Angiologiia i sosudistaia khirurgiia = Angiology and vascular surgery最新文献

{"title":"[The role of lumbar sympathectomy in the treatment of lower limb ischemia. 100 years of practice and research (review)].","authors":"S L Valov, V G Lutikov","doi":"10.33029/1027-6661-2026-32-2-20-26","DOIUrl":"10.33029/1027-6661-2026-32-2-20-26","url":null,"abstract":"<p><p>This article presents literature data on the history, mechanism of action, clinical application, and effectiveness of lumbar sympathectomy in the treatment of lower extremity ischemia. The results of numerous studies are compared and the seminal works on this topic are examined in more detail, with a particular focus on systematic reviews. It concludes that lumbar sympathectomy remains a recommended surgical procedure when other treatments are impossible or ineffective.</p>","PeriodicalId":7821,"journal":{"name":"Angiologiia i sosudistaia khirurgiia = Angiology and vascular surgery","volume":"32 2","pages":"20-26"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148962928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Effectiveness of femoro-femoral crossover bypass in patients with critical limb ischemia: a retrospective clinical analysis].","authors":"R O Makkamov, A E Saduakas, M A Zhakubayev, A Zh Matkerimov, N N Yerkinbayev, T N Demeuov, A S Shamshiyev","doi":"10.33029/1027-6661-2026-32-2-117-122","DOIUrl":"https://doi.org/10.33029/1027-6661-2026-32-2-117-122","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the effectiveness of femoro-femoral crossover bypass in high-risk patients with unilateral aorto-iliac occlusive disease.</p><p><strong>Material and methods: </strong>A retrospective analysis was conducted on 26 patients (22 men, 4 women; mean age 67.8±7.4 years) who underwent femoro-femoral crossover bypass using a ring-reinforced PTFE graft at the National Scientific Center of Surgery named after A.N. Syzganovbetween 2017 and 2025. Graft patency, postoperative complications, mortality, and limb salvage were assessed during early and long-term follow-up.</p><p><strong>Results: </strong>All operations were technically successful with restoration of distal blood flow in 100% of cases. Postoperative complications occurred in 2 patients (7.6%): one late graft infection and one in-hospital death (3.8%). The mean hospital stay was 14±5 days. At five-year follow-up (available in 9 patients), graft patency remained 100%, with complete limb salvage and no major reinterventions.</p><p><strong>Conclusion: </strong>Femoro-femoral crossover bypass is a safe and reliable revascularization method for patients with aorto-iliac occlusive disease who are unsuitable for direct aortic reconstruction. The procedure provides excellent long-term patency, full limb salvage, and minimal morbidity and mortality.</p>","PeriodicalId":7821,"journal":{"name":"Angiologiia i sosudistaia khirurgiia = Angiology and vascular surgery","volume":"32 2","pages":"117-122"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148962917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Factors of unfavorable outcome of emergency coronary artery bypass grafting in high-risk acute non-ST elevation coronary syndrome].","authors":"A B Nishonov, A A Khorlampenko, R M Velieva, A I Danilovich, R S Tarasov","doi":"10.33029/1027-6661-2026-32-2-42-48","DOIUrl":"https://doi.org/10.33029/1027-6661-2026-32-2-42-48","url":null,"abstract":"<p><strong>Introduction: </strong>Acute coronary syndrome without ST-segment elevation remains a highly relevant problem due to the heterogeneity of the patient population and the poor prognosis in high-risk groups. Identifying risk factors in this patient group will improve the outcomes of open myocardial revascularization. Aim - to identify factors for adverse outcome of coronary artery bypass grafting in patients with high-risk non-ST-segment elevation acute coronary syndrome.</p><p><strong>Material and methods: </strong>Over an eight-year period, 209 emergency coronary artery bypass grafting surgeries were performed within the first 24 hours of admission for high-risk non-ST-segment elevation acute coronary syndrome. Two groups were formed based on the development of major cardiovascular events in the postoperative period: those with such events (Group 1, n=20) and those with a favorable hospital course (Group 2, n=189). Univariate and multivariate regression analyses were conducted, and a prognostic model was developed.</p><p><strong>Results: </strong>Univariate analysis showed that age over 67 years, Syntax score over 30 points, residual Syntax score over 5, GRACE over 155 points, EuroSCORE II over 4.1%, cardiopulmonary bypass time over 80 minutes, post-CABG urea over 8.3 mmol/l, and glomerular filtration rate under 67 ml/min were factors for unfavorable outcome. A prognostic model was developed, according to which the need for transfusions after surgery increased the risk of unfavorable outcome by 6.5 times, EuroSCORE II over 4.1% by 5.7 times, GRACE over 155 points by 7.4 times, and Syntax score over 30 points by 4 times Conclusion. Independent predictors of the development of MACE after urgent coronary artery bypass grafting for high-risk acute coronary syndrome without ST segment elevation are: high risk according to the GRACE (>155 points) and EuroSCORE II (>4.1%) scales, severe coronary artery disease (SYNTAX >30 points), as well as the development of the need for transfusions of blood components in the postoperative period.