Методика эндопротезирования аневризм брюшной аорты за последние десятилетия используется все более часто. Данное вмешательство показано пациентам с высоким хирургическим и анестезиологическим риском открытого оперативного пособия. Рассматривается опыт 29 эндопротезирований аневризм брюшной аорты EXLUDER Core у пожилых пациентов с высоким риском открытого оперативного вмешательства. В ближайшем и отдаленном периоде летальных исходов не отмечено. После эндопротезирования аневризмы брюшной аорты не отмечено кардиальных и дыхательных осложнений в ближайшие сроки после операции. При динамическом наблюдении (1, 6, 12 мес. после операции) пациентов при компьютерной томографии осложнений (миграции эндопротеза, увеличение диаметра аневризмы, эндоликов I типа) не отмечено. Таким образом, эндопротезирование аневризмы брюшной аорты является методом выбора для пациентов группы высокого риска. Ключевые слова: эндопротезирование, аневризма брюшной аорты, осложнения

Aim. This study aimed to investigate potential use of radiofrequency obliteration (RFO) of angiomatous tissues in patients with venous malformations. Materials and Methods. A single-center study retrospectively involved 42 clinical cases [57.1% of men (n=24), aged 18-44 years; 42.8% of women (n=18) aged 18-56 years] of venous angiodysplasia, with a total of 46 interventions using RFO. Clinical manifestations of the disease were primarily characterized by pain syndrome (71.4%), cosmetic defect (100%), and edema syndrome (95.2%). Results. Clinical improvement was possibly achieved with the reduction of the intensity of manifestations of angiomatous processes in 37 patients (88.1%). Stable and partial obliterations of caverns in the zone of exposure to radiofrequency were recorded in 37 (88.0%) and 5 (12.0%) patients, respectively. In caverns with small diameter, obliteration was achieved in 100% of the cases. Postoperative complications included bleeding (2.4%), burns in the zone of electrode introduction (2.4%), lymphorrhea (2.4%), and hypesthesia (2.4%). With this, according to the results of duplex scanning performed on control visits, no significant disease progression was observed. In the same patient, several complications could occur. All complications regressed within a month and required no treatment in hospital conditions. Conclusion. RFO showed advantage as a minimally invasive treatment method of venous angiodysplasias. Results suggest that RFO can be recommended for use in patients with 1 cm depth of lesion with caverns of medium and large diameter as an independent treatment method and in combination with standard resection methods.

Presented clinical case laparoscopic decompression of celiac trunk syndrome of Dunbar. In most cases, the diagnosis of syndrome of compression of the celiac trunk is by exclusion of other gastrointestinal diseases. Sure, it tells about lack of awareness among the medical community about this specific and rare pathology, as well as a possible skeptical attitude towards it related professionals. The main methods of diagnostics of a syndrome of Dunbar are: ultrasonic duplex scanning of the abdominal aorta, multislice computed tomography and angiography with a respiratory samples. The indication for surgical treatment is the ineffectiveness of conservative therapy, the preservation of the leading symptoms of abdominal ischemia on the ground proved critical in compression of the celiac trunk. Currently, laparoscopic decompression of celiac trunk syndrome Dunbar is the operation of choice. The obvious advantages of laparoscopic surgery are less blood loss, a slight pain syndrome in the postoperative period, short hospital period and better cosmetic effect. In the clinic, where surgeons proficient in the technique of laparoscopic procedures, the surgery can be performed quickly, safely, and efficiently. Additional intervention in the form of endovascular correction is not required in all patients and can be performed in a delayed order.

The aim of this study was to introduce a clinical example of a one-time hybrid reconstruction of symptomatic occlusion of the right subclavian artery with subclavian steal syndrome and critical stenosis of the brachiocephalic trunk in a patient after an aorto-femoral bifurcation bypass surgery and multiple reconstructions of distal anastomoses.