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The number of patients suffering from aneurysms of the abdominal aorta (AAA) is rising simultaneously with the increase of the number of patients afflicted with cardiovascular disorders of atherosclerotic nature. Of the three very serious complications in such disorders-thrombosis, embolism, and rupture-the latter is the most serious and has a dramatic course. In the present study we discuss the surgical approach and the results of the treatment of 11 ruptured AAAs for the period from 1989 to 1991. Ten of the patients were male and one female. Their age was in the range of 51 to 87 (mean age 63.7 years). The diagnosis was primarily made on the basis of anamnestic and clinical evidence. Transvenous aortography was performed in four of the patients, and computer tomography was used in four other patients. Two patients were diagnosed in the operation theater placed there for an operation of acute abdomen. One of the patients was operated on only on the basis of the available clinical evidence because no other investigations were possible to have been performed. One patient died in the operation theater. One patient was operated on again in the early postoperative period because of the acute ischemia he developed in one of the lower limbs due to intraoperative embolic accident, and one patient was operated on later in the postoperative period because of two false aneurysms of the proximal and one of the distal anastomoses.(ABSTRACT TRUNCATED AT 250 WORDS)

The problem of the changes in blood coagulability and blood rheologic characteristics in traumatized patients is both old and topical. There are still many unresolved problems concerning the dynamics of the hemostasiologic status, the duration of immobilization and recovery of physical mobility, the anticoagulation treatment, the ways of reducing the possible complications, etc. In the present study the authors try to resolve some of these problems on the basis of their personal experience with 27 patients with soft-tissue traumas of the lower limbs complicated with deep venous thromboses. The role and place of the existent pathoanatomical changes in the region of the traumas as well as the dynamics of the pathophysiological mechanisms are discussed. The severity of the different complications and the measures for their prevention have also been considered.

Realization of vascular access for patients with chronic renal failure on chronic hemodialysis sometimes proves to be a difficult task. Problems arise when these routes start creating complications and technical difficulties after longterm hemodialysis. A similar problem arises in dealing with arteriovenous aneurysms in patients on chronic hemodialysis. Along with technical difficulties, there also are a number of problems related to hemodynamics and hemostasis. In the present study, 32 patients were analyzed. These patients had advanced arteriovenous aneurysmal dilatations which necessitated surgical intervention. The state of advancement, the causes and the possible types of aneurysms were taken into account. Serious surgical aneurysmal complications were observed in more than 40 percent of the cases. After surgical removal of the arteriovenous aneurysms, the problem of creating new routes for continuing hemodialysis always arose and frequently led to atypical and nonconventional solutions. Suggestions are made for prolongation of life and maximal avoidance of aneurysmal dilatation development in the vascular accesses of patients on chronic hemodialysis.