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Background. One of the underestimated causes of chronic pelvic pain (CPP) in women may be pelvic congestion syndrome (PCS) that is defined as the presence of varicose of ovarian and pelvic veins associated with chronic pain in the region of the pelvis. This pain is present longer than 6 months and intensifies with prolonged standing, coitus and menstruation. The disease constitutes a diagnostic as well as therapeutic problem, thus posing a challenge for the clinician. Transcatheter ovarian vein embolization might be a safe and effective option for PCS treatment. Objectives. The objective of this study was to evaluate the efficacy of ovarian vein embolization ovarian as a method of the PCS treatment. Material and methods. Between 2002-2012, 11 embolization procedures were performed in 10 women (age range: 34-43; median age 39) with the diagnosis of PCS. One patient underwent embolization procedure twice. In 1 case the combined therapy of endovascular embolization and surgical phlebectomy of vulvar varices was performed. Results. There were no major intrainterventional complications. In all the patients (100%) a significant improvement in the clinical status was noted. The procedure improved the quality of life in the patients. Three women (30%) had a mild recurrence of the symptoms at mid-term follow-up. Among 8 women who had complained of dyspareunia prior to embolization 6 patients reported complete pain relief, in other 2 cases the pain subsided partially. There was a significant decrease in the severity of symptoms associated with hemorrhoids. Conclusions. We consider embolization of insufficient ovarian veins an effective and safe way of treatment in a well-selected group of patients with PCS. [ABSTRACT FROM AUTHOR]

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Wstęp. W 2003 roku autorzy niniejszego artykułu rozpoczęli badania nad możliwościami leczenia chorych z krytycznym niedokrwieniem kończyn za pomocą implantacji własnych komórek macierzystych. Po okresie wstępnych przygotowań ustalono schemat postępowania, kryteria włączenia do leczenia i sposób prowadzenia badań kontrolnych oraz procedur bezpieczeństwa. Materiał i metody. Kryteria włączenia obejmowały krytyczne niedokrwienie kończyny niekwalifikujące się do leczenia chirurgicznego, po leczeniu zachowawczym nie krótszym niż 2 miesiące, w którym nie nastąpiła istotna poprawa zagrożonych zabiegiem amputacyjnym. Do kryteriów wyłączenia zaliczono: brak zgody chorego, inne powody niedokrwienia niż miażdżyca, znaczne zaawansowanie zmian zmuszające do pilnej amputacji, a także obecność choroby nowotworowej lub stan ogólny nierokujący przeżycia 6 miesięcy. Chorych po poinformowaniu i uzyskaniu od nich świadomej zgody losowo przydzielano do dwóch grup: kontrolnej (15 osób poddano terapii klasycznej) oraz badanej (14 pacjentów). Zastosowano następujący algorytm: w godzinach rannych wykonywano standardowy zabieg pobrania szpiku (z kości biodrowej), następnie przygotowywano w separatorze zawiesinę komórek za pomocą filtrowania szpiku, zagęszczania i separowania komórek CD34+ (frakcja zawierająca progenitory). Uzyskany materiał podawano chorym dwoma drogami miejscowo do tkanki mięśniowej niedokrwionej kończyny (n = 14) i podczas angiografii, do końcowego odcinka osiowego naczynia kończyny dostępnego cewnikiem (nad okluzję) (n = 4). W obserwacji uwzględniano parametry ogólne (RR, tętno, częstość oddechów, temperatura), wartość współczynnika kostka/ramię (ABI), makroskopowy obraz ewentualnych owrzodzeń i martwicy (fotografie), a także subiektywne odczucia pacjentów (VAS, skala jakości życia wg klasyfikacji WHO). Notowano parametry przed leczeniem, codziennie do momentu wypisu chorego ze szpitala, po 1., 3. i 6. miesiącu terapii. Wyniki. Angiografię wstępną wykonano u każdego pacjenta (wynik badania dyskwalifikował od przeprowadzenia zabiegu rewaskularyzacyjnego), natomiast badanie kontrolne przeprowadzono po 3 miesiącach u 5 chorych z grupy badanej (nie odnotowano różnic w ich obrazie). Punktami końcowymi obserwacji były amputacje (3 w grupie badanej i 7 w grupie kontrolnej) oraz śmierć pacjenta (nie odnotowano). W przypadku amputacji pobierano do badania histologicznego i w przypadku zastosowania komórek macierzystych obserwowano cechy angiogenezy. W większości przypadków uzyskano poprawę subiektywną (12 osób w grupie badanej vs. 7 w grupie kontrolnej). Zaobserwowano zmniejszenie owrzodzenia (8) oraz wygojenie w grupie leczonej komórkami szpiku (5) w stosunku do grupy kontrolnej (3). Amputacje przeprowadzono u 3 chorych (wgrupie kontrolnej u 7 osób). Wnioski. Implantacja własnych komórek macierzystych uzyskanych ze szpiku kostnego jest bezpieczną i budzącą duże nadzieje metodą leczenia, pomimo znanych ograniczeń. Ze względu na możliwość jej rozwoju powinna stanowić przedmiot dalszych dociekań. [ABSTRACT FROM AUTHOR]

