of peripheral arterial disease (PAD). TransAtlantic Inter-Society Consensus (TASC). J.Vasc Surg., 2000;31(1 part2):S1-287.

3.     Lumley J.S. Vascular management of the diabetic foot- a British view. Journal Annals of the Academy of Medicine, Singapore. 1993, Vol 22, N 6, P 912-6 

4.     M.Doherty T., Lorraine A.F., Inoue D., Jian-Hua Qiao, M.C.Fishbein, R.C.Detrano, PK.Shan, T.B. Rajavashisth. Molecular, endocrine, and genetic mechanisms of arterial calcification. Endocrine Reviews. 2004, 25 (4):629-672

5.  Bublik E.V., Galstjan G.R., Mel'nichenko G.A., Safonov V.V., Shutov E.V., Filipcev P.Ja. Porazhenija nizhnih konechnostej u bol'nyh saharnym diabetom s terminal'noj stadiej hronicheskoj pochechnoj nedostatochnosti, poluchajushhih zamestitel'nuju pochechnuju terapiju [Lower limbs’ lesions in patients with diabetesmellitus with end-stage chronic renal insufficiency, receiving replacement therapy]. Saharnyj diabet. 2008; 2: 17-23 [In Russ].

6.     Jager K.A., Phillips D.J., Martin R.L., Hanson C., Roederer G.O., Langlois YE. et al. Noninvasive mapping of lower limb arterial lesions. Ultrasound Med. Biol. 1985;11: 515-21.

7.     Ciaverella A., Silletti A., &Mustacchio A., et al. Angiographic evaluation of the anatomic pattern of arterial obstructions in diabetic patients with critical limb ischemia. Diabet. Metab. 1993;19:586-589.

8.     Jude E.B., Oyibo S.O. & Chalmers N., et al. Peripheral arterial disease in diabetic and nondiabetic patients: a comparison of severity and outcome. Diabetes Care. 2001;24:1433-1437.

9.     Bandyk D.F. Surveillance after lower extremity arterial bypass. perspect vasc surg endovasc ther. Eur Heart J. 2007;19:376-83.

10.   Faglia E., Mantero M. & Caminiti M. et al. Extensive use of peripheral angioplasty, especially infrapopliteal, in the treatment of ischemic foot ulcer: clinical results of a multicentric study of 221 consecutive diabetic subjects. J. Intern. Med. 2002; 252:225-232.

11.   Adam D.J., Beard J.D., Cleveland T., Bell J., Bradbury A.W., Forbes J.F. et al.; BASIL Trial Participants. Bypass versus Angioplasty in Severelschaemia of the Leg (BASIL): multicentre, randomised controlled trial. Lancet. 2005; 366:1925-34.

12.   Norgen L., Hiatt W.R., Dormandy J.A., Nehler M.R., Harris K.A., Fowkes FGR. Inter-society Consensus for the Management of Peripheral Arterial Disease (TASC II). J. Vasc. Surg. 2007; 45(Suppl S):S5-67.

13.   Hirsch A.T., Haskal Z.J., Hertzer N.R., Bakal C.W., Creager M.A., Halperin J. et al; American Association for Vascular Surgery/Society for Vascular Surgery;Society for Cardiovascular Angiography and Interventions;Society for Vascular Medicine and Biology; Society for Inerventional Radiology; ACC/AHA TASC Force on Practice Guidelines. ACC/AHA Guidelines for the Management of Patients with Peripheral Arterial Disease (lower exteremity, renal, mesenteric, and abdominal aortic): a collaborative report from the American Association for Vascular Surgery/Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA TASC Forc on Practice Guidelines (writing committee to develop guidelines for the management of patients with peripheral arterial disease)-summary of recommendations. Circulation. 2006 113: e463-654,

14.   Dick F., Ricco J.B., Davies A.H.: Chapter VI: Follow-up after Revascularisation. Eur. J. Vasc. Endovasc. Surg. 2011; 42: S75-S90.

