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[Thromboaspiration for acute upper limb ischemia in a patient with COVID-19 (case report)]. 【新冠肺炎患者急性上肢缺血致血栓抽吸1例(附病例报告)】。
Q3 Medicine Pub Date : 2022-09-30 DOI: 10.33029/1027-6661-2022-28-3-128-134
Sh R Dzhurakulov, V A Stupin, V I Vechorko, N B Tagaev, D A Maitesyan, K V Tashliev, K Yu Anglichanova

Presented herein is a clinical case report regarding endovascular thromboaspiration in acute upper limb ischemia having developed on the background of the novel coronavirus infection. A 66-year-old male patient had previously undergone in-hospital treatment for novel coronavirus pneumonia, to be discharged with clinical improvement. After discharge, the man by physician's recommendation continued taking rivaroxaban at a dose of 10 mg daily. Despite this, he developed acute thrombosis of the arteries of the forearm and hand. He was admitted to the City Clinical Hospital № 15 named after O.M. Filatov. The examination revealed a clinical picture corresponding to stage IIa acute upper limb ischemia. Anticoagulant and dual desaggregant therapy did not lead to regress of ischemia. The patient was subjected to thromboaspiration, with restoration of blood flow through upper limb arteries.

本文报告了一例以新型冠状病毒感染为背景的急性上肢缺血血管内血栓吸入性感染的临床病例。患者男,66岁,曾因新型冠状病毒肺炎住院治疗,临床好转出院。出院后,根据医生的建议,患者继续服用每日10mg的利伐沙班。尽管如此,他还是患上了前臂和手部动脉的急性血栓。他住进了以O.M.菲拉托夫命名的第15市临床医院。检查显示临床表现为IIa期急性上肢缺血。抗凝和双重解聚治疗没有导致缺血的消退。患者接受血栓抽吸,恢复上肢动脉血流。
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引用次数: 0
[Early results of MANTA percutaneous closure device employment after aortic endovascular procedures]. [主动脉血管内手术后经皮使用MANTA闭合装置的早期结果]。
Q3 Medicine Pub Date : 2022-09-30 DOI: 10.33029/1027-6661-2022-28-3-93-97
E L Kalmykov, I A Suchkov, R Dammrau

Objective: The aim of the study was to assess safety and reliability of using the MANTA closure device in endovascular treatment of patients with aortic aneurysms.

Patients and methods: The obtained results were retrospectively analysed based on the experience of treating 19 patients (from July 01, 2021 to November 31, 2021) for abdominal aortic aneurysms (n=14) and thoracic aortic pathology (n=5). All operations were performed at the Vascular and Endovascular Surgery Clinic, St. Katharine's Hospital, Frechen, Germany. In all cases, sheaths 9-14F were used for graft implantation. The primary endpoint of efficacy was technical success, with neither acute bleeding nor thromboembolic complications. In our study we used the MANTA closure device (Teleflex, Wayne, Pennsylvania), a novel device for closing percutaneous access to the femoral artery following the use of 10-20F (12-25F OD) devices or sheaths in endovascular catheterization procedures.

Results: Of the total number of patients, three had a dissection of the thoracic aorta, two penetrating aortic ulcer, in 14 cases aneurysm of the abdominal aorta. The mean age of the patients was 67±2.2 years. There were 16 males and 3 females. Of the 19 patients, bilateral access was used in 18 (37 inguinal approaches), in one case a monoiliac graft was implanted. The technical success of implantation of the MANTA closure device was 100%, with no conversion to open access to the femoral vessels. The findings of CT angiography confirmed neither complications in the area of the vascular access, nor stenosis of the access area requiring surgical treatment. Fourteen of the 19 patients underwent ultrasound duplex scanning of vessels in the access zone prior to discharge from the clinic, demonstrating no significant stenosis in the area of arterial closing.

Conclusion: The use of the MANTA CD closure device is safe and accompanied by good immediate results, however, further experience is needed with this device.

