RESUMEN
Presented herein are the results of successful one-stage revascularization of the brain and reconstruction of the abdominal aorta in a 78-year old patient with infrarenal abdominal aortic aneurysm, the signs of rupture, stenosis of the left renal artery and multiple aortic arch lesions -- stenoses of both internal carotid arteries and both vertebral arteries. The sequence and technology of surgical intervention are described.
Asunto(s)
Aneurisma de la Aorta Abdominal/cirugía , Anciano , Aneurisma de la Aorta Abdominal/diagnóstico por imagen , Humanos , Masculino , Ultrasonografía , Procedimientos Quirúrgicos Vasculares/métodosRESUMEN
Selective phleborenotesticulography, ++tensiometry of the left iliac, right and left renal veins, vena cava inferior, duplex scanning of the left renal vein were performed in 356, 296 and 57 patients, respectively, of a total of 356 examinees aged 8-17 years with left-side varicocele. Among other tests were measurements of hormones in the blood from the left and right testes (n = 24), pO2, pCO2. Stenosis, aortomesenteric compression (AMC) of the left renal vein, left-side venous renotesticular hypertension (RTH) of the left renal vein were diagnosed in 12, 342 and 158 patients, respectively. Secondary genesis of left varicocele has been proved. The diagnosis of left-side phlebohypertensive nephropathy was made preoperatively. Estradiol content in the blood of the left testis was 1.7 times higher than from the right one. 4 groups of patients were formed: group 1 patients (n = 142) had stenosis, AMC, dilatation of the testicular vein (DTV) and RTH; group 2 patients (n = 18) had AMC, DTV, borderline high pressure; group 3 patients (n = 18) had AMC, RTH, multiple thin testicular veins; group 4 patients (n = 174) had moderate AMC without hypertension. 160 patients of group 1 and 2 have undergone two-direction venous testiculo-iliac anastomosis operation. 193 patients of groups 3 and 4 have undergone Ivanissevich's operation. After Ivanissevich's operation 2 patients with secondary varicocele of the third degree retained varicocele of the first degree. After establishment of anastomoses, neither varicocele recurrences nor anastomosis thrombosis were registered.
Asunto(s)
Venas Renales , Venas Renales/fisiopatología , Testículo/irrigación sanguínea , Varicocele/cirugía , Venas/fisiopatología , Adolescente , Presión Sanguínea , Niño , Electrocardiografía , Humanos , Masculino , Flebografía , Venas Renales/diagnóstico por imagen , Varicocele/fisiopatologíaRESUMEN
244 patients with ischemia of the lower limbs were treated surgically in the specialized cardiovascular center. No lethal outcomes were reported because previously derived algorithm of detecting silent myocardial ischemia in patients with intermittent claudication and load tests (bicycle ergometry and drug stress tests) had allowed the surgeons to ascertain the extent of coronary damage and detect subclinical cardiac failure. Valid assessment of cardiac factors enabled the right choice between surgical and therapeutic methods and staging of the procedures.