Notes

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orm adequate myocardial revascularization. Performing endarterectomy from coronary arteries is associated with an increased risk for the development of myocardial infarction, but its use is justified if it is impossible to create an anastomosis by means of other techniques.Occlusive and stenotic lesions of lower-limb arteries appear to be amongst the most common manifestations of the pathology of the cardiovascular system and are characterized by various degree of chronic arterial insufficiency. Revascularization is the main stage of treatment for chronic arterial insufficiency of the lower extremities. Performing a reconstructive operation aimed at restoring the arterial blood flow in the ischaemized extremity is accompanied and followed by the development of reperfusion syndrome. The purpose of this study was to assess efficacy of using regional lymphotropic therapy for treatment of reperfusion syndrome in patients with chronic ischaemia of lower limbs in the postoperative period. The study included two groups of patients the comparison group with standard postoperative treatment and the study group where the standard therapy was supplemented with regional lymphotropic therapy. In the postoperative period, the patients in both groups developed reperfusion oedema of the operated lower limb on day 3 after arterial reconstruction, however, on POD 7 after revascularization, the severity of oedema was apparently less in the study group. Lymphorrhoea after operative treatment in the study group was encountered significantly less often as compared with the control group. According to the findings of ultrasonographic examination of soft tissues in the postoperative period, patients of both groups on POD 3 were found to have pronounced oedema of soft tissues. However, on POD 7 the study group patients demonstrated a dramatic decrease in the thickness of oedema of the subcutaneous fat versus the comparison group patients. Regional lymphotropic therapy after reconstructive operations on arteries of lower limbs promoted a decrease in the severity of reperfusion syndrome on the operated lower limb.Obliterating peripheral artery disease is a commonly occurring pathological condition, most often resulting from an atherosclerotic lesion of vessels with progressive narrowing of their lumens. The consequences of decompensation of chronic arterial insufficiency such as ischaemic pain, claudication, and trophic impairments are in some instances difficult to treat, despite using multicomponent medicamentous therapy and/or performing revascularizing interventions. This article describes a clinical case report regarding the use of spinal stimulation in a patient presenting with stage IV chronic lower limb ischaemia according to the Fontaine classification. This is accompanied and followed by depicting the dynamics of the laboratory, instrumental, and clinical parameters over a two-year follow-up period. In order to explain the choice of the intervention and the causes of the described picture, discussed are the existing theories of the mechanisms of action of spinal stimulation. To this is added a literature review of using this method in treatment of lower limb critical ischaemia when performing reconstructive angiosurgical treatment is unavailable. Mention is also made of the incidence and types of probable complications, as well as possibilities and limitations of the method.
The study was aimed at assessing the remote results of infrainguinal reconstructions in patients with critical lower limb ischaemia depending upon the bypass graft material used.

Analysed herein are the results of 237 infrainguinal bypass procedures performed over a 9-year period from January 1st, 2010 to December 31st, 2018. The patients were divided into three groups depending on the level of the distal anastomosis. Each group was then subdivided into subgroups based on the bypass graft material. Group One comprised 40 patients having endured femoral-proximal-popliteal bypass grafting. Group Two was composed of 77 patients after femoral-distal-popliteal bypass graft operations. Group Three included 120 patients after femorotibial bypass graft procedures. The comparative analysis was carried out in the first group between autovenous and synthetic grafts, in the second group - between autovenous, synthetic grafts and xenografts, and in the third group - between autovenous, composite grafts and xenografts.rafts when shunting to the distal portion of the popliteal artery or tibial arteries. Despite worse patency, with their help it is possible to achieve regression of critical ischaemia and an acceptable limb salvage rate, which is comparable to the results of autovenous grafts.Our study was aimed at determining advantages of profundoplasty in patients with critical ischaemia of lower limbs in repeat arterial reconstructions. It included a total of 56 patients subjected to redo operations for thrombosis of a femoropopliteal bypass graft. Of these, 29 underwent profundoplasty (group I) and 27 repeat femoropopliteal bypass grafting (group II). Critical ischaemia was relieved in the early postoperative period in 28 (97%) and 24 (89%) patients of group I and II, respectively. The 3-year patency rate after profundoplasty amounted to 100% and after femoropopliteal bypass grafting to 47% (p0.05).
The aim of our investigation was to analyse the results of treatment of patients with atherosclerotic lesions of the femoropopliteal segment by means of femoropopliteal bypass grafting or loop endarterectomy within the framework of a single-centre retrospective study.

The study included a total of 177 patients who were divided into two groups. Group One was composed of 108 patients subjected to loop endarterectomy from the arteries of the femoropopliteal segment, and Group Two comprised 69 patients who endured femoropopliteal bypass surgery using a synthetic graft.