目的:本研究的目的是评估使用MANTA封闭装置在血管内治疗主动脉瘤患者的安全性和可靠性。患者和方法:回顾性分析19例(2021年7月1日至2021年11月31日)腹主动脉瘤(n=14)和胸主动脉病理(n=5)的治疗经验。所有手术均在德国Frechen St. Katharine医院血管和血管内外科诊所进行。在所有病例中,鞘9-14F用于移植物植入。疗效的主要终点是技术上的成功,没有急性出血和血栓栓塞并发症。在我们的研究中,我们使用了MANTA封闭装置(Teleflex, Wayne, Pennsylvania),这是一种新型装置,用于在血管内插管过程中使用10-20F (12-25F OD)装置或鞘后关闭经皮股动脉通路。结果:14例腹主动脉动脉瘤中,3例发生胸主动脉夹层,2例发生穿透性主动脉溃疡。患者平均年龄67±2.2岁。男性16人,女性3人。在19例患者中,18例(37例腹股沟入路)采用双侧入路,1例植入单髂移植物。MANTA闭合装置植入的技术成功率为100%,没有转换为开放的股血管通道。CT血管造影结果证实血管通路区域未出现并发症,也未出现需要手术治疗的通道狭窄。19例患者中有14例在出院前对通道区血管进行超声双工扫描,显示动脉闭合区无明显狭窄。结论:使用MANTA CD闭合装置是安全的,并具有良好的立竿见影的效果,但需要进一步的经验。
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引用次数: 0
[Role of physician-in-ordinary privy councilor N.F. Arendt (1786-1859) in the formation of angiology and vascular surgery in Russia]. [普通内科医生阿伦特(N.F. Arendt, 1786-1859)在俄罗斯形成血管学和血管外科中的作用]。
Q3 Medicine Pub Date : 2022-09-30 DOI: 10.33029/1027-6661-2022-28-3-8-14
S P Glyantsev, Yu Yu Kryukov

The article is devoted to analyzing the surgical and scientific activity of physician-in-ordinary privy councilor N.F. Arendt (1786-1859) in the field of angiology and vascular surgery and putting into scientific circulation his article published in 1823 in the first issue of the 'Military Medical Journal'. The content analysis of the article revealed that N.F. Arendt was one of the first in Russian literature to describe arteriovenous malformation and its surgical treatment by ligation of the common carotid artery. It was also shown that for the first time in Russia N.F. Ardent performed ligations of the external iliac and subclavian arteries, brachiocephalic trunk, constructed and introduced into practice an instrument for applying ligations onto vessels, also publishing several scientific works dedicated to vascular surgery. N.F. Arendt's priority achievements significantly contributed to the development of angiology and vascular surgery in Russia.

这篇文章致力于分析普通内科医生阿伦特(N.F. Arendt, 1786-1859)在血管学和血管外科领域的外科和科学活动,并将他在1823年第一期《军事医学杂志》上发表的文章纳入科学流通。文章内容分析显示,N.F. Arendt是俄罗斯文献中最早描述动静脉畸形及其通过结扎颈总动脉手术治疗的人之一。研究还表明,在俄罗斯,N.F. Ardent首次对髂外动脉和锁骨下动脉、头臂干进行结扎,建造并应用了一种血管结扎的仪器,并发表了几篇专门研究血管外科的科学著作。阿伦特的优先成就显著促进了俄罗斯血管学和血管外科的发展。
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引用次数: 0
[Neural networks in the field of intravascular ultrasound studies (literature review)]. 【神经网络在血管内超声研究领域的应用(文献综述)】。
Q3 Medicine Pub Date : 2022-09-30 DOI: 10.33029/1027-6661-2022-28-3-32-36
E A Kovalev, L D Khidirova

This article is a review discussing neural networks used in the field of intravascular ultrasound examinations and performing functions of automatic identification of unstable plaques, isolation of vascular walls, prediction of the fractional flow reserve. Based on the analysed material, it was determined that neural networks in the field of ultrasound studies are currently an emerging and actively developing trend of intravascular imaging. In case if it is possible to achieve the human-comparable accuracy of the obtained results and to prove them in direct comparison in a clinical trial it could lead to decreasing the cost and increasing the rapidity of performing a percutaneous coronary intervention. We also believe that in future it will be possible to combine the algorithms of automated detection of unstable plaques and prediction of fractional flow reserve, thus unifying intravascular ultrasound examinations for many clinical situations.

