Multislice Computed Tomography Angiography Research Articles

Multislice computed tomography angiography in assessment of pulmonary vascular abnormalities

Abstract Background Multidetector computed tomography (CT) angiography with maximum intensity projection, multiplanar reformations and 3D reconstructions, and volume rendering technique provide visualization of normal vascular anatomy and variants. Aim The aim of this work was to evaluate the role of multislice CT angiography in the evaluation of pulmonary vascular diseases, classification of diseases, and to be familiar with technique and finding. Patients and methods This observational trial was carried out on 30 cases suspected of or diagnosed with acute chest pain, suspected pulmonary embolism, and pulmonary arterial or pulmonary venous abnormalities. Patients were classified equally into two groups. All patients underwent pulmonary angiography using CT, which involved the following steps: preparation of the patient, examination procedure, data collection, reconstruction and postprocessing of the images, and image explanation. Results In group 1, 60% of cases had normal pulmonary vein whereas 20% of them had venous drainage anomaly. The majority of cases (86.7%) had confluent pulmonary artery findings. The highest percent of cases had dilatation of main pulmonary artery, left pulmonary artery (46.7%), and right pulmonary artery. Overall, 26.7% had either atretic or hypoplastic main pulmonary artery, 40% had normal right pulmonary artery, and 26.7% had normal left pulmonary artery. In group 2, 80% of cases had normal pulmonary vein, whereas 20% had abnormal findings. The majority of cases (80.0%) had pulmonary embolism, and 33.3% had pulmonary hypertension (one case had both embolism and hypertension). Conclusions CT angiography is a very effective and beneficial method in the evaluation of pulmonary vascular abnormalities with or without congenital cardiac and/or extracardiac anomalies.

Case Report: Pulmonary Sequestration in an Adult Not A Metastasis

Introduction: Pulmonary sequestrum is a rare congenital lung anomaly defined as an area of dysplasia and nonfunctional lung tissue with abnormal systemic blood supply and various forms of venous drainage. We report the case of a 43-year-old man who was followed up for prostate adenocarcinoma with bone and lung metastases. The diagnosis of bronchopulmonary sequestration was made. Case report: The patient was 62 years old and was being followed for metastatic prostate adenocarcinoma to the bone. The frontal chest radiograph showed a poorly limited right basal opacity. Bronchial endoscopy noted an inflammatory appearance of the right lower lobar bronchus. A thoraco-abdomino-pelvic CT scan was requested as part of the extension work-up to identify a focus of intra-parenchymal condensation on the right posterior basal side vascularized by an abnormal systemic vessel emanating from the descending thoracic aorta in favor of an intra-lobar sequestration. Discussion and Conclusion: Pulmonary sequestration is a rare malformation whose diagnosis must be evoked in front of repeated infections in the same pulmonary territory, in particular the posterobasal territory. Multislice CT or MRI angiography are the examinations of choice for diagnosis and assessment. Surgical treatment remains the most important option.

Application effect of multi-slice spiral CT angiography combined with MRI in the diagnosis of cerebral aneurysm

ABSTRACT To investigate the clinical value of multi-slice spiral computed tomography (CT) angiography (MSCTA) combined with MRI in the diagnosis of cerebral aneurysm. A total of 90 patients with cerebral aneurysms diagnosed by DSA were selected as the subjects of this study. Another 30 patients with cerebral infarction were selected as negative controls (NC). Before diagnosis, all patients underwent comprehensive examination using MSCTA and MRI. The results of the comparison and the clinical data of all patients were retrospectively analyzed. MSCTA and MRI examinations can clearly show the specific location, shape, size and anatomical relationship with surrounding tissues of cerebral aneurysms. MSCTA diagnosed 82 patients and missed or misdiagnosed 8 patients in the 90 patients with cerebral aneurysm. The diagnostic sensitivity and accuracy of MSCTA were 91.1 (82/90) and 89.2 (107/120), respectively. MRI examination diagnosed 87 patients and missed or misdiagnosed 3 patients in the 90 patients with cerebral aneurysm. The diagnostic sensitivity and accuracy of MRI were 96.7 (87/90) and 96.7 (116/120), respectively. The sensitivity and accuracy of MSCTA combined with MRI were 100.0 (90/90) and 99.2 (119/120), respectively. MSCTA combined with MRI can not only display the whole picture of brain tissue, but also display the size, shape and relationship with the parent vessel of the aneurysm. The combination of MSCTA and MRI has high sensitivity and accuracy in diagnosing intracranial aneurysms, which provides a promising diagnostic protocol for patients with aneurysms.

