Carotid body tumors, also commonly known as nonchromaffin paragangliomas and chemodectomas, is a slowly growing neoplasm originating from carotid body chemoreceptors. Herein we have presented a case series of surgical treatment of patients with carotid body tumors in National Scientific Center of Surgery named after AN Syzganov (2009-2020). Total number of patients was 10 with 11 neck mass, of which 7 (70%) were women, the average age was 47 (31-73) years, one case we faced with a bilateral location. The main complaint was slow-growing neck mass. On computed tomography angiography most of cases (70%) were of the 3th type according to the Shamblin grade with average size of 5.9 (4-8) cm. The main treatment was surgical excision in all cases. Mean duration of surgery 111.5 (75-190) min and hospital stay days 12.1(8-20) were registered. Total number of complications were 2 (20%), where in 1 case surgery complicated by bleeding more than 500 ml, and 1 patient presented dysphonia after the surgery, which resolved by time. Duration of surgery and hospital stay days were directly associated with size of mass and distance to base of skull. Pathology results showed that two patients (20%) had malignant cells, one of them with metastases to the nearest lymph nodes. Surgical resection is the treatment of choice for carotid body tumors. The large size of the masses and involvement of the carotid arteries and cranial nerves in the process directly affect the surgical approach and increase the risk of complications.

This literature review shows the essence of the problem of extracranial carotid artery stenosis, since this disease is a treatable cause of ischemic stroke and can be reliably detected and assessed by using vascular ultrasound. In Kazakhstan, due to acute disorders of cerebral circulation, 11.1 thousand patients die every year. The reliability of the information in the article was obtained by using the literature data of the last 10 years. The reflection of the criteria for diagnosing stenosis of the extracranial carotid artery, the use of which, in conjunction with standard tests and other sensitive methods, makes it possible to determine the lesion of the extracranial carotid artery at an early stage, as well as a detailed description of diagnostic methods of this complication and evaluation of their effectiveness. Screening for carotid stenosis is important, and whether routine carotid ultrasound is recommended in general population for the prevention of ischemic stroke remains controversial. Screening for carotid stenosis by ultrasound is crucial not only for the daily clinical setting, but also for the management of patients with acute ischemic stroke.

Primary biliary cholangitis (PBC, formerly known as primary biliary cirrhosis) is one of the most significant diseases that is predominantly verified in women. The prevalence of PBC is 1.9-40.2 per 100,000 population. Antimitochondrial antibodies (AMA) are of major importance for the diagnosis of primary biliary cirrhosis (PBC), and it has also been suggested that they may be involved in the pathogenesis of the disease. Objective: The aim of this study was to characterize the clinical, biochemical parameters and response to UDCA (Paris I criteria) PBC patients depending on AMA status in the Republic of Kazakhstan. Material and methods. The study was conducted on the basis of the Research Institute of Cardiology and Internal Diseases from 2014 to 2019. A total of 212 patients with primary biliary cholangitis were recorded. Results. Among 212 patients, 171 (80.7%) were AMA-positive and 41(19,3%) - AMA-negative. Vast majority of patients in both groups were Asian (179; 84.4%) and female (206; 97.2%). Severe disease (F3/4) was revealed in 108 (63.2%) AMA-positive and in 18 (43.9 %) AMA-negative patients (p>0.05). AMA-positive and AMA-negative PBC were associated with autoimmune hepatitis in 88 (51.5%) and 10 (24.4%) cases (p<0.01), rheumatoid arthritis in 26 (15.2%) and 5 (12.2%), autoimmune thyroiditis in 35 (20.5%) and 4 (9.8%), vitamin D deficiency in 89 (52.1%) and 19 (46.3%), osteoporosis in 48(28.1%) and 7 (17.1%), gallstone disease in 43 (25.4%) and 8 (21.2%) respectively (p >0.05). Response to ursodeoxycholic acid (UDCA) treatment according to Paris I criteria was noted in 24 out of 81 (29.6%) AMA-positive and in 9 out of 22 (40.9%) AMA-negative patients (p>0.05). Conclusion. In patients with AMA-positive PBC compared with AMA-negative, there is a statistically significant high value of autoimmune hepatitis and autoimmune thyroiditis. Whereas, response to UDCA treatment according to Paris I criteria is higher in AMA-negative PBC.

Critical lower limb ischemia (CLI) is the final stage of peripheral arterial disease and occurs with chronic pain at rest, loss of tissue and limb. Despite the active development of new technologies, including endovascular and open surgical methods of treatment, and the development of various guidelines, CLI still remains an unresolved burden of vascular surgery around the world. The second part of the review describes large randomized trials, open and endovascular methods of lower limb revascularization in CLI. Also, the use of deep vein arterialization technology in No-option cases for conventional methods of revascularization.

Central venous catheters (CVCs), such as the tunneled catheters and the totally implanted ports, play a major role in general medicine and oncology. Thrombosis associated with CVCs is a common complication in cancer patients. Thus, in order to more widely study the problem of catheter-associated thrombosis in cancer patients, we initiated a study for 2022-2023 within one region. Purpose. Evaluation of the efficacy and safety of thromboprophylaxis of catheter-associated thrombosis with rivaroxaban in cancer patients. Material and methods. Prospective multicenter study, conducted since 01/05/2022 and planned to be completed by the end of 2022, on the basis of three centers. The subjects are divided into 2 groups to randomize 60 participants in each. The first group: receive DOACs (rivaroxaban) at a dosage of 20 mg per day the day before the inserting of the CVC. Second group: treatment of the underlying disease without the use of DOACs. Results. None of the patients developed submassive or massive pulmonary embolism. There were no cases of CAT in the thromboprophylaxis group compared to the non-thrombotic prophylaxis group (0% vs 15.7%). The relative risk of developing CAT is 0.86, which indicates the effectiveness of thromboprophylaxis with rivaroxaban. Conclusion. Our interim results show the efficacy of rivaroxaban at a dosage of 20 mg per day in cancer patients. The final results are planned to be published at the end of the study