本文就神经网络在血管内超声检查中的应用及其在不稳定斑块自动识别、血管壁隔离、血流储备分数预测等方面的应用作一综述。根据分析的材料,确定了超声研究领域的神经网络是目前血管内成像的新兴和积极发展的趋势。如果有可能达到与人类相当的结果准确性,并在临床试验中直接比较证明它们,则可能导致降低成本并增加进行经皮冠状动脉介入治疗的速度。我们也相信,未来将有可能将不稳定斑块的自动检测算法与血流储备分数的预测算法结合起来,从而统一许多临床情况的血管内超声检查。
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引用次数: 0
[Ultrasound assessment of the significance of vascular pathology for headaches of 'unclear origin' (lecture)]. [超声评估血管病理对“不明原因”头痛的意义(讲座)]。
Q3 Medicine Pub Date : 2022-09-30 DOI: 10.33029/1027-6661-2022-28-3-15-22
M V Shumilina
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引用次数: 0
[Profundoplasty and balloon angioplasty of deep femoral artery in patients with atherosclerotic lesion of lower limb arteries (literature review)]. [下肢动脉粥样硬化病变患者股深动脉深度成形术和球囊血管成形术[文献综述]。
Q3 Medicine Pub Date : 2022-09-30 DOI: 10.33029/1027-6661-2022-28-3-135-142
A V Gavrilenko, Z A Kavteladze, Ya M Sarkhanidze, G F Magomedova

Atherosclerosis of the lower extremities arteries accounts for 20% of the pathology of the cardiovascular system. The spread of the pathological process, high rates of disability, amputations, and mortality are characteristic of this pathology. In patients with lower limb ischemia, the state of the deep femoral artery performs a significant role. With femoral-popliteal occlusion, the viability of the limb depends entirely on the condition of the deep femoral artery. The elimination of stenotic changes in this arterial pool more frequently envisages open reconstructions, however, the correction of the inflow and outflow pathways is often carried out by the endovascular method. Proponents of open surgery note satisfactory long-term clinical results, while balloon angioplasty is becoming a less invasive method, accompanied by a low incidence of postoperative complications in persons with a high surgical risk, both in the presence of intermittent claudication and in the case of critical ischemia.

下肢动脉粥样硬化占心血管系统病理的20%。病理过程的扩散、高致残率、截肢率和死亡率是这种病理的特征。在下肢缺血患者中,股深动脉的状态起着重要的作用。对于股腘动脉闭塞,肢体的生存能力完全取决于股深动脉的状况。为了消除动脉池狭窄的改变,更常见的方法是开放重建,然而,流入和流出通道的纠正通常是通过血管内方法进行的。开放手术的支持者注意到令人满意的长期临床结果,而球囊血管成形术正在成为一种侵入性较小的方法,并且在存在间歇性跛行和严重缺血的情况下,对于手术风险高的患者,术后并发症的发生率低。
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引用次数: 0
[Simultaneous removal of carotid paraganglioma and carotid endarterectomy (case report)]. 【同时切除颈动脉副神经节瘤及颈动脉内膜切除术(1例报告)】。
Q3 Medicine Pub Date : 2022-09-30 DOI: 10.33029/1027-6661-2022-28-3-98-102
A V Chupin, A L Golovyuk, A S Kutovaya, N I Verdikhanov

Carotid paragangliomas are rare disease. Radical removal of the tumor is the method of choice in the treatment such patients. The risks of surgical treatment are potential injury of the branches of the cranial nerves of the caudal group and the possible reconstruction of the carotid arteries. The combination of a tumor process with an atherosclerotic lesion of the carotid artery bifurcation is extremely rare. Single cases of both simultaneous and staged removal of the tumor and reconstruction of the carotid bifurcation due to atherosclerotic lesions are observed. We present a unique clinical case of simultaneous open surgical treatment of a patient with a large carotid chemodectoma type I according to the Shamblin classifi cation and hemodynamically significant atherosclerotic stenosis of the ipsilateral internal carotid artery. Accumulated expirience in treating patients with paragangliomas of the neck, as well as atherosclerotic lesions of the brachiocephalic arteries, allowed us to choose the optimal tactics of surgical treatment and achieve acceptable results.

