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Panfilov DS, Kozlov BN, Panfilov SD, Priakhin AS. [Treatment of iatrogenic femoral artery pseudoaneurysms]. Angiol Sosud Khir 2018; 24:19-24. [PMID: 30321142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The article is a review generalizing foreign and Russian experience and devoted to problems of diagnosis and treatment of iatrogenic false aneurysms of the femoral arteries. Based on the present-day scientific data, advantages and disadvantages of each of the currently existing therapeutic approaches are elucidated. Special attention is paid to the division dedicated to a promising minimally invasive trend in angiology, i. e. puncture obliteration of false aneurysms with the use of thrombin.
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Affiliation(s)
- D S Panfilov
- Tomsk National Research Medical Centre of the Russian Academy of Sciences, Tomsk, Russia
| | - B N Kozlov
- Tomsk National Research Medical Centre of the Russian Academy of Sciences, Tomsk, Russia
| | - S D Panfilov
- Municipal Clinical Hospital No29, Novokuznetsk, Russia
| | - A S Priakhin
- Tomsk National Research Medical Centre of the Russian Academy of Sciences, Tomsk, Russia
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Panfilov DS, Kozlov BN, Panfilov SD, Kuznetsov MS, Nasrashvili GG, Shipulin VM. [Puncture treatment of pseudoaneurysms of femoral arteries with the use of human thrombin]. Angiol Sosud Khir 2016; 22:62-67. [PMID: 27935882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The authors analysed both immediate and remote results of puncture treatment with the use of human thrombin under ultrasound control in patients with iatrogenic false aneurysms of femoral arteries. The study included a total of 32 patients presenting with post-puncture pseudoaneurysms of femoral arteries after previous endovascular manipulations. The clinical diagnosis was verified by means of ultrasound duplex scanning. Puncture treatment was carried out using lyophilisate of human thrombin at a concentration of 500 IU according to the patented technique. The obtained outcomes were assessed at various terms (up to 12 months). The predominant ultrasound characteristics of a false aneurysm were as follows: an arterial defect sized 2.1-3 mm with prevailing localization in the superficial femoral artery (singe-chamber pseudoaneurysm with the volume of its cavity amounting to 31-60 cm3). The average dose of thrombin sufficient for obliteration of the cavity amounted to 320.8±104.6 IU. The puncture treatment proved to be effective in 30 (93.7%) patients. In the remaining 2 (6.3%) cases the outcomes of puncture treatment turned out unsatisfactory, thus requiring an operative intervention. No relapsed were observed in the remote period. A conclusion was drawn that puncture treatment is a highly effective method in relation to false aneurysms of femoral arteries and is neither accompanied by relapses nor followed by allergic, thrombotic, infectious complication at various terms of follow up. Efficacy of treatment with human thrombin does not depend on taking antithrombotic agents by the patients.
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Affiliation(s)
- D S Panfilov
- Department of Cardiovascular Surgery, Scientific Research Institute of Cardiology, Tomsk, Russia
| | - B N Kozlov
- Department of Cardiovascular Surgery, Scientific Research Institute of Cardiology, Tomsk, Russia
| | - S D Panfilov
- Department of Vascular Surgery, Municipal Clinical Hospital No29, Novokuznetsk, Russia
| | - M S Kuznetsov
- Department of Cardiovascular Surgery, Scientific Research Institute of Cardiology, Tomsk, Russia
| | - G G Nasrashvili
- Department of Cardiovascular Surgery, Scientific Research Institute of Cardiology, Tomsk, Russia
| | - V M Shipulin
- Department of Cardiovascular Surgery, Scientific Research Institute of Cardiology, Tomsk, Russia
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Panfilov SD, Panfilov DS. [Modern approaches to surgical treatment of post-injection vascular complications in intravenous drug addicts]. Angiol Sosud Khir 2015; 21:134-139. [PMID: 26355934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
An ever-growing number of injection drug abusers causes great concern over specific post-injection complications involving major vessels, not uncommonly infected ones. The review is dedicated to the problem of vascular complications in drug abusers, clinical peculiarities of the nosology concerned, as well as a present-day view on diagnosis and policy of surgical treatment of infected false aneurysms in this cohort of patients. Surgical decision-making is based on a series of factors: baseline general condition of the patient, possibility of surgical care depending on the specific situation (scope and level of the infected area, phase of the course of the wound process, degree of ischaemia of the limb, choice of a plastic material), and probability of further injections of narcotic drugs. In treatment of such patients a promising trend includes endovascular and minimally invasive technologies, however assessing the remote results thereof requires accumulation of larger experience.