</p>","PeriodicalId":7821,"journal":{"name":"Angiologiia i sosudistaia khirurgiia = Angiology and vascular surgery","volume":"32 2","pages":"42-48"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148962906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Vein-specific symptoms: clinical significance, difficulties in interpretation].","authors":"S V Sapelkin, A V Nikonov","doi":"10.33029/1027-6661-2026-32-2-99-104","DOIUrl":"10.33029/1027-6661-2026-32-2-99-104","url":null,"abstract":"<p><p>The publication considers the problem of subjective symptoms in chronic venous diseases. The analysis of the international SYM Vein Consensus statement, as well as advisory documents with an emphasis on vein-specific symptoms is carried out. It is concluded that their vein specificity is often manifested not by the fact of ascertainment, but by the dependence of the severity of these symptoms on time characteristics. SYM Vein Consensus currently requires more serious analysis, validation and cannot currently serve as an absolute standard for clinical trials. There is an objective need to discuss the problem of venospecificity of subjective symptoms in chronic venous diseases at the level of professional communities.</p>","PeriodicalId":7821,"journal":{"name":"Angiologiia i sosudistaia khirurgiia = Angiology and vascular surgery","volume":"32 2","pages":"99-104"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148962997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Course of arterial hypertension after open and endovascular procedures for significant carotid artery stenosis: single-center randomized study.","authors":"A N Vachev, V N Sevryukova, E V Frolova","doi":"10.33029/1027-6661-2026-32-2-64-69","DOIUrl":"10.33029/1027-6661-2026-32-2-64-69","url":null,"abstract":"<p><strong>Background: </strong>Arterial hypertension is present in most patients with ischemic stroke and is frequently associated with significant internal carotid artery (ICA) stenosis. Carotid endarterectomy (CEA) and carotid artery stenting (CAS) are the primary techniques for carotid revascularization; however, their long-term effects on blood pressure control remain debated, particularly given the role of the carotid body in regulating sympathetic activity. Objective - to assess how the chosen method of carotid reconstruction influences the long-term course of arterial hypertension.</p><p><strong>Methods: </strong>This single-center, randomized, open-label study enrolled 155 patients with unilateral hemodynamically significant ICA stenosis (70-99%) and resistant grade 2-3 hypertension. Group 1 (n=53) underwent CAS, and Group 2 (n=102) underwent CEA with mandatory carotid body excision. Follow-up exceeded 36 months. Changes in systolic blood pressure (SBP) were evaluated using 24-hour ambulatory monitoring, remote monitoring, and analysis of patient self-monitoring diaries.</p><p><strong>Results: </strong>During the first postoperative year, both groups demonstrated a significant reduction in SBP (p<0.001) with no between-group difference in magnitude (p=0.688). Beyond one year, significant differences emerged: SBP reduction after CEA was greater (median 45 mmHg) than after CAS (-20 mmHg; p<0.001). The antihypertensive effect remained stable in the CEA group, whereas a tendency toward SBP increase relative to the 1-year follow-up was observed after CAS. Target blood pressure was achieved in 62.8% of patients after CEA and 27.5% after CAS (p<0.001; OR 4.46; 95% CI 2.12-9.37). Although the number of antihypertensive medications decreased significantly in both groups (p<0.001), sustained BP control with reduced pharmacologic burden was observed only after CEA.</p><p><strong>Conclusion: </strong>Both carotid revascularization strategies significantly reduce SBP within the first postoperative year. In the long term, CEA with carotid body excision provides a more durable antihypertensive effect and a higher likelihood of achieving target BP compared with CAS. These findings suggest that the type of intervention may influence peripheral baro- and chemoreflex mechanisms of blood pressure regulation and merit further investigation.</p>","PeriodicalId":7821,"journal":{"name":"Angiologiia i sosudistaia khirurgiia = Angiology and vascular surgery","volume":"32 2","pages":"64-69"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148962992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Blood levels of angiogenic factors in patients with chronic lower limb ischemia at treatment stages].","authors":"L S Kokov, N V Borovkova, B V Kozlovskiy, I P Mikhailov, I N Ponomariev, M V Storozheva","doi":"10.33029/1027-6661-2026-32-2-27-32","DOIUrl":"https://doi.org/10.33029/1027-6661-2026-32-2-27-32","url":null,"abstract":"<p><strong>Objective: </strong>Comparative analysis of the content of angiogenesis regulatory proteins in patients presenting with chronic lower limb ischemia (CLLI) and undergoing either surgical treatment or conservative therapy supplemented with local administration of autologous platelet lysate.