颈动脉副神经节瘤是一种罕见的疾病。肿瘤根治术是治疗此类患者的首选方法。手术治疗的风险是可能损伤尾侧群脑神经分支和可能重建颈动脉。肿瘤过程合并颈动脉分叉处的动脉粥样硬化病变是极为罕见的。同时和分阶段切除肿瘤和重建颈动脉分叉由于动脉粥样硬化病变的单例观察。我们提出了一个独特的临床病例,同时开放手术治疗患者的大颈动脉化疗瘤I型根据Shamblin分类和血流动力学显著动脉粥样硬化性狭窄的同侧颈内动脉。在治疗颈部副神经节瘤患者以及头臂动脉粥样硬化病变方面积累的经验,使我们能够选择最佳的手术治疗策略,并取得令人满意的效果。
{"title":"[Simultaneous removal of carotid paraganglioma and carotid endarterectomy (case report)].","authors":"A V Chupin, A L Golovyuk, A S Kutovaya, N I Verdikhanov","doi":"10.33029/1027-6661-2022-28-3-98-102","DOIUrl":"10.33029/1027-6661-2022-28-3-98-102","url":null,"abstract":"<p><p>Carotid paragangliomas are rare disease. Radical removal of the tumor is the method of choice in the treatment such patients. The risks of surgical treatment are potential injury of the branches of the cranial nerves of the caudal group and the possible reconstruction of the carotid arteries. The combination of a tumor process with an atherosclerotic lesion of the carotid artery bifurcation is extremely rare. Single cases of both simultaneous and staged removal of the tumor and reconstruction of the carotid bifurcation due to atherosclerotic lesions are observed. We present a unique clinical case of simultaneous open surgical treatment of a patient with a large carotid chemodectoma type I according to the Shamblin classifi cation and hemodynamically significant atherosclerotic stenosis of the ipsilateral internal carotid artery. Accumulated expirience in treating patients with paragangliomas of the neck, as well as atherosclerotic lesions of the brachiocephalic arteries, allowed us to choose the optimal tactics of surgical treatment and achieve acceptable results.</p>","PeriodicalId":7821,"journal":{"name":"Angiologiia i sosudistaia khirurgiia = Angiology and vascular surgery","volume":"93 1","pages":"98-102"},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89082892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
[Arterial hypertension after carotid endarterectomy and internal carotid artery stenting]. [颈动脉内膜切除术和颈内动脉支架置入术后动脉高血压]。
Q3 Medicine Pub Date : 2022-09-30 DOI: 10.33029/1027-6661-2022-28-3-68-76
A N Vachev, E V Frolova, V N Sevryukova, O V Tereshina, P A Lebedev

We performed a comparative analysis of the course of arterial hypertension after internal carotid artery stenting (CAS) (group I, n=31) and carotid endarterectomy with glomectomy (Keni's modification) (SEA) (group II, n=32). The study was randomized, including patients with grade 2 and higher arterial hypertension, ischemic stroke ipsilateral to carotid lesion, stenosis of the internal carotid artery exceeding 70%, no clinical signs of vertebrobasilar insufficiency, renal artery stenosis, or diabetes mellitus, with the glomerular filtration rate exceeding 80. In the early postoperative period, the mean values of blood pressure decreased significantly after both CEA and CAS, with the Wilcoxon criteria amounting to 293.5 and 27, respectively (p<0.05). However, a statistically significant difference between the baseline and 1-year values was observed only in the CEA group (р<0.001). Long-term follow-up revealed a statistically significant decrease in the proportion of patients with grade 3 hypertension in the CEA group (р<0.001). Whereas after carotid stenting, the difference turned out to be statistically insignificant. There were between-group statistically significant differences in the Kaplan-Meier estimates for arterial hypertension recurrence and freedom from cardiovascular events, thus suggesting clinical advantage of CEA with glomectomy over CAS in patients with arterial hypertension (р<0.005). Conclusion. When choosing a method of reconstruction in patients with initially uncontrolled hypertension, unilateral carotid bifurcation stenosis, a history of ischemic stroke ipsilateral to carotid lesion, preference should be given to CEA with glomectomy, as it leads to a long-term (over 1 year) blood pressure decrease.

我们对颈内动脉支架植入术(CAS) (I组,n=31)和颈动脉内膜切除术合并肾小球切除术(Keni’s modification) (SEA) (II组,n=32)后动脉高血压的病程进行了比较分析。研究随机纳入2级及以上高血压、缺血性卒中伴颈动脉病变、颈内动脉狭窄超过70%、无椎基底动脉功能不全、肾动脉狭窄、糖尿病、肾小球滤过率超过80的患者。术后早期,CEA和CAS术后血压平均值均明显下降,Wilcoxon标准分别为293.5和27 (p
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引用次数: 0
[Resection of a visceral artery aneurysm using the robot-assisted surgical system da Vinci Xi (case report)]. 使用机器人辅助手术系统da Vinci Xi切除内脏动脉瘤(病例报告)。
Q3 Medicine Pub Date : 2022-09-30 DOI: 10.33029/1027-6661-2022-28-3-108-112
P V Sukhoruchkin, A Yu Popov, A B Zakeryaev, V Ya Lichishchin, S R Butaev, D M Tumasov, R A Vinogradov, A G Baryshev, V A Porhanov

