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Objective: To evaluate the efficacy and safety of endovascular treatment of extracranial dissection of the internal carotid artery, as well as pseudoaneurysm associated with dissection.Clinical cases: In this article we report the results of endovascular treatment of 2 patients with iatrogenic and spontaneous dissection of the cervical segment of the internal carotid artery.Conclusions: Internal carotid artery dissection can lead to significant narrowing of the vessel lumen, occlusion or pseudoaneurysm followed by hemodynamic or embolic stroke despite anticoagulant therapy. In some cases, endovascular stenting for dissection is a safe and effective method of restoring vessel lumen integrity with a good clinical outcome.

In most cases, patients with multifocal atherosclerotic lesions, including brachiocephalic arteries, are denied surgical treatment due to the high risks of intra- and postoperative complications. Despite the severe stenotic lesion of the carotid arteries, which can lead to such a major complication as ischemic stroke, in most cases surgeons refuse to perform the operation. Endovascular surgery is often the only option for these patients. After analyzing the world experience in the treatment of hemodynamically significant lesions of the arteries of the brachiocephalic basin and applying in practice various methods of endovascular interventions in patients with complex stenotic lesions of the internal carotid arteries, we were convinced that endovascular correction of such lesions is often the main method of treatment for patients with multifocal atherosclerosis, and can also be used as a primary method of treatment, as it demonstrates high effectiveness, low risk of complications and good long-term results.

The search for the optimal approach in the treatment of brachiocephalic arteriovenous fistulas is one of the current problems of neurosurgery and vascular surgery. It is important to note that the best prognosis requires timely diagnosis and the earliest possible dissection of the fistula. Also, the method of treatment should have the least negative consequences and a good clinical effect. Previously, surgeons used open surgical vessel ligation with great technical difficulties due to anatomical difficulties of access as well as bleeding. In recent decades, the endovascular approach to treatment has demonstrated advantages over open interventions. Despite the low traumaticity, there is a risk of complications such as untargeted vascular embolization, perioperative stroke, etc. In this article we demonstrate the experience of arterio-venous vertebral artery fistula dissection using an occluder.

This report presents a clinical case of emergency endovascular treatment of acute rupture of the abdominal aortic aneurysm in complex anatomically difficult conditions. Although this pathology is rare, it has a high mortality rate. Moreover, according to different authors endovascular repair is safer as compared with open surgery. We demonstrate the decision-making algorithm, show the technical nuances during the intervention which allowed us to achieve an acceptable clinical and angiographic result. Our experience will be interesting and useful for specialists who treat patients with vascular diseases.

The treatment of pulmonary valve disease is one of the urgent problems of modern cardiology and cardiac surgery. In most cases, pulmonary valve abnormalities are congenital. Synthetic conduits (homografts) and bioprosphetic valves are currently used in the surgical treatment of patients with the diseases mentioned above. Pulmonary valve surgical prosthetics allows one to normalize the circulatory dynamics and condition of the patient, however, time-dependent degradation results in conduit and valve dysfunction. The abnormal circulatory dynamics caused by valve and conduit dysfunction is linked to exercise intolerance, arrhythmia, right ventricular failure, and sudden death. Starting in childhood, affected patients undergo repeated openheart surgeries to restore valve function and potentially reduce morbidity and mortality. Percutaneous transcatheter treatment of the pulmonary valve stenosis with the Melody® valve (Medtronic Inc.) has been performed in a large number of patients worldwide. Despite minimal invasiveness, this procedure restores pulmonary valve function and reduces repeated open-heart interventions. Recent clinical trials have shown excellent and durable results in terms of both restoring valve function and decreasing right ventricular outflow tract obstruction. In this study, we want to reflect the relevance of the Melody transcatheter valve and present our first experience of its usage.

The paper discusses the etiology, pathogenesis, classification, principles of diagnosis and tactics of surgical treatment of dural arteriovenous fistulas. The study presents two case reports of successful treatment of patients with symptomatic dural arteriovenous fistulas.

Coronary artery perforation is a rare (0.1–3.0%) but rather severe complication that occurs during the coronary interventions. Treating the perforation caused by the coronary conductor is extremely complicated, as it could be caused quite unexpectedly and may be accompanied by catastrophic consequences if misdirected. Choosing effective treatment techniques is not easy, as evidenced by hospital and remote clinical outcomes with high mortality rates.

This report presents a clinical case of endovascular treatment of a rare complication – a spurious aneurysm from a linear aorto-femoral shunt. We performed implantation of a self-expandable stent graft directly into the vascular prosthesis in the projection of the defect of its wall. We tried to foresee possible procedural complications, and in this regard to justify the choice of tactics of treatment and selection of the applied tools. Given the lack of available literature data on the methods and techniques of interventions in this pathology, we believe that our experience will be interesting and useful for professionals involved in the treatment of patients with vascular diseases.