15.   Bondarenko O.N., Ajubova N.L., Galstjan G.R., Dedov 1.1. Dooperacionnaja vizualizacija perifericheskih arterij s primeneniem ul'trazvukovogo dupleksnogo skanirovanja u pacientov s saharnym diabetom i kriticheskoj ishemiej nizhnih konechnostej [Preoperative visualization of peripheral arteries with the help of ultrasonic duplex scanning in patients with critical ischemia of lower limbs and diabetes mellitus]. Saharnyj diabet. 2013; 2: 52-61 [In Russ].

16.   Arvela E., Dick F: Surveillance after Distal Revascularization for Critical Limb Ischemia. Scandinavian Journal of Surgery. 2012; 101:119-124. 

17.   Diehm N., Baumgartner I., Jaff M., Do D.D., Minar E., Schmidli J. et al. A call for uniform reporting standards in studies assessing endovascular treatment for chronic ischemia of lower limb arteries. Eur. Heart J. 2007; 28: 798-805.

Abstract:

Intraoperative vascular injury is infrequent complication (0.02-0.06%) during surgical operations on lumbar discs. We report a case of a 44-year-old man with oedema and varicose veins of the right lower limb. Despite an 4-year history of oedema and varicose veins, he appeared to be asymptomatic and could recollect no traumatic injury or surgery that might have caused it. Near the vertebral column, we found a small scar, the result of spinal disk surgery six years before. CT scan showed pseudoaneurysm of the right iliac artery with a 54 mm diameter. Thereafter, we located the suspected arteriovenous fistula by selective angiography of the aorta and its branches: a communication of the right iliac artery with the right iliac vein had resulted in a large shunt. This lesion was repaired by transluminal placement of stent-grafts Aorfix (Lombard Medical, UK). We had to use three stent-grafts due to the large difference in diameter between the common and external right iliac arteries. Hemodynamic improvement was immediate, and the postoperative course was uneventful. At the present time, almost six months postoperatively, the patient is asymptomatic. Sealing of pseudoaneurysm and arteriovenous fistula as a complication of lumbar-disc surgery with a stent graft is simple and is suggested as an excellent alternative to open surgery for iatrogenic vessel injuries. 

References

1.     Canaud L., Hireche K., Joyeux F., et al. Endovascular repair of aorto-iliac artery injuries after lumbar-spine surgery. Eur. J. Vasc, Endovasc. Surg. 2011; 42 (2): 167-171.

2.     Papadoulas S., Konstantinou D., Kourea H.P., et al. Vascular injury complicating lumbar disc surgery. A systematic review. Eur. J. Vasc. Endovasc. Surg. 2002; 24 (3): 189-195.

3.     Mulaudzi T., Sikhosana M. Arterio-venous fistula following a lumbar disc surgery. Indian J. Orthop. 2011; 45 (6): 563-564.

4.     Machado-Atias I., Fornes O., Gonzalez-Bello R., Machado-Hernandez I. Iliac arteriovenous fistula due to spinal disk surgery. Causes severe hemodynamic repercussion with pulmonary hypertension. Tex. Heart Inst. J. 1993; 20 (1): 60-64.

5.     Jarstfer B., Rich N. The challenge of arteriovenous fistula formation following disk surgery: A collective review. J. Trauma. 1976; 16: 726-733.

6.     Енькина Т.Н. Состояние сердечно-сосудистой системы у больных с хронической почечной недостаточностью на программном гемодиализе. Автореф. дис. ... канд. мед. Наук СПб. 1999. [En'kina T.N. Sostojanie serdechno-sosudistoj sistemy u bol'nyh s hronicheskoj pochechnoj nedostatochnost'ju na programmnom gemodialize [Condition of cardiovascular system in patients with chronic renal insufficiency on dialysis]. Avtoref. dis. ... kand. med. nauk SPb. 1999]. [In Russ].

7.     Brewster D., Cambria R., Moncure A., et al. Aortocaval and iliac arteriovenous fistulas: Recognition and treatment. J. Vasc. Surg. 1991; 13 (2): 253-264.

