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To date, modern outpatient minimally invasive interventions for varicose veins, such as endovenous laser or radiofrequency ablation, microphlebectomy, sclerotherapy, non-thermal non-tumescent methods (NTNT), are widely introduced into clinical practice in the Russia. In the approved by the Ministry of Health of the Russian Federation in 2021 clinical guidelines "Varicose veins of the lower extremities" they are recommended as preferred over open surgery. At the same time, there are no federal regulations of preoperative examination of patients before these minimally invasive procedures for varicose veins. That is why the medical community is often forced to prescribe unnecessary diagnostic tests on the "just-in-case" principle, in order to protect itself for cases of complications and subsequent checks. This undoubtedly harms both the patients and the medical service, which has an additional useless and inappropriate burden. The purpose of the round table held on September 28, 2021 under the auspices of the Self-Regulatory Organization “The National College of Phlebology” together with the legal partner “The Faculty of Medical Law LLC” (Moscow), was to review the existing legislation on this issue and then to prepare a resolution regarding the justified preoperative examination of patients before minimally invasive interventions for varicose veins of the lower extremities. The prepared document consists of two parts. The first part presents the legal regulation of the diagnostic tests before interventions in phlebology. The second part contains the opinion of the professional community regarding the appropriateness or inexpediency of different pre-procedural examinations. In addition, based on the conclusions of legal analytics, a form of order of the chief physician has been developed, which regulates the diagnostic tests before the considered phlebological interventions in the clinic.

The article describes a case of successful treatment of the rupture of aortic aneurysm by the endovascular method. Patient P., 71 years old, was hospitalized in a multidisciplinary hospital with a diagnosis of acute cerebral circulation disorder. The patient was examined in the intensive care unit. Signs of neurological symptoms regressed. Spiral computed tomography of the chest organs was performed with suspected pulmonary embolism, the results of which revealed an aneurysm of the descending thoracic aorta, complicated by a rupture with the formation of a right-sided hemothorax. The patient underwent endoprosthesis of the thoracic aorta with stent graft. After 2 days, thoracoscopic sanitation, drainage of the right pleural cavity was performed. The postoperative period proceeded without peculiarities. The patient was discharged on the 12th day in satisfactory condition. At control examination in 1, 6, 12 months, the long-term steady positive result was noted. Endovascular methods minimize the risk of postoperative complications, contributing to a favorable outcome of the disease.

Recently collated scientific data on the management of C1 clinical class of chronic venous disorders; wide prevalence of the disease and high variability amongst medical practitioners in relation to managing this category of patients and absence of any regulatory documents has prompted the development of clinical guidelines for the treatment of patients with reticular varicose veins and telangiectasias of the lower extremities and various parts of the body. These guidelines have been developed by a self-regulated organization Association “The National College of Phlebology”. The purpose of the de novo guidelines is to systematize the existing evidence and offer minimal standards of care for chronic venous disorders in C1 patients.

The objective of this article was to analyze current researches on the peculiarities of performing coronary artery bypass grafting in patients who primarily underwent intraluminal angioplasty and stenting due to acute coronary syndrome. Despite the priority of stenting in patients with acute coronary syndrome (ACS), there is still a significant number of unresolved issues in this category of patients, especially when these patients, previously stenting due to ACS, undergo coronary artery bypass grafting due to a repeated ACS case. The tactics of management and preparation of patients who were admitted for repeated CABG after preliminary stenting are still not clear, and therefore, a significant number of unresolved issues remains when performing CABG against the background of repeated ACS cases with a previously compromised vascular bed and the presence of chronic inflammation in the coronary arteries. Questions about the perioperative and postoperative complications in this category of patients remain open. We analyzed the latest works and researches about that problem using such systems as NLM, Google Scholar and Elibrary. Due to the current situation of mass use of stenting, a number of questions remain open (the time of cancellation of double disaggregation therapy, the need for shunting the previously stented vessel, the possibility of performing a combined method of treatment for ACS). There is a very little information on the need to bypass the previously stented coronary artery at an earlier date than indicated in the European recommendations.

The article describes the clinical experience of treatment of life-threatening pathology by minimally invasive methods. There is a long-term stable positive result after the operation. The introduction of new technologies in medicine minimizes the risk of postoperative complications, contributing to a favorable outcome of the disease.