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The authors assessed the effect of carbonization and its influence on the parameters of endovasal laser obliteration (EVLO) depending on wavelength of laser radiation (970 and 1470 nm) using a light guide with radial emission. They also analysed the value of drop of radiation power of the light guide after performing EVLO and visually assessed the degree of damage of the glass tip of the radial fibre by means of ultra-close-up photography. The study comprised a total of 20 patients with varicose disease. A total of ten procedures of EVLO were performed in two modes mode one - W-laser 1470 nm, mode two - H-laser 970 nm, using fibre with radial emission, an automatic retractor of the light guide. It was determined that the median of power loss after EVLO with W-laser amounted to 0.6 W, and that for H-laser - 3.15 W (p=0.002). Ultra-close-up photography showed pronounced damage of the glass tip of the radial light guide while using H-laser and no damages while using the W-laser. It was proved that using laser radiation with wavelength of 970 nm using the light guide with radial emission leads to pronounced carbonization on the surface of the glass tip of the light guide, its damage, a decrease in radiation power and risk of mechanical destruction of the flask. Using the laser with wavelength of 1470 nm with the use of radial light guide did not result in the development of such negative effects, which increases the service life of laser fibre and makes it possible to use it for obliteration of several segments in one patient.The authors studied efficacy of using sulodexide (Vessel Due F) in treatment of patients with clinical class C6 chronic venous disease (CVD) and type 2 diabetes mellitus (DM). The study included a total of sixty-two 18-to-75-year-old patients of both sexes suffering from class C6 CVD and type 2 DM. The patients were randomly assigned to either the Study Group (Group I) and Control Group (Group II) in the ratio of 11. The Study Group patients received treatment with sulodexide according to the standard regimen during 50 days. The study included taking case history, examination by a phlebologist and endocrinologist, measuring the malleolar volume, body weight, ultrasound examination of lower-limb vessels, clinical and biochemical blood analyses, coagulogram, planimetry of trophic ulcers, microbiological and cytological study. The primary end point was epithelialization of trophic ulcers after 1 month. Secondary endpoints were ulcer healing after 2 months and dynamic alterations during epithelialization. The Study Group patients as compared to the Control Group patients were found to have statistically significant improvement of the composite index of clinical assessment of VSCC severity, decrease in the malleolar volume, positive dynamics of speed velocity parameters of venous outflow and improvement of quality of life according to the SF-36 questionnaire. After 30 days, epithelialization was achieved in 11 (33.5%) cases in the Study Group and in 6 (19.4%) cases in the Control Group (p less then 0.05). After 60 days, epithelialization was achieved in 27 (87.1%) and 15 (48.4%) patients of the Study and Control Groups, respectively. The time to complete epithelialization in Group I and II patients amounted to 49.8 ± 1.4 and 76.6 ± 2.4 days, respectively (p less then 0.05). A conclusion was drawn that administration of sulodexide (Vessel Due F) is effective and pathogenetically substantiated in treatment of patients presenting with class C6 CVD and type 2 DM.Despite a high level of the development of modern angiology and vascular surgery, the problem of chronic venous insufficiency (CVI) complicating the course of various venous diseases seems to have no tendency towards being solved, thus calling forth permanent search for optimization of methods of treatment and rehabilitation of patients presenting with the above-mentioned syndrome. The article presents a review of contemporary studies dedicated to the problem of correcting CVI. Special attention is paid to the endothelial state in CVI and possibilities of correcting endothelial dysfunction with the use of bioflavonoids, in particular, diosmin. Also presented herein are the results of an original experimental study dedicated to peculiarities of the endothelial functional state, endothelial dysfunction, and correction thereof on the background of the existing CVI.Widely incorporated into vascular surgery pharmacological thrombolysis in treatment for deep vain thrombosis is fraught with a series of unsolved problems requiring further consideration. In spite of aggressive nature of treatment in a series of cases pharmacological thrombolysis sometimes turns out ineffective. Along with it, the results of experimental studies suggest a possibility of accelerating resorption of thrombotic masses and inhibiting remodelling of the venous wall by means of influencing effector cells of endogenous thrombolysis. A detailed study of the mechanisms of thrombolysis would make it possible to formulate strict criteria for carrying out pharmacological thrombolysis and to increase its efficacy.The authors assessed the effect of a micronized purified flavonoid fraction (MPFF) on the course of the postoperative period after endovenous thermal ablation (EVTA). The patients of the Study Group matching by the main studied parameters to the Control Group patients were given the MPFF according to the suggested regimen for 7 days. The obtained results were analysed by means of questionnaires (CIVIQ, VCSS, VAS) and ultrasound angioscanning. The obtained findings were statistically processed by means of the program Statistica 6.0 and reliability of the results was assessed with the help of the Student t-test. Patients of the both groups showed complete stable obliteration of the target veins. No statistically significant differences of the items of the questionnaires CIVIQ and VCSS at the beginning of the study and at the last examination were revealed, differences were noted on days 2-14 after EVTA and were not statistically significant (p>0.05). Phlebotrophic therapy in the postoperative period after EVTA helps to decrease phlebitic alterations in the coagulated vein, to improve motor activity and mental psychoemotional state of the patients.Presented herein is a case report concerning successful endovascular treatment of a patient with an infrarenal abdominal aortic aneurysm combined with a horseshoe kidney. The diagnosis was verified by multispiral computed tomography. The patient underwent of endovascular repair of the abdominal aorta with a stent-graft AORFIX (Lombard Medical). The postoperative period turned out uneventful, with no complications. The patient was examined 3 years after the intervention. The findings of control check-up computed tomography showed no signs of either stent graft dislocation or endoleak.The authors describe herein the use of balloon-distensible stent grafts for endovascular treatment of patients presenting with traumatic arteriovenous fistulas in the first segment of the vertebral artery, exemplified by two clinical case reports. In both cases, the arteriovenous fistula formed after a stab-and-slash wound in the neck area. In order to exclude the arteriovenous aneurysm from the blood flow in the first case we performed endoprosthetic repair of the first segment of the subclavian artery with shutting off of the ostium of the vertebral artery carrying the aneurysm. In the second case, in order to remove the arteriovenous shunt we carried out performed endoprosthetic repair of the first segment of the vertebral artery. These cases show possibilities of roentgenoendovascular methods of treatment, making it possible to successfully replace technically complicated surgical interventions in traumatic arteriovenous fistulas of vertebral arteries.