8.     Akpinar B., Peynircioglu B., Cil B., et al. Iliac vascular complication after spinal surgery: Immediate endovascular repair following CT angiographic diagnosis. Diagn. Inters. Radiol. 2009; 15 (4): 303-305.

9.     Hans S., Shepard A., Reddy P., et al. Iatrogenic arterial injuries of spine and orthopedic operations. J. Vasc. Surg. 2011; 53 (2): 407-413.

10.   Zajko A., Little A., Steed D., Curtiss E. Endovascular stent-graft repair of common iliac artery-to-inferior vena cava fistula. J. Vasc, Inters. Radiol. - 1995; 6 (5): 803-806 

Abstract:

Aim. Was to demonstrate our experience of using the stent-assistant technology for treatment of thromboembolic complication during endovascular procedures in extra- and intracranial arteries.

Materials and methods. Five patients with thromboembolic complication were successfully treated using stent-assistant technology In one case thromboembolic complication appeared during stenting of ICA, another - during performing of diagnostic cerebral angiography In 3 cases thromboembolic complications appeared during endovascular occlusion of intracranial artery. In four cases we used stent Solitaire (Covidien) in one case - Enterprise (Codman).

Results. In all cases we achieved full restoration of blood flow in intracranial vessels. Three patients were discharged without any neurological deficit. Two patients were discharged with minimal neurological deficit (mRS 1).

Conclusion. Stent-assistant technology can be successfully used in treatment of thromboembolic complications during endovascular procedures in extra- and intracranial arteries.

References

1.     Connors J., Sacks D., Furlan A., et al. Training, competency, and credentialing standards for diagnostic сervicocerebral angiography, carotid stenting, and cerebrovascular intervention: a joint statement from the American academy of neurology, American association of neurological surgeons1, American society of interventional and therapeutic radiology, American society of neuroradiology, congress of neurological surgeons, AANS/CNS cerebrovascular section, and society of interventional radiology. Radiology. 2005; 234: 26-34.

2.     Qureshi I., Luft R., Sharna M., et al. Prevention and treatment of tromboembolic and ischemic complications associated with endovascular procedures: Part I. Pathophysiological and pharmacological features. Neurosurgery. 2000; 46: 1344-1359.

3.     Bracard S., Abdel-Kerim A., Thuillier L., et all. Endovascular coil occlusion of 152 middle cerebral artery aneurysms: initial and midterm angiographic and clinical results. J. Neurosurg. 2010; 112: 703-708.

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5.     Blackham A., Meyers P., Abruzzo T., et al. Endovascular therapy of acute ischemic stroke: report of the standards of practice committee of the society of neurointerventional. J. NeturoIntevent. Surg. 2012; 4: 87-93.

6.     Costalat V., Machi P., Lobotesis K., et al. Rescue, combined, and stand-alone thrombectomy in the management of large vessel occlusion stroke using the solitaire device: a prospective 50-patient single-center study: timing, safety, and efficacy. Stroke. 2011; 42:1929-1935.

7.     Gonzalez F., Jabbour P., TJoumakaris S., et all. Temporary endovascular bypass: rescue technique during mechanical thrombolysis. Neurosurgery. 2012; 70: 245-252.

8.     Saver J., Jahan R., Levy E.I., et all. Primary results of the Solitaire With Intention for Thrombectomy (SWIFT) multicenter, randomised trial. Presented at the international stroke ranference 2012. 

Abstract:

Acute severe pancreatitis remains one of the actual issue in urgent surgery Forecast of the disease is dependant on spread of purulent necrotic process in pancreas and retroperitoneal tissues. Therefore diagnosis of purulent complications becomes extremely important.

The aim of the study was to demonstrate and evaluate features of ultrasonography in diagnosis and treatment strategy definition of purulent necrotic complications of acute severe pancreatitis.

