[Influence of complete autoarterial revascularization of functional state on the myocardium.].
Explore the source record for details and available documents.
Humans↗
Biomedical subjects
P O Kazanchian
Publications and source records attributed to P O Kazanchian.
[Surgical treatment of patients with rupture of abdominal aorto-aneurysm].
Thr experience in surgical treatment of 69 patients with rupture of abdominal aorto-aneurysm was analyzed. Multifactorial statistical analysis was carried out to determine detect influence of different parameters on postoperative lethality. The most significant parameters were initial blood loss (odds ratio (OR) -- 10.4, confidence interval (CI) -- 2.0-37.1, intraoperative hemorrhage (OR=8.5, CI 1.5-27.8), minute diuresis (OR=15,7, CI 1.8- 49.3), location of rupture (OR=12.1, CI 2.0-33.5). Combination of two and more factors led to the most unfavorable prognosis. The proposed algorithm allowed the authors to optimize treatment policy and improve significantly results of surgical treatment of patients with rupture of abdominal aorto-aneurysm: postoperative lethality has decreased from 71.4 to 28.5%.
Aged↗
[Long-term results of femoro-tibial reconstructions].
Results of 136 femoro-tibial bypasses performed in 127 patients were analyzed. There were the following complications: lethal outcome (1.5%) due to myocardial infarction, thrombosis of shunts (10.3%). Surgery with "in situ" technique has demonstrated the best patency of femoro-tibial autovenous bypasses (68.7%). Combination of femoro-tibial bypass with lumbar sympathectomy and creation of arterio-venous fistula leads to improvement of bypasses function in long-term period after surgery.
Adult↗
[Ruptures of abdominal aortic aneurysms. The clinical course and classification].
Surgical treatment of abdominal aortic aneurysm (AAA) ruptures is a matter of great concern in current vascular surgery. The results of surgical treatment of patients presenting with such severe disease could have been improved due to the early and correct diagnosis. The present work is concerned with a study into the characteristic features and causes of the atypical clinical manifestations and the course of AAA ruptures as well as with the development of the classification accessible for practical uses. Later on it would allow to refine the treatment policy for an extremely severe patient group and to define a permissible algorithm of examination in the postoperative time and would favour the early diagnosis of disease. The study is based on an analysis of the clinical course of AAA rupture in 53 patients operated on at the Department of Vascular Surgery. MONIKI. The clinical manifestations were typical in 46 (86.8%) patients. The progressing course of AAA rupture was observed in 21 (39.6%) patients; the disease ran a wave-like course in 17 (32.1%) patients. Stabilization of the condition was marked in 15 (28.3%) cases. In 39 (73.6%) cases, AAA rupture affected the retro-peritoneal space, the free abdominal cavity was affected in 8 (15.1%), the duodenum in 2 (3.8%), the sigmoid intestine in 2 (3.8%), and the inferior vena cava in 2 (3.8%) of cases. The rupture of the posterior wall of the aortic aneurysm was identified in 29 (54.7%), of the lateral wall in 12 (22.6%), and of the anterior wall in 8 (15.1%) patients. Four (7.5%) patients demonstrated aneurysmal rupture of the iliac artery. The clinical manifestations of AAA rupture were marked by polymorphism whereas its course was often masked by other diseases making it difficult to establish the early and correct diagnosis. The difficulties in the diagnosis of AAA ruptures gave rise to a lot of diagnostic errors and late hospitalization to specialized unita.
Aged↗
[Ultrasonographic evaluation of major vessels in patients with vibration disease].
Common carotic arteries, odd visceral branches of abdominal aorta were subgected to ultrasound Doppler examination and color duplex ultrasound in 100 vibration disease patients and 57 liquidators of Chernobyl power accident consequences. Stenosis of various degree and thickened vascular wall were revealed in 23.6 +/- 4.5% of vibration disease patients and in 46.2 +/- 7.98% of liquidators (p < 0.05). These data prove that the liquidators being younger (4 years average age difference) than the vibration disease patients demonstrate more significant atherosclerotic changes of vascular wall.
Adult↗
[Eversion carotid endarterectomy: advantages and disadvantages].
A comparative analysis of results of 70 operations fulfilled by the method of classical with autovein plasty of the internal carotid artery (ICA) and of 103 operations by the method of eversion carotid endarterectomy (CEAE) was made. The time of compression of the carotid artery during the eversion CEAE proved to be considerably less (22.5 +/- 6.5) min, than when using the "classical" method (32.5 +/- 5.3) min. In the nearest postoperative period no neurological complications of embologenic genesis or those associated with acute thrombosis of ICA after the eversion CEAE were noted while after the "classical" method they developed in 3 patients and 2 of them died. After the eversion CEAE 1 patients died of myocardial infarction. In remote periods after the "classical" CEAE the restenosis and reocclusions appeared in 6 patients, while after the eversion method--in 3 patients. CEAE fulfilled by the eversion technique is an effective operation reducing the amount of postoperative neurological complications as well as of late restenosis and reocclusions. It can be used without the applying of the internal bypass.