One of the causes of intra-abdominal bleeding may be a ruptured aneurysm of visceral arteries of the abdominal aorta. Given high mortality from ruptured aneurysms, treatment for both symptomatic and asymptomatic aneurysms is mandatory. This article reports a clinical case concerning treatment of a splenic artery aneurysm with the help of a robot-assisted surgical system da Vinci Xi. Based on the analysis of the world experience in visceral arteries aneurysm treatment and the presented clinical case, the most rational treatment method is an endoscopic method of aneurysm resection using the da Vinci surgical system, which has proved reliable and yields excellent functional, clinical, and economically promising positive results.

腹内出血的原因之一可能是腹主动脉内脏动脉的动脉瘤破裂。鉴于动脉瘤破裂的高死亡率,治疗有症状和无症状的动脉瘤是强制性的。本文报告一个使用机器人辅助手术系统达芬奇Xi治疗脾动脉瘤的临床病例。通过对国内外内脏动脉动脉瘤治疗经验的分析,结合本文的临床病例,认为最合理的治疗方法是采用达芬奇手术系统进行内窥镜下动脉瘤切除术,该方法已被证明是可靠的,具有良好的功能、临床和经济前景的积极效果。
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引用次数: 0
[Antithrombotic therapy in patients with lower limb chronic ischemia: is therapy with aspirin alone suffi cient?] 下肢慢性缺血患者的抗血栓治疗:阿司匹林单独治疗是否足够?]
Q3 Medicine Pub Date : 2022-09-30 DOI: 10.33029/1027-6661-2022-28-3-143-151
K A Andreychuk, G Yu Sokurenko

Peripheral artery diseases have increasingly been gaining in medical and social importance due to not only growing morbidity but also therapeutic outcomes not fully satisfying both clinicians and patients, especially those with manifestations of critical limb ischemia. Revascularizing interventions combined with optimal medicamentous treatment are the 'gold standard' in treatment of symptomatic lesions of peripheral arteries. Along with it, risks for the development of thrombotic complications both in the zone of the reconstruction and in other vascular basins, negatively influence overall rates of patients' mortality and disability. Antiplatelet agents have so far remained in fact the only substantiated from the point of view of evidence-based medicine therapeutic factor decreasing the risks for the development of thrombotic complications in this patient cohort. A series of other drugs influencing blood coagulation system, as well as a combination thereof, by the findings of hitherto performed trials failed to demonstrate sufficient efficacy and/or safety. Oral anticoagulants opened new possibilities for antithrombotic prevention and treatment and have widely been used in various cardiovascular diseases. The results of a series of trials the most significant of which may be considered VOYAGER PAD showed possibilities and feasibility of introducing anticoagulants into therapeutic regimens for patients with PAD. Safety and efficacy of treatment regimens envisaging a combination of antiplatelet drugs with rivaroxaban at a dose of 2.5 mg twice daily were demonstrated both for patients undergoing conservative treatment and those after endured endovascular revascularizing interventions.

外周动脉疾病在医学和社会上的重要性日益增加,不仅由于发病率的增加,而且由于治疗结果不能完全满足临床医生和患者,特别是那些表现为严重肢体缺血的疾病。血管重建干预结合最佳药物治疗是治疗外周动脉症状性病变的“金标准”。与此同时,在重建区和其他血管盆地发生血栓性并发症的风险,对患者的总体死亡率和致残率产生了负面影响。从循证医学的角度来看,抗血小板药物迄今为止实际上仍然是唯一被证实的降低该患者队列中血栓性并发症发生风险的治疗因素。一系列影响凝血系统的其他药物及其组合,迄今为止进行的试验结果未能证明足够的有效性和/或安全性。口服抗凝剂为抗血栓预防和治疗开辟了新的可能性,并已广泛应用于各种心血管疾病。一系列试验的结果,其中最重要的可能被认为是VOYAGER PAD,显示了将抗凝剂引入PAD患者治疗方案的可能性和可行性。抗血小板药物联合利伐沙班治疗方案的安全性和有效性被证实,剂量为2.5 mg,每日2次,用于接受保守治疗的患者和接受血管内血管重建干预的患者。
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引用次数: 0
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Angiologiia i sosudistaia khirurgiia = Angiology and vascular surgery
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