Materials and methods. The study included 115 patients with acute destructive pancreatitis aged of 21-81 years The major part of them (50%) were persons at most able-bodied (working) aged 32-59 years. All patients underwent ultrasound diagnostics for determination the spread of pathology and detection of complications of the disease.

Ultrasound scanning was carried out as follows:

1. inspection of pancreatic parenchyma;

2. inspection of cellular tissues;

3. detection of free liquid in the abdominal cavity;

4. evaluation of the abdomen and kidneys;

5. inspection of the pleural cavity

Results. Examination of the parenchyma revealed that the pancreas was often inlarged, had a fuzzy, uneven contours and heterogeneous structure. However, it should be noted that in some cases, the pancreas was normal size and structure. Infected necrosis, acute liquid accumulation and/or free liquid in the abdominal cavity had occurred in 100% of cases in various combinations during examination of cellular tissues. Regarding the abdominal organs following complications were revealed: obstructive jaundice - in 5(4.3%) cases; portal vein thrombosis - in 1 (0.9%) case; splenic abscess - in 1 (0.9%) case. The presence of liquid in the pleural cavity was determined by leaves dissociation of the parietal and visceral pleura. The volume of the liquid was determined according standard classification.

Conclusion. Ultrasound scanning allows to determine the presence and extent of local complications arising at the stage of purulent necrotic complications of acute severe pancreatitis and general complications as a result of systemic pathological effect on the body of the disease.

References

1.     Охотников О.И. Перкутанная диапевтика в неотложной абдоминальной хирургии органов панкреато-билиарной зоны. Автореф. ... дис. докт. мед. наук. Воронеж. 1998; 39 с.

2.     Echenique A.M., Sleeman D., Yrizarry J. et al. Percutaneous catheter-directed debridement of infected pancreatic necrosis in 20 patients. J. Vase. Interv. Radiol. 1998; 9: 565-571.

3.     Затевахин И.И., Цициашвили М.Ш., Будурова М.Д. Комплексное ультразвуковое исследование при остром панкреатите. Анналы хирургии. 1999; 3: 36-42.

4.     Scaglione M., Casciani E., Pinto A. et al. Imaging Assessment of Acute Pancreatitis. Semin Ultrasound CT MRI. 2008; 29:322-340.

5.     Багненко С.Ф., Курыгин А.А., Синенченко ГИ. Хирургическая панкреатология. Санкт-Петербург: Речь. 2009; 608 с.

6.     Loser C., Folsch U.R. Acute pancreatitis: medical and endoscopic treatment. Pancreatic disease. State of the art and future aspects of research. 1998; 12: 66-78.

7.     Martines-Noguera A., Mohtserat E., Torruba S. etal. Ultrasound of the pancreas: update and controversies. Eur. Radiol. 2001; 11: 1594-1606.

8.     Mortele KJ, Girshman J, Szejnfeld D, et al. CT-guided percutaneous catheter drainage of acute necrotizing pancreatitis: clinical experience and observations in patients with sterile and infected necrosis. AJR Am. J. Roentgenol. 2009; 192(1): 110-116.

9.     Kumar P., Mukhopadhyay S., Sandhu M. et al. Ultrasonography computed tomography and percutaneous intervention in acute pancreatitis: A serial study. Austral. Radiology. 1995; 39(2): 145-152.

10.   Balthazar E.J., Freeny P.C., van Sonnenberg E. Imaging and intervention in acute pancreatitis. Radiology. 1994; 193: 297-306.

11.   Mortele K.J., Wiesner W., Intriere L. et al. Modified CT severity index for evaluating acute pancreatitis: improved correlation with patient outcome. Am. J. Roentgenol. 2004; 183(5): 1261-1265.

12.   Bharwani N., Patel S., Prabhudesai S. et al. Acute pancreatitis: The role of imaging in diagnosis and management. Clinical Radiology.2011; 66: 164-175.

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16.   Кармазановский ГГ, Степанова Ю.А. Классификация острого панкреатита - современное состояние проблемы и нерешенные вопросы. Медицинская визуализация. 2011; 4: 133-137.

