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The authors share their experience with transjugular intrahepatic portosystemic shunt (TIPS) procedures preformed in a total of fifty-nine patients diagnosed with and hence operated on for class B and C hepatocirrhosis (according to the Child-Turcotte-Pugh classification), portal hypertension, grade 3 varicosely dilated oesophageal veins, or ascites. Of these, there were 12 women and 47 men (average age 56.3 years). Three types of stents were used: matrix stents (PERICO), self-expanding (ZA-stents, OptiMedsinus-SuperFlex- Visualstents, Zilverstents, SMART), and coated self-expanding stents (Gore Viatorr TIPS Endoprosthesis). Six (11 %) TIPS procedures ended in failure. Of the remaining 53 successful TIPS attempts, thirteen patients developed an in-stent thrombosis at various terms postoperatively, with one patient having experienced it twice Within four postoperative days, thrombosis occurred in three patients, at terms varying from one month to three months in five patients, and from 6 to 12 months in a further five patients. More often thromboses were encountered with the matrix stents (n = 3) 23.0% (PERICO) and self-expanding stents (n = 8) in 61.0% (OptiMed sinus-SuperFlex-Visual). Thromboses were clinically manifested by oesophageal variceal haemorrhage. An in-stent thrombosis was confirmed by means of ultrasonographic duplex scanning (lack of arterial blood flow). The primary stent patency rate following TIPS procedures amounted to 67%. with the secondary assisted graft patency rate equalling 89%. Restoration of the stent's lumen after TIPS procedures by means of endovascular recanalization, rheolytic thrombectomy, balloon angioplasty, and a stent-in-stent technique appears to be a minimally invasive, rather efficient method and virtually the only way to preserve the stent's patency. This technique makes it possible to decrease the rate of recurrent oesophageal variceal haemorrhage.

Presented herein is a clinical case report concerning successful rheolytic thrombectomy (using the AngioJet catheter) followed by stenting and having yielded a good angiographic and clinical outcome in a female patient suffering from thrombosis of the superior mesenteric artery.

The paper reviews the last publications on the etiology and pathogenesis of abdominal aortic aneurysms (AAA), analyses different risk factors and possible pathological mechanisms related to the process of aortic aneurysmal dilatation. The authors conclude that AAA results from the combination of different factors whose special impact can vary in every case.

The paper reviews occurrence, diagnostic tools venous thromboembolic complications. Cost effectiveness of preventive measures for venous thrombosis and pulmonary embolism in general surgery is analysed. The study included 45 patients who underwent elective (21) and urgent (24) abdominal and pelvic interventions. Each patient was examined with ultrasonic with color Doppler imaging before and 8-10 days after surgery. Deep venous thrombosis of lower limbs was diagnosed in 11.1%, most of cases being asymptomatic. Ultrasonic angioscanning appeared to be an acute and reliable diagnostic tool for this pathology. Various approaches to the management of patients at thrombotic risk are reviewed. Cost effectiveness analysis of anticoagulation prevention for postoperative venous thromboembolic complications must address the problem: is prevention outcome worth those extra efforts? Surveillance of 500 patients at high thrombotic risk has shown that preventive use of low weight heparin (Clexane) is economically beneficial then conventional Heparin, the more in the absence of special preventive strategy. Targeted prevention in patients with different risk of postoperative venous thromboembolic complications can yield more then 3-fold reduction in occurrence of these complications.

Resulting from the experimental investigations on 70 dogs and analysis of 3 clinical cases, the authors have established that cryodestruction of the pancreas in extensive hemorrhagic pancreonecrosis permitted to cup off promptly the enzymatic toxemia and prevented the development of secondary purulent complications. The most pronounced anti-enzyme effect was noted in combination of the corpus-caudal resection of the pancreas and cryodestruction of the organ remainder.