Thoroughly analysed were the clinical, demographic, anatomical and perioperative data, as well as intra- and perioperative complications, followed by assessment of primary and secondary patency, with no statistically significant differences in these parameters revealed. Secondary patency was somewhat better in the group of loop endarterectomy. Also determined and examined were specific complications such as insufficient extraction of the plaque, perforation of the artery with the loop, thinning of the wall, detachment of the calcified plaque. This is followed by discussing variants of correction of similar events. In the group of loop endarterectomy, there were no severe complications, such as myocardial infarction, stroke, amputation in the early postoperative period.

Loop endarterectomy is an acceptable alternative to femoropopliteal bypass grafting with a synthetic prosthesis. Taking into account all specific complications, it is possible to achieve minimization of unsuccessful outcomes.
Loop endarterectomy is an acceptable alternative to femoropopliteal bypass grafting with a synthetic prosthesis. Taking into account all specific complications, it is possible to achieve minimization of unsuccessful outcomes.Surgical revascularization of the carotid basin in the acutest period of ischaemic stroke, i.e., within 72 hours, will make it possible to prevent the development of recurrent stroke by removing an embologenically dangerous atherosclerotic plaque of the symptomatic carotid artery and to improve cerebral blood supply, having eliminated haemodynamic stenosis of the carotid artery. However, the problem of safety of carotid endarterectomy in patients during the acutest period of ischaemic stroke still remains debatable.
To comparatively analyse safety of eversion carotid endarterectomy performed in the acutest (0-72 hours) and acute (4-14 days) periods of minor ischaemic stroke.

Between January 2015 and December 2019, specialists of the Department of Vascular Surgery of Municipal Clinical Hospital # 7 of Kazan performed a total of 80 eversion carotid reconstructions in the period of minor ischaemic stroke within 14 days. The patients were divided into 2 groups depending on the terms of performing carotid endarng neurological deficit for 6 months (Rankin scale score 2). The comparative assessment of severity of stroke on the day of operation and at discharge, as well as that of neurological symptomatology during the 1st and 6th months of follow up in both groups proved positive. No events of acute coronary syndrome, recurrent strokes or lethal outcomes were observed during the follow-up period.

According to the findings of our study, patients with acute cerebral circulation impairment caused by embologenically dangerous lesions of internal carotid arteries should be operated on within the first 72 hours, if there are no accompanying changes requiring time for correction thereof.
According to the findings of our study, patients with acute cerebral circulation impairment caused by embologenically dangerous lesions of internal carotid arteries should be operated on within the first 72 hours, if there are no accompanying changes requiring time for correction thereof.Demonstrated in the article are the results of catheter-directed thrombolysis in a male patient presenting with bilateral acute iliofemoral venous thrombosis on the background of aplasia of the inferior vena cava. The incidence rate of this pathology is specified, with an emphasis on no recommendations on choosing optimal therapeutic strategy in this cohort of patients. The main causes and complications of the disease are described. The realized policy of revascularization demonstrated its safety and efficacy. The chosen method of correction resulted in a successful outcome of treatment, preventing phlegmasia cerulea dolens. This policy can be recommended as most preferred for patients with acute iliofemoral venous thrombosis on the background of aplasia of the inferior venal cava.
To evaluate the efficacy of a micronized purified flavonoid fraction in patients with primary venous disease. The study enrolled 31 patients, with varicose veins observed in a total of 47 lower extremities which were divided into 3 groups depending on the CEAP clinical class. The group of class C2 included 19 limbs, with the groups of C3 and C4 comprising 14 limbs each. The patients received a micronized purified flavonoid fraction (Detralex) in a daily dose of 1000 mg for 1 month. The venous function of the lower extremities was examined using venous photoplethysmography before and after the course of pharmacotherapy. Venous refilling time and venous half-refilling time were measured as indicators of total venous reflux. In the overall sample of patients with clinical class C2-C4, a significant increase in venous photoplethysmography parameters was found after the course of administration of the micronized purified flavonoid fraction. Thus, the venous refilling time increased from 15.5 (11; 19) s to 19.3 (as found, and in patients with C4, the increase was not significant. Epacadostat There was an inverse correlation between the increase in venous refilling time after drug exposure and the clinical class of venous insufficiency according to the CEAP, as well as the patient's age. Thus, the administration of the micronized purified flavonoid fraction for 1 month in primary venous disease led to a decrease in the total venous reflux. The effect of the micronized purified flavonoid fraction on the total venous reflux was higher in younger patients and in patients with a lower clinical class of the disease.
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