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Biomedical subjects

I Kh Rabkin

Publications and source records attributed to I Kh Rabkin.

At least 19 recordsLinked to original sources

[Radiologically-guided dilatation in arterial stenosis of transplanted kidney].

Stenosis of the artery of a transplanted kidney is a grave complication of the posttransplanation period. Two method are applied for correction of the disease: reconstructive operation and radiologically-guided endovascular dilatation (RED). The primary method of choice is RED of the stenosis. We applied it in 20 patients. The result of the operation in the early postdilatation period was good in 15 (75%) patients, satisfactory in 2 (10%) patients. In 3 cases the method of RED of the stenosis failed because of technical complications. Restenosis occurred in 8 (47%) patients in the late-term periods after correction. Attempts to repeat RED were successful in 5 patients.

Adolescent

[Transcutaneous transcatheter use of laser recanalization of coronary arteries in patients with ischemic heart disease].

The paper discusses the potential possibility and effectiveness of X-ray endovascular laser recanalization (ELR) of the coronary arteries in order to treat coronary atherosclerosis in patients with coronary heart disease. The intervention was performed in 4 patients (into the anterior interventricular artery in 3 and into the right coronary artery in 1). In 3 of 4 cases, X-ray ELR proved to be successful, in one case the intervention failed due to technological reasons. Recanalization of a completely occluded segment of the coronary artery with a residual stenosis of no more than 40% was observed in two cases. Laser recanalization of profound local coronary stenosis was made in the mid-third of the vessel in one case. It can be stated that X-ray ELR of the coronary artery may extend the scope of X-ray surgical therapeutical tools of the treatment of coronary atherosclerosis. At the same time, accumulation of clinical experience and further improvement of laser and laser catheter engineering are essential in defining the value and possible scope for the application of this method.

Angioplasty, Laser

[Computerized tomography in the diagnosis of heart neoplasms].

Computed tomography (CT) was used to study 56 and 4 patients with primary and secondary cardiac blastomas, respectively. CT allows differentiation between a racemose and dense endocardial tumor, localization of myxoma pedicle, recording its prolapse into the adjacent chamber, identification of extra-, intracardiac and intramyocardial tumor growth as well as changes in adjacent vessels. CT image of cardiac myxoma is similar to a filling defect of diminished density, that of extra-endocardial tumors display polymorphism. Blastomatous invasion of the heart is characterized by blurring of cardiovascular elements boundaries, pericardial thickening and fluid accumulation. CT is advocated as a new, noninvasive and highly efficient diagnostic modality in cardiac tumors.

Adolescent

[The implantation of a nitinol endoprosthesis in treating strictures and atresias of the uterine cervical canal].

The paper is concerned with the description of the first experience in a new method of roentgen endoprosthetics of the cervical canal of the uterus using a nitinol spiral prosthesis. The spiral has a shape memory effect. Prostheses were implanted to 13 patients with strictures or atresia of the cervical canal after bougienage for a period of 193 days. A new canal was formed with further epithelialization within this period. Recurrences after prosthesis removal were unnoticed.

Adult

[Radiologically-guided vascular prosthesis after laser recanalization of occlusive lesions of the blood vessels of the lower limbs].

The article deals with the first clinical experience in radiologically-guided prosthetics after laser recanalization of occluded vessels of the lower limbs in 20 patients. The method was introduced into clinical practice after applying separately the methods of radiologically-guided endovascular prosthetics and laser recanalization with subsequent dilatation and experimental substantiation on dogs with artificially created chronic occlusions of the femoral artery. The first results are promising, although the true place of the method in sparing treatment of vessels will be ascertained after rich clinical experience is accumulated and the late-term results studied.

Adult

[Nonspecific aortoarteritis and vasorenal hypertension].

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.

Aorta, Abdominal

[Combined roentgenoendovascular and direct surgical procedures in the treatment of chronic ischemia of the lower extremities].

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.

Arterial Occlusive Diseases

[Roentgeno-endovascular prosthetics of the superior vena cava in compression syndrome].

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.

Blood Vessel Prosthesis

[The role of computerized tomography in preoperative evaluation of disseminated esophageal cancer].

The authors characterize signs of the spread of carcinoma of the esophagus to the neighboring and remote structures, which were revealed by computerized+ tomography. The value of the method in identifying the stage of esophageal carcinoma is discussed. It is shown that the complex of signs must be taken into account in determining growth of the tumor into the neighboring organs. It is concluded that computerized+ tomography helps in dividing the patients into 3 main groups: patients with curable tumors; inoperable patients; patients in whom the volume of the operative intervention can be determined only during the operation. Conduction of computerized+ tomography in patients with carcinoma of the esophagus before the operation is considered expedient.

Cardia

[5-year experience with roentgenologically controlled endovascular nitinol prosthesis].

Clinical application of roentgeno-endovascular++ prosthesis was initiated in March, 1984, following 2-year developments and experimental implantations of endoprostheses made from an alloy with a mould storage effect. An effect of implantation of the endoprosthesis into the arterial wall by covering it with an nonhyperplastic, nonadhesive neointima. In 103 patients, 121 endoprosthesis implantations had been made into the iliac, femoral, and popliteal arteries over 5 years, 76.8% of the patients had had a severe concurrent disease. The age of the patients ranged from 21 to 72 years. Positive results were obtained in 93.7% of all the implantations. The long-term results were studied during 0.5-5.0 years' follow-ups. Poor results were obtained with endoprosthesis of the superficial femoral and popliteal arteries, which was associated with impaired distal limb blood flow. Indications for endoprosthesis were defined. The technique may be used in critical ill patients in whom direct surgical interventions are contraindicated due to concurrent abnormalities. The methods developed make it possible to successfully make endoprosthesis of the great arteries via a transcutaneous puncture access under local anesthesia.

Adult

[Computerized tomography in evaluating the function of aortocoronary shunts].

An examination was made of 38 patients undergone aortocoronary bypass surgery. Comparing the density of content in the aorta and shunt before and after bolus contrast in computerized tomography makes it possible to evaluate the patency of the aortocoronary shunt. A shunt patency coefficient (SPC) was proposed, which fitted the ratio of density differences in the shunt to those in the lumen of the ascending aorta before and after the injection of a contrast agent. SPC equal to 0.5 or more is indicative of a good patency of the aortocoronary shunt, but that being 0.3 or less suggests no or extremely poor function of the shunt. SPCs that are equal to 0.3-0.5 are transient indicators of its patency.

Adult