Search

Clinical application of roentgeno-endovascular++ prosthesis was initiated in March, 1984, following 2-year developments and experimental implantations of endoprostheses made from an alloy with a mould storage effect. An effect of implantation of the endoprosthesis into the arterial wall by covering it with an nonhyperplastic, nonadhesive neointima. In 103 patients, 121 endoprosthesis implantations had been made into the iliac, femoral, and popliteal arteries over 5 years, 76.8% of the patients had had a severe concurrent disease. The age of the patients ranged from 21 to 72 years. Positive results were obtained in 93.7% of all the implantations. The long-term results were studied during 0.5-5.0 years' follow-ups. Poor results were obtained with endoprosthesis of the superficial femoral and popliteal arteries, which was associated with impaired distal limb blood flow. Indications for endoprosthesis were defined. The technique may be used in critical ill patients in whom direct surgical interventions are contraindicated due to concurrent abnormalities. The methods developed make it possible to successfully make endoprosthesis of the great arteries via a transcutaneous puncture access under local anesthesia.

The presence of multiple renal arteries (MRA) as a congenital developmental anomaly encountered in 13% angiographic examinations is not the cause of vasorenal hypertension. Sustained hypertension develops in affection of one or several of the MRA. The authors analyse 55 patients with vasorenal hypertension in affection of one or more of the MRA. Interventions on the MRA restored their blood flow in 91.0% of patients. Positive results with reduction of hypertension were produced in 85.4% of patients. Complications--restenosis, thromboses--occurred in 12.7% of cases. One patient died from acute renal failure which had developed in thrombosis of the renal arteries. Patients with affection of one or several of MRA of various etiology may be cured successfully by organ-preserving reconstructive operations. Nephrectomy should be resorted to only in intraorganic affection of the renal vessels or in total loss of kidney function.