Biomedical subjects
Publications and source records attributed to A Ia Shabalin.
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The article deals with the experience in surgical treatment of 157 patients with vasorenal hypertension consequent upon unspecific aortoarteritis. On the grounds of communications in the literature and their own clinical findings, the authors analyse the character of the affection in unspecific aortoarteritis and the peculiarities of the course of vasorenal hypertension and emphasize the malignancy of its course and inefficacy of nonoperative treatment. The indications and contraindications for various reconstructive operations on the renal arteries and the dependence of the results of surgery on the duration of the disease and the term of the operative intervention are discussed in detail. The authors also describe their experience in the modern methods of kidney revascularization. With the use of radiologically guided endovascular dilatation and an nitinol endoprosthesis they not only expanded considerably the possibilities of intervention on the renal vessels but improved the results of the management of vasorenal hypertension.
The article analyses the results of combined radiologically-guided and direct surgical operations in 27 patients suffering from chronic ischemia of the lower with multiple affections of the limb arteries. All had concomitant diseases. The radiologically guided intervention was carried out before or after a reconstructive operation. Owing to such a combination the volume of the reconstruction was reduced and its level lowered, better conditions were created for its performance, and, in some cases, correction of complications of surgical operations by the methods of radiologically-guided endovascular dilatation made it possible to avoid a repeated full-volume intervention.
The paper discusses the first Soviet experience of transcatheter intravascular application of endoprosthesis into superior vena cava for compression with paratracheal lymph nodes in a patient suffering Hodgkin's disease. The patient had failed to respond to 3 cycles of combination chemotherapy and 46 Gy of radiation to the mediastinum. Application of the procedure brought the vascular lumen and blood flow to normal which led to regression of compression syndrome. The self-fixing endoprosthesis dilates and forms an interior frame for the vessel thus preventing relapse of compression in case of progression of disease.
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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.
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Explore the source record for details and available documents.
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Explore the source record for details and available documents.
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The article analyzes the results of surgery for a recurrence of vasorenal hypertension developing as a result of an impaired major blood flow in the operated on renal artery. The main causes of the blood flow impairment in the immediate postoperational period included an expansion of indications for the primary reconstructive operation or technical drawbacks during the operation itself whilst in the long-term post-operational period the progression of the underlying disease was the principal culprit. Repeated operations on the renal arteries were performed in 19 patients, and in 28 patients surgery consisted of secondary nephrectomy. Good and satisfactory results after repeated reconstructive operations on the renal arteries were obtained in 73.3% of the cases. The operation of choice in repeated interventions is the autovenous prosthesis of the renal artery.
The experience with 785 operations performed for the period from 1962 to 1983 on 697 patients is presented. The advantage of direct reconstructive operations over restorative interventions with the employment of explantation materials is proved. In the remote period after operation positive results were noted in 85% of patients with fibrose-muscular dysplasia of renal arteries and in 70% of patients with non-specific aorto-arteritis.