Publications by authors named "Klioner L"

On the basis of experience in reconstructive operations on 250 patients with combined affection of the coronary arteries, abdominal aorta, and arteries of the lower limbs the authors discuss the diagnostic and tactical features of surgical management of these patients. The article dwells upon the necessary preoperative diagnostic algorithm as well as that in tactical variants of surgical treatment: (1) one-stage reconstructive operations on several vascular beds; (2) successive stage-by-stage treatment of patients with combined vascular pathology; (3) reconstructive vascular intervention on only one of the vascular beds. Correct practical solution of all these problems allowed the authors to reduce postoperative lethality to 5.

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The authors examined 68 patients with vasorenal hypertension (VRH). In hyperkinetic type of VRH, the tissue hypoxia is caused by the increase in the cardiac index and rate of blood flow, changes in the microcirculation; in hypokinetic type--by decrease in the cardiac index, sharp increase in the specific peripheral vascular resistance and pronounced changes in all the links of microcirculatory channel as well is observed. Timely correction of the hyperkinetic type of VRH in patients leads to normalization of hemodynamics and elimination of tissue hypoxia.

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The article describes an experience with the surgical treatment of repeated re-thromboses after aorto-femoral reconstructions with a bifurcation explant in 34 patients with the Leriche syndrome of atherosclerotic etiology who were subjected to 110 reoperations. Different kinds of reconstructions for revascularization of extremities are considered. Favorable results were obtained in 76.

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The results of surgical and conservative treatment of 207 patients with the post-thrombophlebitic syndrome in pedal veins suggested that modified Linton's operation produced very good long-term effect in late postoperative period. Therefore it can be used as an operation of choice in surgical treatment for this pathology. The efficiency of the operation is improved significantly, if postoperative medical, social and occupational rehabilitation is conducted on a consistent basis.

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The most urgent problems of the terminology, diagnosis and treatment of the post-thrombophlebitic syndrome are discussed. The author believes, in particular, that clinical tests and methods which do not require any special expensive equipment constitute a diagnostic complex that is quite sufficient in the practice of health care. Phlebography should be undertaken when there are definite indications.

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Among 600 patients operated on primarily for atherosclerotic lesions of the aorto-iliac-femoral zone (various plastic operations) secondary interventions were undertaken in 140 persons with re-occlusions of the operated segments. All patients were subjected to secondary reconstructive-plastic operations that gave good results--elimination of ischaemia and preservation of the extremity--in 77.2% of the cases.

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