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Affiliation(s)
- S D Panfilov
- Department of Vascular Surgery, "Municipal Clinical Hospital No 29", Novokuznetsk, Russia
| | - D S Panfilov
- Department of Cardiovascular Surgery, Research Institute of Cardiology under the Siberian Branch of the Russian Academy of Medical Sciences, Tomsk, Russia
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Panfilov SD, Panfilov DS, Vasin AS, Aleksandrov DS, Reĭnik VI, Gotlib AD. [Оperative treatment of an aortocaval fistula]. Angiol Sosud Khir 2014; 20:154-159. [PMID: 25267238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Described herein is successful experience in surgical treatment of a patient presenting with a rare pathology, i. e. an aortocaval fistula which was the cause of non-cardiogenic heart failure. The leading role in the diagnostic search is assigned to contrast-enhanced multispiral computed tomography of the abdominal aorta.
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Affiliation(s)
- S D Panfilov
- Department of Vascular Surgery, Municipal Clinical Hospital No 29, Novokuznetsk, Russia
| | - D S Panfilov
- Department of Cardiovascular Surgery, Research Institute of Cardiology under the Siberian Branch of the Russian Academy of Medical Sciences, Tomsk, Russia
| | - A S Vasin
- Department of Vascular Surgery, Municipal Clinical Hospital No 29, Novokuznetsk, Russia
| | - D S Aleksandrov
- Department of Vascular Surgery, Municipal Clinical Hospital No 29, Novokuznetsk, Russia
| | - V Ia Reĭnik
- Department of Vascular Surgery, Municipal Clinical Hospital No 29, Novokuznetsk, Russia
| | - A D Gotlib
- Department of Vascular Surgery, Municipal Clinical Hospital No 29, Novokuznetsk, Russia
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Sumin AN, Gaĭfulin RA, Korok EV, Panfilov SD, Evdokimov DO, Raĭkh OI, Bezdenezhnykh AV, Kislov EE, Ivanov SV, Barbarash LS. [Long-term survival after reconstructive surgery on non-coronary arteries in different age groups]. Adv Gerontol 2013; 26:501-510. [PMID: 24640702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The study was aimed at assessing long-term survival after reconstructive surgery on non-coronary arteries in different age groups as well as the confounding factors. 469 case histories were analyzed retrospectively. The most patients underwent coronary angiography (CA) and preventive myocardial revascularization along with non-coronary artery exam. The mean follow-up period was 57.5 +/- 14.9 months. The groups were similar in terms of aspirin and statin therapy; however, older patients more often received beta-blockers and ACE inhibitors (p < 0.03). The number of patients who undergone CA increased with age (p = 0.002). Older patients had higher long-term mortality (p = 0.008) and poorer long-term survival (p = 0.001) as compared to patients below 60 years of age. The risk of death increased with age (OR 1.11; p = 0.001), in smokers (OR 2.79; p = 0.009) and in case of complications in the postoperative period (OR 4.09; p = 0.001). In turn, lower mortality was associated with CA and further preventive myocardial revascularization, if medical reasons (OR 0.15; p = 0.001). Thus, routine CA and preventive myocardial revascularization were associated with lower long-term mortality. This allows recommending an aggressive preoperative assessment to this category of patients.