Background. In 2003 we started investigations concerning the possibility of using new techniques, including bone-marrow cell implantation, in the therapy of critical leg ischaemia. Safety procedures, scheme of work and inclusion and exclusion criteria were established during the first faze in collaboration with various local departments and laboratories. Material and methods. Inclusion criteria consisted of critical leg ischaemia, no possibility of surgical operation, no effective 2 months conservative treatment or the possibility of limb amputation in the following months. Exclusive criteria included causes of ischaemia other than atherosclerosis, absence of consent, need for urgent amputation, cancer or poor general condition. After acquiring conscious consent, patients were randomized into two groups: conventional therapy (control group) (n = 15), and those treated with bone marrow cells (n = 14). Standard bone marrow collection was performed as early as the first operation (usually about 8 a.m.) under general anaesthesia. Material was then prepared filtration and concentration in a separator -- using standard procedure. Morphology and measurement of the amount of nuclear cells and CD34 cells were perforated as well as microbiological examination. This material, including progenitor cells, was injected using two methods about 46 hours after bone marrow aspiration. In every case it involved several intramuscular injections into the ischemic limb (thigh and leg). In 4 cases we performed intravascular placement of progenitors using arteriography (in the distal pan near the occluded part of the axial limb artery). Results. Observation was based on several parameters: vital parameters (blood pressure, heart rate, respiratory rate, temperature) measured every day during hospitalisation; ankle/brachial index (ABI), ulcerations or pedal necrosis documented by photography and subjective parameters: feeling of pain (VAS), self care (WHO scale) measured 1, 3 and 6 months after our procedure. Baseline angiography was performed in every case. Control angiography followed bone marrow collection after 3 months in 5 cases. No changes in angiograms were detected. Endpoints were: amputation (10) and death (no observations). In case of amputation, material was histologically examined and signs of angiogenesis (mostly new vein formation) were detected. In the group treated by stem cell implantation we reached greater subjective improvement in 12 cases compared to 7 in the control group; healing of ulcers in 8 cases (complete in 5 cases) compared to 3 cases in the control group. Amputations were performed in 3 patients in the index group compared to 7 in the control group. Conclusions. We think that implantation of patients' bone-morrow progenitor cells in cases of critical leg ischaemia is safe and is a prospective therapeutic method. [ABSTRACT FROM AUTHOR]

Background. At the Department of Vascular, General and Transplant Surgery, 1087 procedures for restoring the patency of a stenosis of an internal carotid artery were carried out in the years 1996 to 2001. Material and methods. 403 patients out of this group were operated on by the traditional method of endarterectomy secured by a plane suture and 306 by the eversion method. The "Y"-arterioplasty technique was applied in 62 patients. Results. During the 3-year follow-up period, recurrent stenosis of an internal carotid artery was observed in 42 patients and involved the external carotid artery in 12 patients. An endarterectomy was closed with a Dacron patch in 30 patients and an arterial partition reconstruction "Y" surgery was performed on 12 patients. In all cases, the diagnosis was made upon a physical examination, coloured Doppler examination and angiography according to Seldinger's method. Conclusions. A "Y"-incision allowed the precise endarterectomy, both of the partition and of the changed initial sections of the external and internal carotid arteries. The described "Y"-arterioplasty of the partition of a common carotid artery complies with the requirements imposed on an endarterectomy of an internal carotid artery partition. Additionally, the shifting of a partition superiorly to the site of a restored patency may safeguard a patient against recurrent stenosis, according to our material, caused mainly by hypertrophic fibrous pathologic changes developing within the site of endarterectomy. [ABSTRACT FROM AUTHOR]

