Due to a false aneurysms of the aortic-prosthetic anastomosis ten patients aged 42-74 years underwent surgery. In three patients, an aneurysm occurred twice. One was operated on after the aneurysm had ruptured. Six patients were treated for hypertension. In the course of the primary procedure, in six cases aortic-bifemoral grafts were implanted, in four--an aortic-femoral, and in two aortic-biiliac grafts were used. In six patients end-to-end anastomoses were performed, and in four--end-to-side. Surgical corrections due to the occurrence of a false aneurysm were performed 3 months to 10 years after the original surgery. On reoperation, purulent matter was found in the site of the prosthesis. In two patients, aortic-intestinal fistulas were detected, and in one--an aortic-cecal fistula. In six patients the anastomoses were totally separated. In the course of 13 procedures performed in false aneurysms, five times replaced, single sutures were applied to the entire circumference of the anastomosis in four cases, including one case where an oblong patch was also used, in three cases an extra segment was sutured between the aorta and the previously implanted prosthesis, and the aneurysmal sac was filled with wire in one patient. Eight patients were reoperated, including three repeated procedures due to a false aneurysm of the proximal anastomosis. Moreover, the patency of prostheses was restored, abscesses were surgically opened and procedures were performed in the colon. Four patients have survived, including one with bilateral amputation of lower limbs. The most common cause of death was myocardial infarction. Two patients died due to massive hemorrhage, and one as a result of uremia.

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[Damage to cranial and peripheral nerves following patency restoration of the internal carotid artery].

UNLABELLED: The aim of the study was an assessment of the incidence of injury to cranial and peripheral nerves as complication of patency restoration of the internal carotid artery, and analysis of the effect of peripheral nerve injury on the results of carotid patency restoration. From Oct 1987 to Sept 1999 543 procedures were carried out for restoration of patency of the internal carotid artery. After the operation hypoglossus nerve injury was found in 7 cases (1.4%), vagus injury in 9 (1.8%). Signs of exclusively recurrent laryngeal nerve damage were found in 6 cases (1.2%). Glossopharyngeus nerve was damaged in 2 cases (0.4%), transient phrenic nerve palsy as a result of conduction anaesthesia was noted in 2 cases (0.4%). Damage to the transverse cervical nerve was found in 96 cases (60%). In 2 patients (1.2%) lower position of mouth angle was due to section of the mandibular ramus of the facial nerve. In another 2 cases skin sensation disturbances were a consequence of lesion of the auricularis magnus nerve and always they coexisted with signs of transverse cervical nerve damage. IN CONCLUSION: damage to the cranial nerves during operation for carotid patency restoration are frequent but mostly they are not connected with any health risks and often they regress spontaneously.

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[Notice regarding the results of delayed therapy for atherosclerotic lower limb ischemia in 14 surgical clinics].

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[Comparison of early and delayed results of unilateral patency restoration and transplantation in aortoiliac obstruction].

Early and delayed results of the treatment of aortoiliac unilateral incompetence in 144 patients were compared. Eighty seven (60%) patients were treated with aortoiliac prosthesis whereas 57 (40%) with arterial patency restoration. Fifty seven patients of group I reported to the control examination. Favourable effect was found in 47 (82.5%) patients, i.e. in 54% of all operated patients. Thirty six patients of group II reported to the control examination. Favourable effect was noted in 27 (75%) patients, i.e. in 47.4% of all treated patients. Twenty two (25.3%) of patients of group I and 9 (15.8%) of group II died. It was noted also that in 20% of operated patients with unilateral aortoiliac incompetence the disorders in the opposite limb develop despite the type of surgery. Therefore, indications to the implantation of bifurcated prostheses should be extended in some cases.

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