Aged↗
[Plastic repair of the carotid artery in carotid endarterectomy].
The work is based on an analysis of results of 70 carotid endarterectomies performed on 68 patients aged from 43 to 67 years. 53% of the patients were operated upon at the stage of a relative compensation of brain blood circulation. Multiple character of injuries of the brachiocephalic arteries took place in 70.5% of the cases. Plasty of the internal carotid artery is thought by the authors to be necessary by means of using a flap of lyophylized allopericardium, with the diameter of its orifice less than 8 mm.
Adult↗
[Surgical treatment of occlusive diseases of subclavian arteries].
The authors discuss their experience in surgical treatment of 37 patients with occlusive lesions of the subclavian arteries. Ten patients had isolated lesions of the subclavian arteries and 37 had combined affections of the carotid and subclavian arteries. Analysis of their own clinical material allowed the authors to put forth their point of view on the indications for surgical treatment, the tactics and order of surgical interventions, and the choice of the optimal method and plastic. material fro reconstructive operations. Sixty-seven reconstructive operations were carried out, in 11 of them one-stage reconstruction of the carotid and subclavian arteries was performed. Fatal outcomes were not encountered. The results of surgery were studied in 20 patients in follow-up periods of 6 months to 3 years. Complete regression of neurological symptomatology was found in 87.5% of patients with TIA and in 88.8% of those with encephalopathy and circulatory disorders. This confirms the effectiveness of surgical treatment of patients with occlusive lesions of the subclavian arteries.
Adult↗
[The current diagnostic aspects of abdominal aortic aneurysms].
Based on diagnostic data in 35 patients with abdominal aortic aneurysm, which were obtained during ultrasonic scan echography, X-ray computed tomography and radioopaque angiography, and on their comparison with intraoperative findings, a diagnostic algorithm for examinations has been developed, which enables errors in the diagnosis to be excluded. The major diagnostic technique for abdominal aortic aneurysms has been found to be X-ray computed tomography which provided no errors in the assessment of the extent of aneurysms and the presence of their complicating components in all 35 patients. In high aneurysms of the abdominal aorta and suspected stenoses in the visceral, renal, and iliac arteries, X-ray computed tomography should be supplemented by radioopaque angiography to clarify the status of aortic branches.
Algorithms↗
[Ischemic stroke and the ways of compensation of cerebral circulation in patients with nonspecific aorto-arteritis with lesions of the brachiocephalic arteries].
In patients suffering from nonspecific aortoarteritis associated with impairment of the common carotid arteries, cerebral blood flow is compensated for at the expense of an increase of the volumetric blood flow in the vertebral arteries. During the first three years since the onset of the first disease symptoms, the blood content in the basin of the internal carotid arteries is reduced. Brain strokes occur most frequently within that period. They mostly develop without any preceding transitory ischemic attacks. The origin of neurological symptomatology depends to a considerable measure on the condition of the anterior and posterior communicating arteries.
Adult↗
[Surgical treatment of traumatic aneurysm of descending aorta with abnormal right subclavian artery].
Among 11 patients with traumatic aneurysms of the descending thoracic aorta, 2 had developmental anomalies of the branches of the arch of the aorta, in particular, independent origin of the right subclavian artery from the descending thoracic aorta. The anomalous right subclavian artery plays the role of a retaining ligament in trauma, and the forming posttraumatic false aneurysm is localized distal of the ostium of the right subclavian artery. The need for clamping the thoracic aorta and both subclavian arteries for the period of aneurysm reconstruction requires catheterization of the arch of the aorta for arterial pressure control. Surgical correction of aneurysm in anomalous origin of the right subclavian artery has peculiarities of its own in the formation of the proximal anastomosis.
Adolescent↗
[A method of portalizing the venous blood flow of the left adrenal gland].
The authors, having studied the long-term results of the operation of creating the renoportal venous anastomoses in patients with severe and malignant course of arterial hypertension, revealed anastomotic thrombosis in presence of hypotensive effect. Developed in the experiment and employed in 7 patients was the technique of dosaged narrowing the central left adrenal vein with the aim of achieving its thrombosis, inclusion of the collateral routes of the left adrenal blood outflow into the system of the portal vein and inactivation of aldosterone in the liver.
Adrenalectomy↗
[Non-invasive diagnosis of dissecting aneurysm of the aorta].