</p><p><strong>Patients and methods: </strong>The study included a total of 26 patients with CLLI. Of these, 10 patients (Group 1) were subjected to surgical treatment and 16 (Group 2) underwent conservative therapy alone supplemented with local administration of autologous platelet lysate. The Luminex platform was used to determine the concentration of angiogenic factors EGF, Ang-1, TIE2, VEGF-A, VEGF-R2 in blood of all patients before and 24 hours after surgery (Group 1) or local administration of autologous platelets (Group 2). We also examined the aliquots of the used autologous platelet lysate and blood plasma of 8 apparently healthy volunteer donors. The obtained data were processed using methods of variation statistics.</p><p><strong>Results: </strong>In chronic ischemia of lower extremities, the concentration of VEGF-A, TIE-2 and VEGF-R2 in blood plasma increased. Group 1 patients demonstrated higher concentrations of Ang-1 and VEGF- A. After surgical restoration of blood flow in the lower extremities, the concentration of cytokines studied did not significantly change. The concentration of EGF, Ang-1 and VEGF-A factors in platelet lysates was significantly higher than in the patients' blood plasma. After local administration of autologous platelets, the concentrations of these factors in the blood plasma of Group 2 patients did not change compared with the baseline values, but there was a significant decrease in the levels of TIE-2 and VEGF-R2.</p><p><strong>Conclusion: </strong>Ischemic tissue damage in CLLI is accompanied by an increase in plasma concentrations of angiogenic factors VEGF-A, VEGF-R2 and TIE-2. Administration of autologous platelet lysate into the ischemic zone does not lead to an increase in the levels of VEGF-A, angiopoietin 1 and EGF in the systemic bloodstream. One of the factors contributing to improved microcirculation in patients with CLLI may be a decrease in plasma levels of VEGF-R2 and TIE-2 after administration of autologous platelet lysate into the ischemic zone. The obtained results suggest further research in this field, with the wide clinical application requiring larger cohorts.</p>","PeriodicalId":7821,"journal":{"name":"Angiologiia i sosudistaia khirurgiia = Angiology and vascular surgery","volume":"32 2","pages":"27-32"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148962810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Carotid endarterectomy in patients with ACS: retrospective analysis of the results of a staged and simultaneous approach].","authors":"Yu A Schneider, V G Tsoi, M S Fomenko, A A Pavlov, P A Shilenko","doi":"10.33029/1027-6661-2026-32-2-49-56","DOIUrl":"https://doi.org/10.33029/1027-6661-2026-32-2-49-56","url":null,"abstract":"<p><strong>Background: </strong>In modern articles contains many studies devoted to various surgical treatment strategies for concomitant coronary and carotid artery disease. However, all studies address this issue only in patients with stable coronary artery disease and do not provide any recommendations on strategies for patients with ACS who are diagnosed with significant carotid artery stenosis be for interventions. Therefore, the decision on a specific approach is left to the discretion of the cardiac team at individual clinics. The aim of our study was to evaluate the results of a staged and simultaneous approach to surgical treatment in patients with significant coronary artery stenosis and acute coronary syndrome.</p><p><strong>Material and methods: </strong>From January 2014 to October 2025, 10 447 patients with ACS were treated in our Center, of which 1423 (13.6%) underwent CABG. Retrospectively, with a continuous sample, 188 (13.2%) patients were included in study with concomitant stenosis carotid and coronary basins. In 134 (71.3%) cases was performed staged intervention and in 54 cases (28.7%) was simultaneous intervention. The average age of patients in the groups was 65.4±7.4 and 64.2±7.4 years (p=0.292). The study was dominated by men (70.7%). The average number of affected vessels was 3.2±0.9. Overall EuroSCORE II was 5.7±2.8% Results. Mortality in the groups no differ 2.9 and 5.5% (p=0.396). The groups no differ in the conditions of the surgery: on pump, off pump. Also, the groups no differ in surgery-related complications. Simultaneous group statistically stayed longer in the intensive care unit p<0.05. The average follow-up period for the group of staged and simultaneous interventions was 67 and 59.5 months, respectively. The 5-year survival rate was 90.8 and 89.2% (Log-rank test, p=0.332). Freedom from AMI at 5 years was 89.6 and 91.3% (Log-rank test, p=0.545). Freedom from stroke at 5 years was 94.2 and 93.8% (Log-rank test, p=0.386). Freedom from re-interventions at 5 years was 89.6 and 91.3% (Log-rank test, p=0.545).</p><p><strong>Conclusion: </strong>Rational choice of surgical treatment strategy, strict adherence to the internal protocol for selection of high-risk surgical patients with combined of carotid and coronary arteries lesions, allows for staged and simultaneous interventions with an acceptable risk of mortality and complications in an experienced center.