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Objective: To evaluate the results of endovascular surgery in patients with chronic limb-threatening ischemia (CLTI) with infrainguinal arterial disease GLASS III., Material and Methods: Treatment outcomes were analyzed for the period 2017-2018. Inclusion criteria were age over 18 years, CLTI, extended (>20 cm) stenosis de novo and occlusion of femoropopliteal segment (FPS) combined with occlusive lesion of tibial arteries. We analyzed 147 patients divided into 2 groups depending on stenting strategy. FPS-1-TA included 53 patients who underwent angioplasty (± stenting) of femoropopliteal arteries and lower leg arteries resulted at least one patent tibial artery. FPS-2-TA enrolled 94 patients who underwent angioplasty of femoropopliteal arteries and lower leg arteries resulted ≥2 patent tibial arteries. Mean age was 71.0±9.8 years. There were 75 men. Demographics and clinical characteristics of patients were similar., Results: Technical success rate was 100%. Mean length of stenting was 203 ± 99 mm. Occlusion of all 3 leg arteries correlated with high incidence of femoropopliteal stenting. In the FPS-1-TA group, stents were implanted in 39 patients, in the FPS-2-TA group - in 71 patients (73.6% and 75.5%, respectively, p =0.8). Braided nitinol stents were used for stenting of the lower third of superficial femoral artery and p1-p3 segments. Mean follow-up period was 22.6±1.1 months. Two-year results were not age-specific in our study. Kaplan-Meier overall survival, freedom from amputation and amputation-free survival for the entire sample were 79.6%, 81.0%, and 66.7%, respectively. We compared these values in both groups using Mantel-Cox log-rank test and obtained significant differences (67.9% vs 86.2%, p =0.004; 64.2% vs 90%, p <0.0001; 47.2% vs 77.7%, p <0.0001, respectively)., Conclusion: Our results are comparable with literature data regarding freedom from amputation and amputation-free survival. We obtained significant differences in overall survival and freedom from amputation depending on endovascular strategy for tibial arteries. Correction of distal vessels with recanalization of at least two tibial arteries is advisable for endovascular treatment of diffuse complex lesions.

Aim: The study was aimed at assessing the incidence of arteriovenous compression in women with chronic venous insufficiency of the inferior vena cava and at developing an optimal diagnostic algorithm., Patients and Methods: During the period 2019-2020, we performed a cross-sectional study including a total of sixty-six 18-to-55-year-old (mean 33.5±5.0) women with clinical manifestations of chronic venous insufficiency of the basin of the inferior vena cava. A diagnostic algorithm included questionnaire, transvaginal ultrasound examination, multislice computed tomography, direct phlebography in combination with phlebotonometry., Results: Chronic venous insufficiency of lower limbs was diagnosed in 66 (100%) cases and was presented by the following clinical classes according to the CEAP classification: C0 - 4.5%, C1 - 60.6%, C2 - 27.2%, C3 - 3%. Symptoms of pelvic venous plethora were revealed in 36 (55.5%) examined patients. Arteriovenous compression syndrome according to the findings of multislice computed tomography was verified in 16 (24%) women, including May-Turner syndrome in 5 (7.6%), aortomesenteric compression syndrome in 8 (12%) women, with a combination of both syndromes observed in 3 cases; the frequency of their detection did not differ statistically in subgroups of women with and without clinical signs pelvic varicose veins. Direct phlebography in combination with phlebotonometry was performed in 9 women, the diagnosis of arteriovenous compression (May-Thurner syndrome) was confirmed in 1 case only., Conclusion: In women with signs of chronic venous insufficiency in the system of the inferior vena cava the frequency of detecting arteriovenous compression on multislice computed tomography may reach 24% and does not depend on the presence of symptoms of pelvic venous plethora. The proportion of arteriovenous compression according to the findings of direct phlebography and phlebotonometry in the structure of causes of the development of pelvic varicose veins did not exceed 11%. An algorithm for diagnosing arteriovenous compression syndromes should obligatorily include multislice computed tomography, direct phlebography and phlebotonometry.

The article is a review of contemporary randomized studies on radiofrequency denervation of renal arteries, followed by critical assessment of their advantages and disadvantages for possible optimization of endovascular treatment of resistant arterial hypertension.

