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The authors consider the tactical features of transcutaneous endovascular angioplasty in 110 patients with multiple arterial occlusive and stenotic lesions of the pelvis and lower extremities. A total of 299 arteries were operated on and desobliteration of stenoses and occlusions were performed. Five procedures of transcutaneous endovascular angioplasty: via transfemoral antegrade, transfemoral retrograde, transfemoral contralateral, transpopliteal, and transaxillary accesses were used alone or in combination. The tactics of transcutaneous endovascular angioplasty was determined by the nature, site, and extent of lesions, as well as the status of the distal arterial bed. Clinical positive results of transcutaneous endovascular angioplasty were obtained in 94 (85.4%) patients. Complications following endovascular interventions were encountered in 5 (4.6%) cases.

The authors analyse the results of endovascular angioplasty of the pelvic and lower limb arteries in 147 patients of various age suffering from arteriosclerosis obliterans. It was found that the results of endovascular angioplasty depended on the state of the lipid balance. The necessity for correcting the shifts in the lipid metabolism is shown. The article evaluates the results of dyslipidemia correction by dietotherapy, pharmacotherapy, and operation for partial ilio-shunting in patients with arteriosclerosis obliterans of the pelvic and lower limb arteries. The efficacy of the listed methods of treatment are analysed according to the severity of dyslipidemia.

The paper outlines the analysis of immediate and late outcomes of transcutaneous transluminal angioplasty (TTA) in 147 patients with atherosclerosis obliterans of the lower extremities. The study has revealed that age and dyslipidemia as TTA risk factors fail to affect the immediate outcomes in the early postoperative period. There is a positive correlation of the reocclusion time after TTA and the age and lipid metabolic disturbances in patients with atherosclerosis obliterans of the lower extremities in long-term periods. The paper provides strong evidence for that it is essential to correct dyslipidemias in order to make TTA results better in these patients.

Regional thrombolysis was performed in 62 patients with thrombosis of the aorta and arteries of the pelvis and lower extremities. The thrombolytics used were avelysin (20 patients) and celiase (42 patients). Complete lysis of the thrombi was recorded in 49 cases. After successful thrombolytic therapy balloon angioplasty of the revealed stenoses was carried out in 39 patients. After thrombolysis was completed 15 patients underwent various reconstructive operations which failed to produce an effect in 4 patients and the extremity was amputated. The complications of thrombolysis included hematomas at the site of catheterization of the arteries in 5 patients, distal embolism in 7, and an allergic reaction in one patient. The authors appraise the dependence of thrombolysis efficacy on the level, extent, and duration of the thrombotic occlusion.

The work is based on a comparison of data gained in experiments with the results of clinical examination of a large group of patients in the late-term period after endovascular occlusion of a patent ductus arteriosus (PDA). The regular features of the course of the morphological process in the zone of the PDA after implantation of a botallo-occluder into it were studied. Clinico-morphological parallels were made. The high efficacy and reliability of the new method of endovascular treatment of PDA, developed at the Moscow Second Medical institute, was substantiated morphologically and confirmed clinically.

The condition of the inferior vena cava system was studied in 597 patients after percutaneous implantation of the antiembolic cava-filter on the basis of the clinical findings and results of angiographic and pathoanatomical examination. The patency of the inferior vena cava was found to be maintained in the immediate postimplantation period in most patients. The causes of occlusion of the inferior vena cava in 10% of cases (according to the clinical findings) were embolic occlusion of the cava-filter and ascending thrombosis of the iliocaval segment.

Experience in clinical application of the new antiembolic REPTELA cava-filter is generalized. The immediate (750 patients) and late-term results (400 patients) of implantation of the filter are discussed. Thromboembolism of the pulmonary artery was encountered in the postimplantation period in 1.2% of patients with 0.2% lethality. Technical faults of implantation were the causes of antiembolic inefficacy of the cava-filter.