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Sumin AN, Korok EV, Panfilov SD, Evdokimov DO, Bezdenezhnykh AV, Kislov EE, Ivanov SV, Barbarash LS. [Myocardial revascularization before abdominal aortic surgery in patients with ischemic heart disease]. Kardiologiia 2013; 53:62-68. [PMID: 23952955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
We retrospectively analyzed 2 cohorts of patients treated in two clinics implementing different strategies of preoperative examination and lowering of perioperative cardiac risk. Patients in clinic 1 (group I, n=86, mean age 59.4+/-7.7 years) were subjected to coronary angiography (CAG) and if indicated - to preventive myocardial revascularization. In patients of clinic 2 (group II, n=95, mean age 54.3+/-6.5 years) only medical therapy was used. In group I CAG was performed in 90%, and myocardial revascularization - in 28% of patients. Total number of complications and hospital mortality were significantly higher in group II compared with group I (20 vs. 8%, p=0.023; 10.5 vs. 2.3%, =0.026). Myocardial infarction was the cause of 6 deaths (6.3%) in group II, while in group I there were no cardiac complications. Thus compared to control group strategy with routine CAG and preventive myocardial revascularization before abdominal aortic surgery was associated with less perioperative complications, myocardial infarctions, and lower mortality.
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Kabirov AV, Vasin AS, Grachev AM, Panfilov SD. [Thromboembolism of the palmar arch and digital arteries on the background of posttraumatic aneurysm of the left brachial artery]. Angiol Sosud Khir 2013; 19:147-151. [PMID: 23863800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The present article is aimed at describing a clinical case report associated with thromboembolism of the distal arterial bed of the left upper extremity (the palmar arches of the hand and interdigital arteries) with the development of severe acute ischaemia on the background of a false post-traumatic aneurysm of the left brachial artery. The patient underwent comprehensive treatment including conservative therapy and stagewise operative interventions. As one of the components of conservative therapy was systemic thrombolysis of Actilyse. The first stage of the operative intervention consisted in upper thoracic endoscopic sympathectomy on the left with positive dynamics of the state of soft tissue of the left hand. The second stage was resection of the pseudoaneurysm of the left brachial artery and amputation of the phalanges II-V of the fingers of the left hand. The mentioned approach made it possible to save the left hand and preserve its grasping function.
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Barabash LS, Zoloev GK, Chechenin GI, Vasil'chenko EM, Koval' OA, Litvinovskiĭ SV, Zoloev DG, Batiskin SA, Panfilov SD, Kislov EE, Lutsenko VA. [Dynamics of the incidence of major amputations and mortality rates in peripheral arterial diseases over 1993-2007: findings of a population-based study]. Angiol Sosud Khir 2010; 16:20-25. [PMID: 21280290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Analysed were a total of 17,695 cases of hospital admission of patients presenting with arterial insufficiency of extremities, complications of diabetes mellitus, ulcers and necroses of the lower limbs, including 11,773 cases of hospitalization of patients diagnosed with peripheral artery diseases according to ICD-9 (till 1998) or ICD-10 (commencing from 1999) over the periods from 1993-1997 (period 1), 1998-2002 (period 2) and 2003-2007 (period 3). The correlation dependence was studied using the Pearson criterion, with the statistical significance of differences between the relative incidence of the parameters being calculated by means of the chi-square (chi2) test. The obtained findings showed a decrease in the number of amputees, the incidence of lethal outcomes and mortality rates, being most significant in the group of patients under 60 years of age. There was an inverse correlation between the above measures and the indices of the number of operations on the arteries performed in grade IV limb ischaemia.
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Kislov EE, Panfilov SD, Zoloev GK, Dedikova TN, Koval' OA. [Comparative assessment of methods used for predicting efficiency of lumbar sympathectomy in patients with lower-limb critical ischaemia]. Angiol Sosud Khir 2009; 15:138-141. [PMID: 19791587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The article deals with the findings of examination and treatment of patients presenting with lesions of the distal-bed arteries and critical lower-limb ischaemia who were subjected to lumbar sympathectomy (LSE). The methods aimed at predicting efficacy of LSE in seventy-five patiens included Doppler ultrasonography with the nitroglycerine test and with the epidural blockade. Of these forty-five patients were subjected to laser Doppler flowmetry (LDF) and measurement of the transcutaneous oxygen tension in tissues before and after the epidural blockade. Presented herein are remote results of LPE obtained at terms up to 36 months for sixty-nine patients (92%) and analyzed depending on the parameters of the functional tests. Our findings suggest that the most statistically significant methods of study for predicting the outcome of lumbar sympathectomy turned out to be LDF and Doppler ultrasonography performed before and after the epidural blockade.
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