The paper reports results of endovascular treatment of 66 patients with post-infarction cardiosclerosis. It was shown that normalization of coronary circulation in patients with viable hibernating myocardium in the zone of the affected artery not only eliminates the signs of chronic ischemia and slows down post-infarction heart remodeling but also restores the lost functions of hibernating myocardium which has beneficial influence on prognosis of the disease. Functioning of hibernating myocardium depends on the timely restoration of coronary circulation.

Two approaches in treatment of 131 patients with postinfarction cardiosclerosis are compared in the work. Tactics of "total" myocardial revascularization means restoration of coronary blood flow in all arteries with hemodynamically significant lesion while "selective" revascularization provides restoration of coronary blood flow only in those arteries which have a viable myocardium in their pool. It was concluded that restoration of coronary blood flow in patients after myocardial infarction permits to prevent postinfarction heart remodeling, development of heart failure thereby affecting on the prognosis. Evaluation of myocardial viability in the area of suggested surgery increases efficiency of revascularization, reduces number of implantable stents and decreases frequency of unfounded coronary interventions. Elimination of ischemia in the area of hibernation provides a rapid restoration of myocardial contractility in most of left ventricle segments with initially impaired kinetics. It was revealed that terms of contractility restoration of hibernating myocardium depend on duration of hibernation period up to revascularization.

Immediate and long-term results of endovascular treatment of multivessel coronary artery disease by using different revascularization strategies were analyzed in 171 patients. Duration of follow up ranged from 12 to 18 months. Complete myocardium revascularization was performed in 63 patients, culprit vessel revascularization--in 86 pts and incomplete revascularization--in 22 pts. Results of this study showed that strategy of complete and culprit vessel revascularization in patients with multivessel coronary artery disease has comparable immediate and long-term results. Strategy of incomplete revascularization reduce immediate clinical success and lead to increased number of myocardial infarctions and needs of coronary artery bypass surgery in long-term follow-up period.

The long-term follow-up treatment results were analyzed for 171 patients operated on the reason of multiple coronary vessels atherosclerosis. The average follow-up time was 14.85 ± 2.52 months. The complete myocardium revascularization was achieved in 63 patients; functionally adequate myocardial function was registered in 86 patients; 22 patients demonstrated noncomplete revascularization rate. Results of complete and functionally adequate revascularization were not significantly different by the myocardial infarction, repeated revascularizative manipulations and main cardio-vessel complications rates. Patients of the third group demonstrated the statistically higher rates of myocardial infarction (p=0.016) and necessity of the coronal shunting (p=0.033).

This study included 171 patients with multivascular lesions in the coronary bed treated endovascularly for myocardial revascularization. The patients divided into 3 groups underwent complete, functionally adequate, and incomplete revascularization respectively. Analysis of clinical, anamnestic and angiographic characteristics of the patients revealed possible risk factors hampering the necessary extent of revascularization in case of multivascular lesions in the coronary bed such as chronic coronary occlusion, occlusion of more than 20 mm of the coronary artery, high risk of percutaneous coronary intervention based on the SYNTAX Score scale, and calcinosis of the effected segment.

Short and long-term results of endovascular treatment of true bifurcational coronary stenosis were analyzed in 229 patients. 68 patients received a "provisional-T" stenting on the first stage of the study. On the next stage 40 patients received the same "provisional-T" stenting, a total bifurcational stenting was conducted in 37 patients. Only coated stents were used. Independent risk factors of "provisional-T" stenting conversion to total bifurcational stenting were revealed. There were no differences between "provisional-T" and total bifurcational stenting considering the short-term treatment results. Long-term results (12-18 months) were analyzed in 70 patients. There were no restenosis of the main artery, whereas restenosis of the lateral branch was noticed in 5.5 and 2.94%, respectively, in the groups of "provisional-T" and total bifurcational stenting. Late thrombosis was registered in 1 case from the group of total bifurcational stenting.

Paper is devoted to the safety rules by surgical interventions on patients with permanent pacemaker. Data of 123 operated patients with intraoperative pacemaker instability were analyzed, possible premises of this complications were discussed. The use of monopolar electrocoagulation proved to be the most frequent of reason of pacemaker failure. Strong correlation between rhythm failure and duration of the single electrocautery exposure was revealed.

7 cases of left ventricular rupture after the mitral valve replacement, which occurred per 900 operations performed in our clinic, were analyzed. A successful closure of the defect has been managed in 2 cases. In all cases the external closure with liners and patch plasty was used. In two cases the autopsy revealed a transmural myocardial infarction, underdiagnosed preoperatively, which had caused a rupture.