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Biomedical subjects

N S Nikitaev

Publications and source records attributed to N S Nikitaev.

15 recordsLinked to original sources
PubMed2005

Endovascular grafting of thoracic aortic pseudoaneurysm after operation for coarctation.

Presented herein is a case of successful repair of thoracic aortic aneurysm by endograft in a female patient 21 years after replacement of the descending aorta for coarctation. During scheduled examination the patient was found to have aneurysm of proximal anastomosis. Additional examination was followed by the stenting of the thoracic aorta using endograft manufactured by the "GORE" Company (USA). The immediate results were classified as good: aneurysm was not opacified, the patency of the vessels of the aortic arch was well preserved. According to the data of check examination carried out 5 months after operation, no graft dislocation was marked, aneurysm was not detectable. The given case demonstrates low-invasive endovascular intervention permitting the avoidance of complicated and traumatic open regrafting of the aorta and attainment of beneficial short- and long-term treatment results.

Adult↗
PubMed2003

[Virtual surgeries based on spiral computed tomography].

Experience of spiral computed tomography with bolus contrast enhancement and subsequent 3D-reconstruction of picture for virtual modeling of surgeries is presented. The method was used in 204 patients with tumors and diseases of the liver, pancreas, spleen, kidneys, adrenal glands, parapapillary diverticula of the duodenum, coarctations and aneurysms of aorta, extraorganic tumors of the retroperitoneal cavity and neck. Coincidence of virtual and real types of surgeries reached 75-92.8% depending on the disease and clinical situation. Perspectives of 3D-reconstruction for evaluation of normal and pathologic anatomic features in an individual patient, choice of an optimal surgical variant, prognosis of possible complications and their prophylaxis are demonstrated. Integration of surgeon's and radiologist's thinking is very important for correct diagnosis and surgical policy.

Adolescent↗
PubMed2003

[Long-term outcomes of balloon angioplasty for aortic coarctation].

From 1994 to 2001 balloon angioplasty was fulfilled for 19 patients aged from 4 to 28 (mean 11.0+/-7.0) with discrete type aortic coarctation. Early outcomes were satisfactory in all cases. Catheterization showed 10 mm Hg decrease in systolic pressure gradient (SPG). Long-term results (from 6 months to 8 years, mean 3.0+/-2.5) were evaluated with transthoracic EchoCG, Doppler ultrasound, duplex scanning of iliofemoral segment and CT-angiography with 3D reconstruction. Surgical outcomes were considered good when SPG did not exceed 20 mm Hg for Doppler ultrasound and 25 mm Hg for Doppler EchoCG. In the study group there was statistically significant decrease in arterial pressure in right upper limb and SPG (measured with both Doppler EchoCG and Doppler ultrasonography) and rise of ankle-brachial index. Beneficial hemodynamic effect was detected in 15 from 19 patients (79%). Recoarctation has developed in 4 (21%) patients, in 1 (5.3%) case it was combined with true posttraumatic aortic aneurysm. Three patients underwent open surgical intervention with uneventful postoperative period. Aneurysmal dilatation of thoracic aorta has developed in 1 patient (5.3%), non-progressive intimal dissection - in another one (5.3%), 2 patients (10.5%) experienced ipsilateral 40-60% stenosis of right external iliac and femoral arteries. Thus good long-term outcomes of balloon angioplasty in patients with discrete type aortic coarctation were achieved in 79% cases. Patients after balloon angioplasty must be assessed regularly with non-invasive diagnostic methods such as Doppler ultrasonography, Doppler EchoCG, CT-angiography.

Adolescent↗
PubMed1990

[Noninvasive radiodiagnosis of aneurysms of the thoracic aorta].

The paper is concerned with analysis of the results of X-ray investigation of 45 patients with aneurysms of the distal part of the arch and descending part of the thoracic aorta. Errors were made in 16 of 35 patients (35.6%) before admittance to hospital. X-ray investigation helped to establish correct diagnosis of aneurysm of the aorta in 42 of 45 patients (93.3%) on the basis of the detection of intense additional shadow formation in left pulmonary field, inseparable from the aortic shadow. The use of a new method of ultrasound diagnosis--duplex scanning--made it possible to establish the presence of aneurysm and to determine its sizes as well as to visualize the relation of the left subclavicular artery to aneurysm in 17 of 21 patients. CT-semiotics of aneurysms of the descending part of the thoracic aorta consisted in its dilatation over 3.5 cm, wall calcification, thrombosis of the cavity and change of the adjacent structures. Basing on the analysis of these signs correct diagnosis was established in 34 of 35 examinees (97.1%).

Adolescent↗
PubMed1976

[Utilization of the thermodilution method for study and assessment of rapid changes in central hemodynamics under clinical conditions].

The authors report of the employment of the thermodilution method for repeated serial measurements of the cardiac output in 60 patients during Fentanyl -- Epontol induction anaesthesia conducted in accordance with Darbinyan's technique. The concept is illustrated by the data obtained during heart catheterization in 38 cases of congenital and acquired heart diseases, various myocardiopathies. The authors describe the technical aspects of the method. With proper technical facilities available, the method of thermodilution proves accessible, simple, precise and safe for the examination of cardiac output.

Adolescent↗
PubMedDate not supplied

[Computed tomography symptomatology of liver hemangiomas].

The paper is concerned with analysis of CT-symptomatology of 72 liver hemangiomas in 43 patients. The authors employed standard and dynamic computerized tomography. All hemangiomas were divided into 2 groups: under 6 cm and over 6 cm. Small hemangiomas were characterized by clear-cut contours and regular density. Zones of low density, regular in structure with clear-cut contours were revealed by CT in hemangiomas over 6 cm. Morphologically, this zone corresponded to a hyaline structure (a hyaline slot) making it possible to differentiate hemangiomas from necrotic tumors. In serious cases dynamic CT with visual evaluation and plotting of time-density graphs was recommended. Visually hemangioma had a picture of contrast medium accumulation, beginning from a focal periphery. Graphically the time of appearance of a contrast medium and the time of reaching a maximum for hemangiomas is delayed as compared to the same intervals of contrast medium accumulation in the liver parenchyma. It tells hemangioma graphs from graphs of other tumors, of which intervals coincide with those of liver parenchyma graphs.

Adult↗
PubMedDate not supplied

[Computerized tomographic arteriography of the liver].

Thirty-three patients with primary and secondary tumors of the liver were examined by computer-tomographic arteriography. Methods of selective intraarterial amplification of a computer-tomographic image is presented, as are indications for and contraindications against the use of such technique. The authors have united on a single working place a computer-aided tomographer Somatom DR-2 and a Siremobil device, this essentially simplifying the examinations. Selective administration of a contrast agent through a catheter into the celiac trunk helped significantly augment the density (200-240 U) of liver parenchyma, this permitting the detection of focal liver involvement undetectable by standard computer tomography because of a density similar to that of liver parenchyma. The method permitted the detection of foci 3-5 mm in diameter. On the whole use of computer-tomographic arteriography helped improve the diagnosis of focal liver involvement by 27%.

Adolescent↗