Acute mesenteric ischemia - a 15-year experience of surgical treatment in a multi-field hospital.

Objective: To evaluate the results of surgical treatment of arterial acute mesenteric ischemia in a single hospital over a 15-year period (from 2007 to 2022).

Material And Methods: There were 385 patients with acute occlusion of superior or inferior mesenteric artery over a 15-year period. The causes of acute mesenteric ischemia were thromboembolism of superior mesenteric artery (51%), its thrombosis (43%) and thrombosis of inferior mesenteric artery (6%).

[Levilimab and baricitinib prescribing experience in outpatient COVID-19 patients' treatment].

Aim: To study the effect of levilimab or baricitinib in combination with standard therapy (ST) on the incidence of severe viral pneumonia associated with a new coronavirus infection COVID-19.

Materials And Methods: A multicenter, open-label observational study of the efficacy and safety of levilimab in combination with ST (group 1, n=100), baricitinib in combination with ST (group 2, n=139), or in comparison with ST (group 3, n=200) in outpatients with verified CT-1 pneumonia.

Results: According to the results of laboratory tests, patients treated with levilimab in combination with ST had the best dynamics of changes in CRP from reliably the highest level (mg/L) to the lowest in comparison with other groups.

[Gas in superior mesenteric artery and celiac axis as a rare CT-sign of extensive bowel necrosis].

The authors report endovascular treatment of acute thromboembolic occlusion of superior mesenteric artery in a 75-year-old patient whose postoperative period was complicated by massive reperfusion and translocation syndrome. Contrast-enhanced CT in 12 hours after successful thrombectomy from superior mesenteric artery revealed CT signs of irreversible bowel lesion, i.e.

[Morphological substantiation of laparoscopic suturing of stomach ulcer with formation of a covered perforation].

Objective: Morphological substantiation of laparoscopic suturing of gastric ulcer with formation of a covered perforation.

Material And Methods: To analyze morphological tissue reaction in surgical area, we used 12 Chinchilla rabbits. All animals were divided into 2 groups by 6 animals.

[Venous thromboembolic complications in patients with intracerebral hemorrhage].

Objective: To evaluate the effectiveness and safety of various heparin therapy regimens for venous thromboembolic complications in patients with acute cerebral circulatory disorders of the hemorrhagic type.

Material And Methods: In a prospective single-center study, treatment results of 62 patients with hypertensive brain hematoma were analyzed. All patients were divided into two comparable groups: the group of «very early» prophylactic heparin therapy or the first 48 hours from the moment of the disease (=35) and the group of «early» prophylactic heparin therapy, or later than 48 hours from the moment of the intracerebral hematoma development (=27).

[Carotid endarterectomy and carotid artery stenting in advanced age patients].

The manuscript is devoted to world experience of carotid endarterectomy and carotid artery stenting in advanced age patients. Some authors report the advantages of endovascular surgery in elderly patients while the others prefer carotid endarterectomy. Senile patients (75-80 years old) with asymptomatic internal carotid artery stenosis is one of the most difficult group for the management.

[Results of endovascular treatment of acute tandem occlusion of internal carotid and middle cerebral arteries].

Objective: To evaluate the results of endovascular treatment of patients with ischemic stroke caused by acute tandem occlusion of the internal carotid and middle cerebral arteries (ICA and MCA).

Material And Methods: Endovascular intervention was performed in 8 patients with tandem occlusion of ICA and MCA. The neurological deficit on admission was 17.

[Treatment of patients with a cerebral arterial aneurysm and stenosis of the internal carotid artery].

Aim: The purpose of this study was to analyse the world literature dedicated to the problem concerning treatment of a combination of internal carotid artery stenosis at the extracranial level and an arterial aneurysm of the brain, as well as to demonstrate own results of surgical treatment of patients presenting with this concomitant pathology of the carotid basin.

Patients And Methods: From 2013 to 2019, a clinical course of combined pathology of the basin of the internal carotid artery (an intracranial aneurysm and stenosis of the internal carotid artery at the extracranial level) was revealed in 35 of 1638 examined patients. There were ten men and 25 women, with a mean age of 66±7 years.

Fast-track recovery for perforated duodenal ulcer.

Objective: To study the outcomes of fast-track recovery in patients with perforated duodenal ulcer (PDU).

Material And Methods: There were 138 patients with PDU who underwent surgical treatment for the period from January 1, 2015 to December 31, 2019. Patients were divided into 3 groups: main group, control group 1 (CG-1) and control group 2 (CG-2).

[Endovascular surgery for acute mesenteric ischemia].

Objective: To demonstrate the results of endovascular treatment of 15 patients with acute mesenteric ischemia.

Material And Methods: There were 15 patients with acute mesenteric ischemia who underwent surgery (9 men and 6 women). Mean age was 77±11 years.

[Treatment of Patients with Stable Manifestations of Atherosclerotic Vascular Disease: New Possibilities (Conclusion of the Council of Experts from November 16, 2018, Rostov-on-Don)].

In the conclusion of the council of experts (list of participants see text) the following issues are discussed: regional specifics of diagnostics and therapy of patients with ischemic heart disease (IHD) and / or peripheral arterial disease (PAD), methods of risk assessment in patients with stable course of atherosclerotic disease, pathogenetic validity of simultaneous inhibition of coagulation and platelet thrombus formation, as well as clinical significance of a novel therapeutic approach - combined use of rivaroxaban and acetylsalicylic acid (ASA). Possible problems and ways to their solution at implementation in clinical practice of the novel scheme of antithrombotic therapy are presented. Importance of multidisciplinary approach to management of patients with IHD and concomitant diseases is stressed.

