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Between September 1999 and until the present time 14 direct myocardial revascularization using arterial conduits were performed at the Department of Vascular Surgery and Surgical Treatment of CAD, V. Vakhidov Scientific Center of Surgery, RU Ministry of Public Health. The internal mammary artery was used in all the cases, right gastroomental artery in 2 cases. Revascularization of one coronary artery was accomplished in 2 patients, of two arteries in 8 and of three coronary arteries in 4 patients. In 12 cases, direct myocardial revascularization was realized on the working heart and in 2 cases, under cardiopulmonary bypass. Ischemic changes on the ECG at rest, recorded in the preoperative period, disappeared following operation. In all the patients, myocardial contractility (EF) after operation rose by 6-8% on an average as compared to the initial level. Physical exercise tolerance was measured by BEM in 6 (42.9%) patients. Angina of effort, FC II, was diagnosed only in 2 patients. All the patients were discharged in a satisfactory condition. Only patients with unstable angina were recommended to take long-acting nitrates whereas the remaining subjects were advised to take the antiaggregation doses of aspirin.

In vascular surgery department of V. Vakhidov Research Center of Surgery 37 patients with diffuse lesion of popliteal-tibial arterial segment in combination with stenotic lesion of profound and common femoral artery were examined and operated. Examination of regional circulation before operation was made with consideration of profundo-popliteal collateral index (PPCI) which permits to evaluate features and degree of lesion of deep femoral artery (DFA). Angiography failed to defect bifurcation of the femoral artery in 17 (48.6%) cases, in 11 of them stenosis of bifurcation of the femoral artery was revealed in intraoperative revision. In these patients PPCI was 0.34 and more, high peripheral vascular resistance was seen in debitometry. The authors believe that calculation of PPCI is one of the main methods of diagnosis of femoral artery bifurcation lesions. Good and satisfactory results were seen in 29 (78.3%) patients, unsatisfactory--in 8. Amputations were performed in 3 patients. 1 patient died. Suppuration of the wounds was in 6 patients, in 4 of them--in the zone of reconstructed artery with arrhosive bleeding. It is suggested that in diffuse lesions of arteries of popliteal-tibial segment examinations of regional hemodynamics and plastic repair of DFA are most effective.

In vascular surgery department of V.V. Vakhidov Research Center of Surgery prolonged intraarterial catheter therapy (PIACT) was applied in the treatment of 97 patients with critical lower limbs ischemia. Both routine and special methods of examination were used. Isolated PIACT was performed in 29 patients, PIACT in combination with other operations--in 68 patients (lumbar sympathectomy--51, microsurgical transplantation of greater omentum--9, arterialisation of venous system--8). Good and satisfactory results were achieved in 82.4% patients, limb amputations were performed in 17.6% patients. PIACT is most effective only in combination with other surgical methods. Use of PIACT in acute limb ischemia is not recommended.

Surgical treatment of injury to the vertebral artery is one of the most difficult problems of modern vascular surgery. Six operations were carried out for injury to the vertebral artery at the Department of Vascular Surgery of the Tashkent Research Center of Surgery, Uzbekistan. In 3 patients the artery was ligated at the orifice. The performance of the compression test for excluding the possibility of the development of cerebral circulatory disorders is obligatory in all such cases. Two patients with injury to the vertebral artery in the medullary canal were treated by a method elaborated in the clinic and consisting in the tight filling of the canal with a mixture of warm wax and a collagen hemostatic sponge. In none of the cases were disorders of cerebral circulation and a clinical picture of vertebrobasilar insufficiency encountered. One patient died.

Ultrasonic examination in occlusion of the abdominal aorta and its visceral branches is effective in 87.7% of cases. In combined lesions of the aorta and its visceral branches the authors suggest one-stage reconstructive operations to correct the blood flow. The mortality rate in such cases reduced by 6.76%.

Immediate results of revascularization of the extremity through the profound femoral artery were compared with data of an analysis of pressure gradients along the extremity. The value of the profound femoral-popliteal collateral index as a method of prognosis of results of profundoplasty was determined. It was found that the index equal to 0.5 or more showed profundoplasty to be not a promising procedure.