</p>","PeriodicalId":7821,"journal":{"name":"Angiologiia i sosudistaia khirurgiia = Angiology and vascular surgery","volume":"32 2","pages":"49-56"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148962813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Carotid endarterectomy under regional anesthesia: intraoperative criteria for placing a temporary intraluminal shunt (meta-analysis)].","authors":"A V Gavrilenko, A Yu Zaitsev, N N Al-Yousef, A V Korshunov, K V Dubrovin, S O Popov","doi":"10.33029/1027-6661-2026-32-2-136-145","DOIUrl":"10.33029/1027-6661-2026-32-2-136-145","url":null,"abstract":"<p><strong>Objective: </strong>Conducting a meta-analysis to assess consistency between the indices of cerebral oxygenation (near infrared spectrometry, NIRS), clinical data, pressure in the stump, findings of transcranial Doppler ultrasonography, and neurosensory status of patients, as well as to determine optimal comprehensive criteria for making a decision on a temporary intravascular shunt during carotid endarterectomy under regional anesthesia.</p><p><strong>Material and methods: </strong>A systematic search was carried out in databases PubMed, Medline and Cochrane Library over the period from January 2015 to October 2025.</p><p><strong>Inclusion criteria: </strong>prospective observational studies or randomized controlled studies with participation of patients subjected to carotid endarterectomy under regional anesthesia, assessing consistency of instrumental methods of monitoring and clinical picture. The statistical analysis was performed in the R program (version 4.2.1).</p><p><strong>Results: </strong>The final analysis included 13 studies (1894 patients). The overall frequency of selective shunting amounted to 11.51% (95% confidence interval 10.11-13.03%). An optimal criterion for placement of a temporary shunt was a decrease of δrSO2 ≥9-10% in combination with the appearance of neurological deficit (sensitivity 90-100% and specificity 70-83%). Multimodal methods of monitoring demonstrated the average AUC 0.90 vs 0.87 for double combinations. The perioperative stroke rate amounted to 1.48% (95% confidence interval 1.11-2.25%), thus corresponding to the modern international quality standards.</p><p><strong>Conclusion: </strong>A combined approach with the use of NIRS-monitoring (threshold of δrSO2 ≥9-10%) jointly with clinical assessment of the neurological status is an optimal criterion for selective shunting in carotid endarterectomy under regional anesthesia. Multimodality monitoring increases the diagnostic accuracy, making it possible to minimize the risk of ischemic complications.</p>","PeriodicalId":7821,"journal":{"name":"Angiologiia i sosudistaia khirurgiia = Angiology and vascular surgery","volume":"32 2","pages":"136-145"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148962908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Various approaches to surgical treatment of infectious aneurysms of the abdominal aorta and iliac arteries (clinical case)].","authors":"N V Susanin, V V Zavatsky, A V Pletnev, N N Yakovlev","doi":"10.33029/1027-6661-2026-32-2-123-129","DOIUrl":"https://doi.org/10.33029/1027-6661-2026-32-2-123-129","url":null,"abstract":"<p><p>The article presents clinical observations of surgical treatment of patients with infectious aneurysms of the aorta and iliac arteries. Initially, the patients sought medical help for pain in the lumbar region. The examination revealed aneurysms of various localization, accompanied by a syndrome of systemic inflammatory response. An open surgery was chosen as the treatment strategy. One patient required reintervation after the first operation due to the formation of a pseudoaneurysm of the distal anastomosis. Both patients were discharged for outpatient treatment after massive antibacterial therapy and normalization of their parameters.</p>","PeriodicalId":7821,"journal":{"name":"Angiologiia i sosudistaia khirurgiia = Angiology and vascular surgery","volume":"32 2","pages":"123-129"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148962892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Complications during carotid artery stenting (literature review and practical guidelines)].","authors":"A V Ter-Akopyan, A S Abramov, A A Kalinin, V F Likov, A B Gurdzibeev","doi":"10.33029/1027-6661-2026-32-2-105-116","DOIUrl":"https://doi.org/10.33029/1027-6661-2026-32-2-105-116","url":null,"abstract":"<p><p>Carotid artery stenting is an effective method for treating stenotic lesions of the carotid arteries and preventing stroke. However, despite continuous technological advancements in stents and neuroprotection systems, the procedure carries the risk of complications that can affect clinical outcomes. This article provides a review of the literature on complications associated with carotid artery stenting, their classification, risk factors, clinical manifestations, prevention and management strategies, as well as the authors' own experience in endovascular treatment of patients with stenotic carotid artery lesions at the Department of Endovascular Surgery and Invasive Cardiology of the 'Central Clinical Hospital with Polyclinic' of the Administrative Directorate of the President of the Russian Federation.</p>","PeriodicalId":7821,"journal":{"name":"Angiologiia i sosudistaia khirurgiia = Angiology and vascular surgery","volume":"32 2","pages":"105-116"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148962935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}