Background. Assessment of endovascular methods possibilities in the treatment for carotid-cavernous fistulas.Material and methods. The results of endovascular treatment in 22 patients with carotid-cavernous fistulas in the period from 2008 to 2018 were evaluated. The number of male patients was 13 (59%), female patients – 9 (41%). Fifteen patients (68%) had traumatic damage, 7 patients developed a spontaneous disease. All patients had a specific clinical features of carotid-cavernous fistula, confirmed by anamnesis and angiographic study. After verification of the diagnosis, all patients underwent permanent transcatheter embolization of the pathological connection using detachable balloons, microspirals and adhesive composition. Results. Twenty-one patients (95.5%) underwent one-stage embolization of carotid-cavernous fistulas. One patient (4.5%) required three procedures: two embolization with detachable balloons, final embolization with detachable spirals, due to deflation of the balloons in the early postoperative period. Destructive embolization of carotid-cavernous fistulas was performed in 2 cases (9%), reconstructive interventions were performed in 20 cases (91%). The angiographic success of the procedure was 100%. All treated patients had regression of symptoms during their hospital stay. During this period, one complication was identified in the form of post puncture hematoma, which required conservative treatment.Conclusion. Endovascular treatment is a modern, effective and safe method for treating carotid-cavernous fistulas. Destructive occlusion (if there is no possibility of performing reconstructive intervention) is also a safe and clinically justified method for treating this pathology.

Correction of the patent ductus arteriosus (PDA) takes an important place in management of congenital heart defects (CHD). Untreated PDA can lead to heart failure due to left ventricular myocardial hypertrophy (LVH), pulmonary hypertension, bacterial endocarditis, pulmonary infection, and rarely the development of ductal wall aneurysm, its calcification and further rupture.It is believed that the closure of PDA is indicated in any child or adult who develops pathognomonic symptoms: expansion of the left heart; the presence of signs of pulmonary hypertension with left-right blood discharge; prior endocarditis. In asymptomatic patients with PDA accompanied by left ventricular hypertrophy closure of the duct is indicated to reduce the risk of further complications.There were various surgical methods of PDA treatment discovered in the period of the development of medical industry. Previously the most common intervention was ligation of the duct, accompanied by thoracotomy. However, in the present days the ligation of PDA is extremely rare. Endovascular occlusion has taken the lead in the modern practice. Its purpose is to close the duct with intravascular access with help of specialised tools.In this article we present a case of PDA management in a patient with clinical manifestation of PDA at the age of 35 years.

In the present article we report a clinical case of successful two-stage treatment for juvenile aortic coarctation with aortic arch dysplasia in a newborn. We demonstrated possible application of balloon angioplasty, as a palliative procedure in children with severe health condition.

Today we observe increasing rates in diabetes prevalence of diabetes, especially in industrialized countries where about 5–6% of the population have this disease. Trophic ulcer changes of tissues for diabetic foot in 70% of cases lead to high amputations, despite all ongoing efforts on decreasing percent of high amputations, progress in this field remains rather low. For high economic and social importance of diabetic foot syndrome, approach to treatment of this pathology has to be multidisciplinary and unite experts of various areas. Timely diagnosis and then effective and predicted treatment in patients with the ischemia threatening to a limb with a diabetic foot syndrome, depend on more exact stratification of patients. Now there are a number of classifications for a diabetic foot syndrome which include basic ideas of the main pathogenetic mechanisms on development of this serious complication, and consider serious affection of the peripheral nervous system, the peripheral arterial bed, assessment of the wound defect extent and evidence of infectious process. The detailed description of SVS WlFI classification offered in 2014 by Society of vascular surgeons is presented in this article.

Mortality without treatment shows the highest rate among all ischemic stroke subtypes. In most cases acute thrombosis coexists with an atherosclerotic stenosis therefore treatment of both pathologies during one intravascular intervention is required quite often. Patients who underwent successful recanalization of the basilar artery have lower mortality rate. Considering all published reports, mortality for not restored blood flow in this artery is 87% vs 39% for successful recanalization. The clinical case of a successfully treated patient with an acute occlusion of a basilar artery using of a mechanical thrombectomy with angioplasty and stenosis stenting which was a reason for arterial occlusion development is presented in this article.

We present a clinical case of surgery performed for giant cell tumor of thoracic spine. This surgery was aimed to perform total en-bloc spondylectomy for three vertebral bodies invaded by tumor to follow principles of radicality and prevent local recurrence. We applied complex multidisciplinary approach when a team of thoracic surgeons, vertebrologists and X-ray experts was involved. We performed an operation of necessary volume for 420 minutes with 800 ml of blood loss. Postoperatively this patient showed no neurologic disorders. Spinal cord functions were completely preserved. The patient has been observing for 4 postoperative years and demonstrated no tumor recurrence and stability of the placed metal construction.