[Endovascular treatment of tandem occlusion of internal carotid and middle cerebral arteries in acute ischemic stroke].

The paper presents the literature data concerning the results and surgical approaches to the treatment of tandem occlusion in the ICA system. The authors describe two clinical cases of endovascular treatment of tandem ipsilateral occlusion of ICA and middle cerebral artery (MCA). In both cases, the cause of two-level occlusion was complicated by thrombosis atherosclerotic plaque in ICA in the extracranial part with distal thromboembolism in SMA.

[Prevalence of hepatitis B and C viral infection according to the data on fetal outcomes in Moscow in 2015-2017].

Objective: To elucidate the prevalence of hepatitis B and C viral infection among the people who died in Moscow in 2015-2017, by studying the primary medical records of a representative sample of fatal outcomes, followed by the mathematical extrapolation of the data obtained to the total number of all deaths.

Material And Methods: The 2015-2017 primary medical documentations from 8 therapeutic-and-preventive establishments with morbid anatomy units in the administrative districts and from 2 infectious diseases hospitals of the Moscow Healthcare Department were studied. The sample of those who died was 11.

[Fast track rehabilitation in perforated duodenal ulcer].

Aim: To analyze the outcomes of fast track rehabilitation program in patients with perforated duodenal ulcer (PDU).

Material And Methods: For the period 2013-2016 at the Department of Surgery and Endoscopy 206 PDU patients have been treated. Inclusion criterion for the main group (n=77) was duodenal ulcers, their dimension up to 1 cm, laparoscopic suture of perforated ulcer, fast track rehabilitation program implementation.

[Therapeutic policy in stenosis of the internal carotid artery combined with intracranial vascular malformation].

Presented herein is the world experience of surgical treatment and various tactical approaches in a combined lesion of the extracranial and intracranial portions of the internal carotid artery (ICA): a combination of its stenosis or occlusion with vascular malformation of the brain (a cerebral aneurysm, pathological anastomoses, arteriovenous malformations). Also pointed out is the prevalence of the pathology involved, followed by describing various types of surgical policy in this condition: staged and simultaneous interventions, endovascular and standard operative auxiliary techniques. Taking into consideration a low incidence rate of combined pathology of the ICA, there are currently no randomized studies that would make it possible to work out a common tactical approach to management of this cohort of patients.

[Endovascular interventions in treatment of patients with acute impairment of mesenteric blood circulation].

The authors share herein their experience of treating a total of eight patients with acute impairment of mesenteric blood circulation, describing both technical and instrumental peculiarities of interventions on the superior mesenteric artery. Technical success defined as restoration of the main blood flow through the superior mesenteric artery was achieved in seven (87.5%) patients.

[Outcomes of open endovascular operations on the internal carotid artery in acute stage of ischaemic stroke].

Introduction: The authors share their experience in diagnosis and treatment of patients with acute ischaemic stroke.

Patients And Methods: The study included a total of 33 patients. Of these, 20 patients (Study Group) were operated on at terms ranging from 2 to 7 days after onset of acute cerebral circulatory impairment.

[Diagnosis and treatment of extracranial internal carotid artery lesion combined with cerebrovascular malformation].

Aim: To analyze own experience of diagnosis and treatment of patients with extracranial internal carotid artery lesion and cerebrovascular malformations.

Material And Methods: There were 16 patients with combined lesion of extracranial and intracranial internal carotid artery for the period January 2013 - December 2014. Occlusive-stenotic lesion and tortuosity of ICA were observed in 11 and 5 cases respectively.

[Early reconstruction of brachiocephalic arteries as a prevention of recurrent ischemic stroke].

Aim: To assess an efficacy and safety of brachiocephalic arteries reconstruction at the acute stage of stroke.

Material And Methods: Early reconstruction of brachiocephalic arteries was made in 7 patients (mean age 67±9 years). Mean terms of brachiocephalic arteries reconstruction after stroke were 4.

[Early reconstruction of supra-aortic vessels as a prevention of recurrent ischemic stroke].

Aim: To evaluate the efficacy and safety of supra-aortic vessels reconstruction within acute period of stroke.

Material And Methods: Early surgery was performed in 7 patients aged 67±9 years. Revascularization was made after 4.

[Stenting of the superior mesenteric artery in a patient with severe chronic intestinal ischaemia].

Presented herein is a clinical case report concerning endovascular treatment of severe chronic ischaemia of digestive organs in a patient with lesions of all three visceral arteries. Peculiarities of endovascular technique in mechanical revascularization of the superior mesenteric artery are described. Restoration of blood flow through even one visceral artery, i.

[Endovascular interventions for acute ischemia of intestine].

It is presented 5 clinical observations of acute ischemia of intestine in which different endovascular interventions including isolated superior mesenteric artery stenting, rheolytic and aspiration thrombectomy and combination of techniques were applied. Surgical success with blood flow restoration in superior mesenteric artery was achieved in 4 of 5 patients. 2 patients have required laparotomy and intestinal resection.

[Immunological aspects in spleen ruptures surgery due to closed abdominal trauma].

The remote results of immunity investigation in 30 patients after organ-preserving surgery and in 30 patients after splenectomy forspleen rupture are presented in the article. Indexes of cellular and humoral immunity were normal and life quality did not differ from that in healthy individuals after organ-preserving operations with splenic artery ligation. Splenectomy leads to deterioration of life quality and disorders in cellular immunity including decrease of T-helpers/inductors cells (CD4), immunoregulatory index (CD3/CD4) and general number of T-lymphocytes (CD3) in some cases on background of compensatory increase of normal killers (CD16).