17.   Сидорова Ю.В., Шабунин А.В., Араблинский А.В., Шиков Д.В., Бедин В.В., Лукин А.Ю. Острый панкреатит: некоторые вопросы диагностики и лечения. Диагностическая и интервенционная радиология. 2011; 5(2): 15-26. 

Abstract:

Aim: was to combine results of surgical treatment of patients with primary reconstruction of arteries of lower limbs with patients who underwent reconstructive operations on early stented arteries.

Materials and methods: research included 93 patients with critical ischemia of lower limbs. All patients were devided into two groups with division to subgroups. Group 1a - 23 patients after stenting of iliac arteries. Group 1b - 23 patients with stenosis or occlusion of iliac arteries without previous operations. Group 2a - 22 patients with thrombosis or restenosis of arteries lower than inguinal ligament after previous endovascular treatment. Group 2b - 25 patients with primary atherosclerotic lesion of arteries of lower limbs lower than inguinal ligament .

Results: in early postoperative period and 6 months after reconstructive operation there were no difference in all groups and subgroups of treated patients. The level of complications in late post-operative period is lower in case of primary reconstruction of arteries lower than inguinal ligament in comparison with operations after endovascular interventions.  

References

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6.     Bondarenko O.N., Galstjan G.R., Ajubova N.L., Egorova D.N., Dedov 1.1. Rol' ul'trazvukovogo dupleksnogo skanirovanija v ocenke ishodov jendovaskuljarnyh vmeshatel'stv u bol'nyh saharnym diabetom i kriticheskoj ishemiej nizhnih konechnostej v rannie sroki nabljudenija [The role of ultrasonic duplex scanning in estimation of results of endovascular interventions in patients with diabetus mellitus and critical ischemia of lower limbs in early postoperative period]. Diagnosticheskaja i intervencionnaja radiologija. 2014; 8(3)15-28 [In Russ]. 

Abstract:

Ventricular septal defect after myocardial infarction (post-MI VSD) is one of the most rare and lethal complication.

We present a case report of patient with recurrent VSD, 7 months after coronary artery bypass graft with cardiosurgical correction of post-MI VSD. Due to the high risk of re-operation, it was decided to perform endovascular closure of VSD.

Despite acceptable stability test, after delivery system disconnection - migration of occluder to left ventricular occurred. All efforts to retrieve device were not successful, due to strong fixation of the device in anterior leaflet chordal tendons of mitral valve (MV). The presence of 12 mm occluder didn't influence on existed MV insufficiency, so the decision to leave this device in place and to implant the bigger one to VSD was made. 14 mm occluder was successfully implanted, with immediate reduction of left-right shunt and normalization of pulmonary artery pressure. Follow-up period is 3 years - patient doesn't have any complaints. Ejection fraction 55%, mitral insufficiency 30% by volume, device is fully endothelialyzed.

Endovascular VSD occlusion can be effectively used in case of post-surgery re-occurence. In cases of migration of endovascular devices, thorough functional analysis should be performed for choosing the best strategy of further actions. In this clinical case the decision to leave the device in LV didn't cause any negative outcomes for the patient.

References

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6.     Calvert PA., Cockburn J., Wynne D. et al. Percutaneous closure of postinfarction ventricular septal defect: in-hospital outcomes and long-term follow-up of UK experience. Circulation. 2014;129:2395-402.

7.     Deja M.A., Szostek J., Widenka K. et al. Post infarction ventricular septal defect - can we do better? Eur J Cardiothorac Surg. 2000;18:194-201.

8.     Takahashi H., Arif R., Almashhoor A., et al. Longterm results after surgical treatment of postinfarction ventricular septal rupture. Eur J Cardiothorac Surg. 2015;47(4):720-724.

9.     Holzer R., Balzer D., Lock Qi-Ling Cao K., Hijazi Z.M. Device closure of muscular ventricular septal defects using the Amplatzer muscular ventricular septal defect occluder. J Am Coll Cardiol. 2004;43:1257-1263.