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Biomedical subjects

L P Verbovetskiĭ

Publications and source records attributed to L P Verbovetskiĭ.

At least 19 recordsLinked to original sources
PubMed1995

[Use of cava-filter in the treatment of acute venous thrombosis in the end of pregnancy].

Cava-filters were implanted in 16 women suffering from acute thrombosis of the deep veins of the lower limbs in the third gestation trimester. Initial or relapsing thromboembolism of the pulmonary artery (TEPA) had place in 5 cases. Two types of filters were used, the REPTEPA ones being used more frequently. As a rule, a filter was implanted in the infrarenal segment of vena cava inferior. Complications occurred in two patients: perforation of right atrial wall and thrombosis of the filter. Pregnancy ended in delivery in all the cases, cesarean section was made in the majority of patients. No TEPA was recorded from the moment of cava-filter implantation. In remote period 15 women developed moderately expressed postthrombotic syndrome.

Adolescent↗
PubMed1991

[Surgical tactics in occlusive lesions of the brachiocephalic and coronary arteries].

Surgical management of combined arterial occlusions is a difficult problem. Combined lesions of the coronary arteries and brachiocephalic trunk are marked by significant mutual aggravation. The authors examined 48 patients with this pathological condition in the last 4 years, 32 of them underwent restorative surgical interventions. The direct effect was positive in 87% of patients. Four patients died after the operation. Comparative evaluation of the late-term results was carried out by the actuarial method. The authors believe a stage-by-stage character of the intervention to be expedient, except for cases of one-stage critical ischemia carried out simultaneously in two arterial channels and the possibility of simultaneous reconstruction of the sternotomy approach.

Arterial Occlusive Diseases↗
PubMed1991

[Replacement of infected vascular prosthesis by the femoral vein].

The article discusses restorative treatment of 12 patients with an infected prosthesis in the inguinal region after aortobifemoral, unilateral common iliofemoral, and submusculofemoral shunting. The infected segment of the prosthesis was removed 9 days to 5 weeks after the first operation by cutting it in tissues which were not involved in inflammation. The lacking segment of the shunt was replaced by the patient's femoral vein which was drawn through the infected wound. In 11 patients the wound in the inguinal region healed with maintained patency of the shunt. In 2 patients the extremity was amputated. Marked temporary venous insufficiency was encountered in one case.

Adult↗
PubMed1991

[Freezing an acutely necrotized extremity for the purpose of preparing the patient for amputation].

102 patients of a high operative risk were prepared for amputation of a lower extremity with acute ischemic gangrene by its freezing and tourniquet application. A special portable freezing chamber was used in most cases which could be installed in any surgical hospital. The refrigeration ranged from 18 hours to 14 days. Purposeful intensive treatment of all disorders suffered by the patient was conducted at the same time. In 92 patients the condition improved and the extremity was amputated. As compared to the control group, the postoperative mortality due to refrigeration reduced from 41 to 18.4%. The method was found to be highly effective in cases with gangrene and diabetes mellitus.

Adult↗
PubMed1990

[The effectiveness of G. A. Ilizarov's method in treating patients with III- and IV-stage chronic ischemia of the lower extremities].

The method of treatment after Ilizarov was used in 28 patients with occlusion of lower extremity arteries, mainly of distal localization, with the III and IV degrees of ischemia. Osteotomy of mainly the tibial bone and distraction of the free osseous split was performed during 31-36 days. Two patients had fractures of the bone during operative interventions, after operation four patients had purulent complications or necrosis of the skin around the wire. The immediate positive result was noted in 20 patients. Their fate was followed-up in remote periods from 2 to 19 months, good results were observed in 18 patients. The use of the Ilizarov method was most justified in patients with the III and IV degrees of ischemia when other methods of treatment failed to give any effect and surgical reconstruction of the vessels is impossible. When treating patients with the IV degree, it is necessary to take into consideration the late appearance of revascularization and possibility of temporary deterioration. The use of the Ilizarov method foresees provision of the joint work of an angiosurgeon and a traumatologist-orthopedist.

Adult↗
PubMed1990

[Pre-amputation freezing of the extremity in acute ischemic gangrene].

When preparing for amputation in 153 patients with acute ischemic gangrene of a lower extremity, the tourniquet-cold isolation was used. In 137 patients, the damaged extremity was freezed by means of a special portable freezing chamber, which can be used in any surgical in-patient department. The duration of cooling ranged from 18 hrs to 14 days. The state improved in 136 patients, the amputation of the extremity was performed in them. The use of freezing of the damaged extremity permitted to reduce the postoperative lethality from 41 to 19.1%. A high effectiveness of the method in gangrene of the extremity against the background of diabetes mellitus was noted.

Adult↗
PubMed1990

[Simultaneous intrathoracic restoration of the coronary and brachiocephalic blood flow].

The treatment of 3 patients with combined occlusive affection of the brachiocephalic and coronary arteries is discussed. A one-stage intrathoracic operation was carried out. Prosthetics of one or two brachiocephalic branches was conducted at first after which a double of triple aortocoronary shunt was formed under conditions of extracorporeal circulation with the use of cardioplegia. The outcome of treatment was favourable. The formation of an aortobifemoral shunt will be undertaken in one of the patients in a short time. Various problems of tactical and surgical character in one-stage correction of the coronary and brachiocephalic blood flow are discussed.

Arteriosclerosis↗
PubMed1989

[Cooling of the extremities in acute ischemic gangrene].

This is a report on 39 patients (from 36 to 84 years of age) with acute ischemic gangrene of the lower limbs and severe concomitant diseases (ischemic heart disease, arterial hypertension, diabetes mellitus, etc.). Cooling of the necrotic limb with the application of a tourniquet and general nonoperative treatment were conducted in preparation for amputation. Cooling was accomplished with dry ice and common ice in 16 patients and with a special refrigerator in 23 patients. Six patients whose condition was very grave died during refrigeration. Amputation of the lower limb was performed in 33 patient, 26 of them tolerated the operation favourably. Wound complications were encountered in 9 patients.

Acute Disease↗
PubMed1984

[Choosing the method of anesthesia in aortofemoral shunting].

The influence of 4 kinds of anesthesia (neuroleptanalgesia, peridural anesthesia by trimecaine hydrochloride, peridural morphine analgesia, fluoroxene anesthesia) upon the process of reestablishment of blood circulation in lower extremities and possibilities of using a rheographic method for the intraoperative assessment of the efficiency of the aorto-femoral shunting were studied in 112 patients with the help of rheography of the shin and great toes. The authors recognize that trimecaine hydrochloride anesthesia and peridural sympathetic block allow with the help of rheography to timely detect an inadequacy of the aorto-iliac reconstruction in 9 cases.

Anesthesia, Epidural↗
PubMed1983

[Central hemodynamics in patients with arteriosclerosis obliterans of the lower limbs].

Central hemodynamic status was studied using integral body rheography in 93 patients with arterial atherosclerotic occlusions in lower extremities and aorto-iliac region. Changes in central hemodynamic parameters were established in 65,6% of the patients, correlating with the severity of aorto-arterial lesion, location of the process and duration of the disease. Improvement of peripheral circulation under the effect of conservative and surgical treatment (lumbar sympathectomy and reconstructive vascular surgery) was accompanied with favourable changes in central hemodynamic parameters in all the patients.

Adult↗