Possibilities of noninvasive radial diagnostics were studied in examination of 27 patients with dissecting aneurysms of the aorta. Classical X-ray examinations of chest organs have diagnosed aorta wall dissection in 2 of 24 patients. In 19 patients the diagnosis of aorta dissection was suspected. The ultrasound examination gave correct diagnosis in 3 of 4 patients examined. The non-contrast computed tomography has revealed dissecting aneurysms in 8 of 24 patients, an investigation with the intravenous injection of the contrast substance--in 13 of 15 patients. The diagnosis was based upon the detection of 2 canals of the aorta with the dissected intima between them, thrombosis of the false aorta canal and accumulation of the liquid in the pleura and pericardium cavity. When planning operative procedures it becomes necessary to perform aortography.
Adult↗
[Indications for and the methods of revascularization of visceral branches in aorto-femoral reconstruction].
The work presents data of 774 patients with occlusing injuries of the abdominal aorta and arteries of lower extremities subjected to aorto-femoral reconstructions. In 546 of these patients (70.5%) there were different variants of injuries of visceral branches. A detailed analysis of the clinical picture of injuries of the visceral branches is presented related with the injury volume, etiology of the occlusing process and coexistent arterial hypertension. The authors have an experience with 169 observations of revascularizations of visceral branches during aorto-femoral reconstructions. Reconstruction of the inferior mesenterial artery was made in 134 cases, that of the celiac trunk of the superior mesenterial artery-in 35 cases. A detailed description of indications to correction of the visceral branches blood flow in aorto-femoral reconstructions is presented as well as the methods of revascularization of the visceral arteries.
Adult↗
[Noninvasive radiodiagnosis of aneurysms of the thoracic aorta].
The paper is concerned with analysis of the results of X-ray investigation of 45 patients with aneurysms of the distal part of the arch and descending part of the thoracic aorta. Errors were made in 16 of 35 patients (35.6%) before admittance to hospital. X-ray investigation helped to establish correct diagnosis of aneurysm of the aorta in 42 of 45 patients (93.3%) on the basis of the detection of intense additional shadow formation in left pulmonary field, inseparable from the aortic shadow. The use of a new method of ultrasound diagnosis--duplex scanning--made it possible to establish the presence of aneurysm and to determine its sizes as well as to visualize the relation of the left subclavicular artery to aneurysm in 17 of 21 patients. CT-semiotics of aneurysms of the descending part of the thoracic aorta consisted in its dilatation over 3.5 cm, wall calcification, thrombosis of the cavity and change of the adjacent structures. Basing on the analysis of these signs correct diagnosis was established in 34 of 35 examinees (97.1%).
Adolescent↗
[A method of pancreato-duodenal resection and total duodeno- pancreatectomy].
During 1975-88 the staff of the Vishnevskiĭ+ Institute of Surgery performed 95 pancreatoduodenal resections (PDR) and 23 total duodenopancreatectomies (TDPE) in malignant tumors of the head of the pancreas (49), major duodenal papilla (30), terminal choledochus (12), duodenum (12), and in 15 patients with chronic pancreatitis. In 13 cases PDR and TDPE were undertaken as a second operation after creation of biliodigestive anastomoses: after laparoscopic cholecystostomy in 24 and after various abdominal operations in 20 cases. In 30 cases PDR was carried out with the formation of a pancreaticojejunal+ anastomosis, by the longitudinal techniques in 7 of them, in 47 cases with occlusion of the pancreatic duct, and in 6 with the formation of a "occlusive" pancreaticojejunal anastomosis++ suggested by the authors. PDR was performed in 3 cases with maintenance of the stomach and in 4 in combination with vagotomy. The mortality rate was 20% after PDR and 39.1% after TDPE.
Choledochostomy↗
[Changes in basic hemodynamic and electrocardiographic parameters in patients with severe vasorenal hypertension].
Major hemodynamic and electrocardiographic parameters were examined in 47 patients with severe vasorenal hypertension at rest, and in 20 patients after stress exposure. Three (hyper-, eu- and hypokinetic) types of circulation were demonstrated, like the ones seen in essential hypertension. Hemodynamic values at rest were indicative of relative cardiovascular compensation in severe vasorenal hypertension. Stress testing demonstrated that exercise disrupted that compensation. Arterial blood pressure response to physical stress showed no correlation to baseline values of the parameters examined.
Adolescent↗
[Reconstructive vascular surgery in patients with diabetes mellitus].
Presented are the literature data and original research findings in management of atherosclerotic occlusions of major arteries in diabetic patients. Reconstructive surgery in diabetes results in significant anti-ischaemic effect, gangrene localization, and trophic ulcer healing saving these patients from invalidism and prolonging their life.
Arterial Occlusive Diseases↗