Copyright of Acta Angiologica is the property of VM Medica-VM Group (Via Medica) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Angiologica is the property of VM Medica-VM Group (Via Medica) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim of Study: The aim of this study was to evaluate the effectiveness of hydrophilic catheters and guidewires during endovascular overcoming long stenoses or occlusions of the superficial femoral and popliteal artery., Material and Methods: Based on 142 procedures rated the functionality of the equipment of the hydrophilic coating. The operations were performed in the years 2010-2012 in the Department of Vascular, General and Transplantation, Medical University in Wroclaw. Procedures related to recanalization or enlargement of the superficial femoral artery. Patients were divided into groups according to the Consensus TASC II depending on the length change. Each patient was assessed ankle-brachial ratio (ABI), claudication distance measured and constructed with double ultrasound imaging (USG-DD). In doubtful cases an additional study was performed with contrast computed tomography (angio-CT). The procedure was performed at the Laboratory of angiography using a angiograph Siemens Artis Zee Ceiling. Every time the contrlateral access was made, and as the first step the angiography was performed to verify type of changes in the arteries, Results: . A significant benefit of using hydrophilic guidewires and catheters in patients with long stenoses or occlusions. In case of long and calcified changes, hydrophilic catheters was the only option because it gave good support for hydrophilic guidewire., Conclusions: The changes in the type C and D according to the criteria for TASC II, an essential tool to achieve a positive treatment effect is the use of hydrophilic catheters and guidewires.

The authors of the present paper demonstrate the head and neck paraganglioma, discuss its location, clinical picture, diagnostics and treatment. Paragangliomas are relatively rarely occurring tumors, stemming from the autonomic nervous system. Initially asymptomatic, they do not present any characteristic clinical picture during the further development. Not large size of the tumor contributes to the late diagnosis which is most regrettable due to its potential malignancy (10%). Diagnostic and therapeutic problems cause it's medication reasonable only in specialist centers. Perioperative mortality is estimated at 5 to 13%. Postoperative neurological lesions in a form of the cranial carebro-vascular failure occur in 8 to 20% of cases. A contemporary advanced angiosurgical and anesthesiologic technology allow reducing a postoperative mortality to 5% and neurological complications by 10%. During the previous years many centers carried a preoperative embolization of a tumor during angiographies. An alternative to the large tumor vessels obliteration may be a radium therapy, although several reports confirm its low radiosensitivity.

Chemodectoma is exceptionally rarely tumor comes from the parasympathetic part of nervous system. Cases description first of all concern multiple, single tumors localized on the neck, occasionally somewhere else. Tumors expansion in internal carotid vein aperture or in ear provoke serious complications from cranial nerves paralysis to cerebellum lesion. In this paper authors present a case of bilateral chemodectoma. Surgical treatment has required--not only simple tumor excision but also internal carotid artery reimplantation.

The varices of the lower limbs and its complications are very common Surgical procedure which consists of ligatur of the venous tranks or stripping of them, ligation of perforating veins are basic methods of the treatment. After surgery, veins compression prevents secondary bleeding and above all, the development or recurrence of thrombosis The purpose of this study was the assessment of graduated compression stockings in prophylaxis of varicose vein disease recurrency. The study included 120 patients who underwent phlebectomy due to varicose veins. The period of follow up lasts 3 years and has been carried out in two groups. The first one was agreed to use compression therapy following surgery. The second group did not get any physical support to their legs. Compression class I and II: calf, thigh, panty medical stockings and were used. The first group of 60 patients (102 legs) wearing medical stockings following surgery have no either subjective or objective signs of venous insufficiency in long period of time after surgery. Statistical analysis pointed out marked significance between both groups of patients p < 0.001.