[Clinical study of efficacy and safety of Aducil in patients with chronic lower limb ischaemia].

Aim: The study was aimed at assessing efficacy and safety of treatment with Aducil® (cilostazol) compared with Trental® 400 in patients with moderate-to-severe intermittent claudication due to peripheral atherosclerosis.

Patients And Methods: The study included a total of one hundred and forty-five 36-to-75-year-old patients. The participants were distributed into 2 groups according to the inclusion/exclusion criteria in a 2 to 1 proportion: patients in group 1 received Aducil® 100 mg BID, in group 2 - Trental® 400 TID for 12 weeks.

[Present-day possibilities of non-invasive control over microcirculation and metabolism in man].

The main function of the microcirculatory bed consists in maintaining tissue homeostasis at an optimal level irrespective of the effect of various external and internal factors. Of all types of metabolism (diffusive, filtration-reabsorption and vesicular), directly dependent on the haemodynamic parameters is filtration-reabsorption metabolism which provides exchange of water, low-molecular-weight and water-soluble substances at the opposite to the heart «pole» of the cardiovascular system. The present study was aimed at testing a hypothesis that activation of metabolic processes in man would be accompanied by alterations in haemodynamic parameters which may be registered by means of modern non-invasive methods of examination, i.

[Effect of drug therapy for chronic obliterating diseases of lower-limb arteries on the state of the microcirculatory bed].

Unlabelled: Search for an optimal method of conservative treatment of patients presenting with chronic obliterating disease of lower limb arteries (CODLLA) still remains an important and hitherto unsolved problem. Comparative studies of different drugs and objective assessment of their efficacy may be carried out using the method of laser Doppler flowmetry (LDF) with wavelet analysis of fluctuations in blood flow.

Objective: The study was aimed at assessing efficacy of using Actovegin in conservative treatment of patients presenting with chronic obliterating disease of the lower extremities induced by occlusive and stenotic lesions of the arterial bed.

[Cardiosynchronized sequential antegrade pneumocompression in treatment of patients with multifocal atherosclerosis].

The work was aimed at assessing efficacy and safety of indications for and contraindications to a promising method of treatment for multifocal atherosclerosis - enforced external counterpulsation, suggesting a new noninvasive method of treatment of chronic obliterating diseases of lower-limb arteries - cardiosynchronized sequential antegrade pneumocompression.

[Peculiarities of performing hybrid operation in a patient with atherosclerosis of lower limbs and developed critical ischaemia].

Currently, there is a tendency towards an increase in the incidence rate of cardiovascular disease. According to the data of the World Health Organization the incidence rate of obliterating diseases of peripheral arteries varies from 5 to 10%. Diseases of peripheral arteries manifest themselves by such a severe condition as lower-limb critical ischaemia.

[Experience with hybrid techniques of surgical treatment of patients with lower limb critical ischaemia].

The authors present their original experience with the use of hybrid techniques of surgical treatment in a total of 19 patients with lower limb critical ischaemia (LLCI) on the background of complex lesions of the arteries of lower extremities. They describe various types of hybrid techniques of surgical treatment of patients with critical ischaemia on the background of chronic obliterating diseases of lower-limb arteries. Also discussed are 3 varieties of clinical situations in which it is appropriate to employ the hybrid method: thrombosis of the bypass graft, multi-storey lesions of lower-limb arteries, and the use of a hybrid technique in order to decrease the size of the surgical wound.

[Management of thrombotic occlusions of femoropopliteal bypass grafts treated by a combined method].

Presented in the article are two clinical case reports concerning remote results of successful surgical management of thrombotic occlusions of femoropopliteal bypass grafts treated by a combined method. The first stage of surgical treatment in both cases in the roentgen-equipped operation room consisted in open thrombectomy of the shunt, with the second stage being endovascular recanalization - in the first case balloon angioplasty of the proximal and distal anastomosis and in the second case - balloon angioplasty and stenting of the distal anastomosis, distal arterial bed.

[A clinical example of operative intervention on previously stented peripheral artery in a patient with critical ischaemia of lower limbs].

The problem of open surgery of peripheral arteries after previously performed interventions is currently of considerable interest. This is associated with the development of roentgenoendovascular technologies, on the one hand, and with the fact that it is not always possible to use them properly, on the other. Nowadays, one may single out a small group of patients having endured balloon angioplasty and stenting of the arterial segment followed by open operation.

[Comparative characteristics of the open and endovascular methods of treatment for carotid artery stenoses].

