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J Nanobachvili

Publications and source records attributed to J Nanobachvili.

3 recordsLinked to original sources

[Preoperative risk factors as deciding criteria in surgical treatment strategy of infrarenal aortic aneurysm].

Significant risk factors of operative therapy in patients with infrarenal aortic aneurysms (AAA) were determined. Best treatment strategy (open surgical repair, transluminal endovascular aneurysm management (TEAM) or conservative treatment) was selected on the base of evaluated risk factors, tendency of rupture and life expectancy. Of the typical risk factors impaired renal and/or lung function showed a significant influence on hospital mortality. In patients without these significant risk factors open surgical repair leads to good clinical results. Acceptable postoperative mortality rates after elective exclusion of an AAA with average size in patients presenting significant comorbidities can only be achieved using TEAM. If TEAM can not be performed, open surgery is only justified in the case of very large AAA diameter.

Aged↗

Vascular surgery between the millenniums.

Modern diagnostic modalities as well as ongoing improvement of vascular prosthetic material and surgical techniques have stimulated progress in vascular surgery. New discoveries concerning the mechanism of endothelial function, atherosclerosis, developments in gene therapy and endovascular techniques will expand the future therapeutic spectrum of vascular surgery. Endoluminal implantation of stent grafts for the treatment of aortic aneurysm may be a reasonable alternative to conventional surgery, especially in high-risk patients. Long-term results of this procedure, however, are not yet available. Stenting of internal carotid artery stenosis may be considered as an experimental method of treatment. Its feasibility, efficacy, safety and long-term results must be analyzed before the application of the method may be restricted or recommended. Endoluminal irradiation (brachytherapy) reduces intimal hyperplasia/restenosis and can improve the long-term results of percutaneous transluminal angioplasty. Anti-atherosclerotic and anti-aggregatory therapy (with statins, estrogens, antibiotics, nitric oxide precursor/donors, glycoprotein IIb/IIIa receptor inhibitors) will play an important role in the prevention of ischemic diseases and improve the results of surgical/interventional treatment by reducing intimal hyperplasia and restenosis. Gene therapy opens new vistas in vascular medicine. Angiogenetic factors can be used for the treatment of patients with distal occlusion of the peripheral arteries. Gene transfer may be useful in the conservative treatment of progressive aortic aneurysms. A more unified vision toward vascular medicine might be the key for research and development in the future.

Aortic Aneurysm↗