Over 2010-2013 we anonymously interrogated a total of 397 therapeutists of municipal polyclinics of six regions of Russia (Chelyabinsk, Kurgan, Sverdlovsk, Orenburg, and Saratov Regions and the Republic of Bashkortostan), studying their awareness of the indications and

of ultrasound examination of brachiocephalic arteries (US BCA) in patients presenting with arterial hypertension (AH) and revealing the physicians' attitude to carrying out surgical prevention of stroke in hypertensive patients. As the indications for USS BCA 35 (8.82%) of physicians reported symptoms of local cerebrovascular lesions, mentioning "complaints of unilateral weakness in the extremities" (n=18), "complaints of speech impairments disorders" (n=2), "complaints of loss of fields of vision" (n=4), "endured TIA" (n=11). A total of 261 (65.74%) respondents considered the grounds for US BCA to be as non-specific cerebrovascular symptoms (isolated dizziness, headache, disequilibrium, syncope). 242 (60.96%) physicians with the purpose ofsound examination" is attached to the article.

of ultrasonic duplex scanning of major arteries of the head. 256 (64.65%) physicians answered that they do not recommend their hypertensive patients with AH to undergo surgical prevention of ischaemic stroke. The obtained findings reflect poor awareness of physicians of the primary medical care (PMC) on diagnostic criteria for cerebrovascular diseases (CVDs). The revealed problems concerning follow up of CVDs would help decide upon publication and active distribution of All-Russian guidelines for primary care physicians (therapeutists, cardiologists, neurologists, functionalinsts) on selection patients for BCA USS and angiosurgical interventions. A draft of the informational letter "Indications for BCA ultrasound examination" is attached to the article.The authors describe their first experience of a new approach in dispensary follow up of patients presenting with atherosclerosis obliterans of lower-extremities vessels. The work was based on the municipal system of rendering outpatient medical care in the city of Kemerovo. The patients were subdivided into two groups one group remained under supervision of the surgeon, the other one was referred to the cardiologist. The mean duration of follow up amounted to 12 ± 1.5 months. The scope of carried out diagnostic, therapeutic and preventive procedures was assessed. The new approach to outpatient follow up, i. e., participation of the cardiologist in the therapeutic process made it possible to improve quality of medical care, also revealing positive alterations in diagnosis, treatment, and prevention of atherosclerosis obliterans of lower-limb vessels.The study was aimed at examining efficacy of preoperative preparation (pharmacological preconditioning) for carotid endarterectomy in patients with chronic cerebrovascular insufficiency. For this purpose, we analysed the outcomes of surgical treatment in a total of 80 patients presenting with haemodynamically significant unilateral and bilateral lesions of carotid arteries. Of these, 40 patients were operated on immediately and a further 40 patients underwent surgery after pharmacological preconditioning with Actovegin taken at a daily dose of 1,200 mg for 1.5 months. It was demonstrated that preoperative preparation prior to surgery increases cerebral perfusion which is determined by means of single-photon emission computed tomography, thus substantially improving the outcomes of surgical treatment. Statistically significant differences in cognitive function of these groups of patients were revealed 7 days and 6 months after the operation. learn more Improvement of cognitive functions was associated with fewer symptom-free postoperative cerebral ischaemic foci in various regions of the brain.