The article is dedicated to the problem concerning treatment for stenoses of the extracranial portions of carotid arteries. From March 2004 to November 2009 at the Department of Vascular Surgery No 2 of the N. A.

[Administration of prostaglandin E1 in the treatment of patients with chronic lower limbs critical ischemia with concomitant ischemic heat disease].

Drug treatment of chronic lower limbs critical ischemia (CLLCI) remains an important problem, particularly in patients with concomitant ischemic heart disease treated with prostaglandins E1 (PGE1). Experience in treatment of these patients with alprostadil is presented. Symptoms of a high risk of coronary events are demonstrated, prophylactic measures are proposed.

[Disorders of rheologic properties of blood and their correction in postthrombophlebitic syndrome].

Pathogenetic mechanisms of disorders of rheologic properties of blood in postthrombophlebitic syndrome (PTPS) are analyzed. Thirty-six patients were examined and divided into 2 groups. In combined therapy of the study group (18 patients) pentoxyfillin tablets were included.

[The diagnosis of vasculogenic impotence as a consequence of pathological venous drainage of the corpora cavernosa].

A total of 184 patients with suspected impaired venous drainage of cavernous bodies were examined. Dynamic perfusion cavernosography with cavernometry was employed. Venous drainage abnormalities were detected in 158 of 184 examinees.

[The risk prediction of erectile failure developing after the reconstruction of the aortoiliac segment].

The authors suggest their method for prognosticating the risk of formation of erectile incompetence after reconstruction of the aortoiliac segment. In 78 patients with Leriche's syndrome and maintained erectile function 13 qualitative parameters were determined before the operation (the degree of intermittent claudication, the duration of the disease of the lower limbs, the results of ultrasonic dopplerography and angiography), which were then converted to quantitative discrete characteristics. The obtained set of characteristics was used for prognosticating the condition of the sexual function after the operation by means of the familiar methods of regressive analysis on a personal PS/XT computer according to a program of multidimensional regression in the packet of programs.

[The prognosis of the efficacy of revascularization of the penile corpora cavernosa in the surgical treatment of Leriche's syndrome].

The authors have developed a procedure for predicting the efficiency of penal spongy body revascularization in surgical management. Thirteen qualitative parameters, such as duration of sexual dysfunction, libido, having a sexual intercourse partner, degree of intermittent claudication, duration of lower extremity diseases, penal erection angle after drug test and ultrasound Doppler echography with drug test, were evaluated in 36 patients with Leriche's syndrome and erectile dysfunction. The qualitative parameters obtained were converted to quantitative discrete characteristics.

Surgical treatment and prevention of vasculopathic impotence in conjunction with revascularisation of the lower extremities in Leriche's syndrome.

The results are presented of combined revascularization of the lower extremities and the penis in 29 patients with Leriche's syndrome. This was effected by placing an autogenous venous shunt between the branch of a prosthesis or the common femoral artery and one of the dorsal arteries of the penis. Preoperatively lost sexual function was restored in 6 patients, while in 16 the sexual function was maintained at the preoperative level or improved in the late postoperative period.

[A new method of surgical treatment of vasculogenic impotence].

The authors describe a method of surgical management of vasculogenic impotence consisting in the formation of an anastomosis of an autovenous shunt with the dorsal artery of the penis. To prevent revascularization of the cavernous bodies of the penis with the restoration of erection, the dorsal artery of the penis is divided transversely at the root of the penis, the distal end of the autovenous shunt is given the shape of a trapezium with the upper side sutured, after which the autovenous shunt is anastomosed end to end with both the distal and proximal segments of the dorsal artery of the penis at the lateral sides of the trapezium where the angles were not sutured. The method allows incompetence and thrombosis of the vascular anastomosis to be prevented, raises the efficacy of revascularization of the cavernous bodies of the penis by creating favourable hemodynamic conditions through separation of the blood flow into the distal and proximal segments of the dorsal artery of the penis, which provides retrograde supply of blood into the deep artery of the penis sufficient for adequate revascularization of the cavernous bodies.

[Surgical treatment and prevention of angiogenic impotence in combination with revascularization of the lower extremities in Leriche's syndrome].

The article deals with the results of combined revascularization of the lower limbs and penis in 29 patients with Leriche's syndrome. It was accomplished by creating an autovenous shunt between the blades of the prosthesis or common femoral artery with the dorsal artery of the penis. In the late-term postoperative period the initially lost sexual function was restored in 6 patients and improved or maintained on the preoperative level in 16 patients.