The effectiveness of MRI and CT with intravenous contrast in the assessment of carotid chemodectoma at the preoperative stage and in dynamics after surgery

Background. Carotid chemodectoma is rare, slow growing, richly vascularized lesion. It is a single unilateral or bilateral tumor, localized mainly in the area of the carotid triangle. Different forms and bilateral cases are also known. A complex of radiological studies, including MRI and CT with intravenous contrast, can help in determining the surgical treatment strategy, as well as treatment monitoring. Objective. To determine the role of MRI and CT with intravenous contrast in the assessment of carotid chemodectoma at the preoperative stage and at post-surgery monitoring. Materials and Methods. We analyzed the results of a comprehensive radiological examination of 12 patients with suspected carotid chemodectoma, including MRI and MSCT with intravenous contrast, and X-ray angiography. All patients got operated, the results were confirmed by histological and immunohistochemical study. Results. Multislice computed tomography, supplemented by CT angiography, allows visualizing chemodectoma, determining its size, shape, structure, and relations with the nearby vessels. In addition to size, shape, structure of chemodectoma MRI can provide a detailed picture of the internal vascular network, the walls of adjacent vascular structures, as well as the soft tissue structures of the peripharyngeal area, which is helpful for vascular surgeons in surgical intervention. It was not possible to determine the histogenesis of the tumor according to the methods of radiation diagnostics. Conclusions. In order to determine the option of surgical treatment of carotid chemodectomas and reduce the risk of intraoperative complications at the preoperative stage, it is necessary to carry out the entire spectrum of radiation diagnostic methods (including ultrasound, MSCT, MRI and X-ray angiography).

Acute mesenterial ischaemia: a contemporary view

During the COVID-19 pandemic, the incidence of acute mesenteric ischemia (AMI) increased to 10.9 per 100 000 population. Here we discuss causes, symptoms, current diagnosis and treatment of AMI.Frequently, such patients suffer from stenosis or occlusion of superior mesenteric artery accompanied by coronary artery disease, chronic heart failure, or chronic brain ischaemia. The main clinical symptom is constant abdominal pain which is sharp in case of mesenteric artery thrombosis or dull if thrombosis is restricted to the branch of superior or inferior mesenteric veins. Conventionally, the diagnosis of AMI is verified by multislice computed tomography angiography and contrast-enhanced multislice computed tomography. Timely diagnosis with emergency surgery reduces mortality from 90% to 30-50%. The best treatment outcomes are observed after early revascularizations and minimally invasive endovascular interventions.

Headache as a Symptom of Carotid Web

Headache is a frequent symptom in emergency department, especially in patients with hypertension. Carotid web, also known as the variant of fibromuscular dysplasia (FMD), is a rare disorder, found in only 1- 1.2 % of patients undergoing angiography, and it should be searched for in patients with cryptogenic stroke. We present a female hyper- tensive patient presented to emergency department with headache and visual symptoms, in whom further work-up revealed carotid web. A 46 years old female patient presented to the ED with headache occurring few days before the examination. It was a constant left temporal headache accompanied with flashes in the right half of the visual field. History taking revealed well-controlled hypertension with calcium channel antagonists. The first manifestation of hypertension was eclampsia during pregnancy. In emergency department normal neurologic status was obtained, brain CT scan was normal. Neurosonological examination revealed right carotid web, confirmed by MSCT angiography.

Angiographic patterns of portal venous system in children with extrahepatic portal hypertension and its etiological and clinical relevance.

To study the relationship between the angiographic pattern of extrahepatic portal vein obstruction (EHPVO) and its etiology and clinical manifestations. Clinical, etiological, and angiographic findings in 155 children with EHPVO were reviewed. Anatomy of extrahepatic portal venous system (EPVS) was categorized into five imaging patterns. Assessment of the severity of esophageal and gastric varices (EV and GV) was performed by upper gastrointestinal endoscopy. Based on multislice CT angiography, most commonly observed pattern of EHPVO was type I (48.4%) and type II (29%). According to anamnesis, 68 (43.8%) children had pathological conditions in neonatal period. Of these, 35 (22.6%) had an umbilical vein catheterization, 11 (7.1%) had a history of omphalitis, and 9 (5.8%) had prolonged jaundice. Thirteen (8.4%) patients had various septic conditions in neonatal period and it was more common associated with widespread thrombosis throughout the EPVS (type 5)-28% of observations. Significantly lower risk of bleeding from EV (p = 0.01) was noted in children with type IV pattern, whereas children with type III and V patterns had higher grades of EV. Angiographic pattern of portomesenteric occlusion may provide a clue to its etiology, and clinical manifestation, especially in children with widespread thrombosis throughout the EPVS.

Arterial Thrombosis of Vermiform Appendix Resulting in Gangrenous Appendicitis

Acute appendicitis is still the most common surgical disease in the experience of surgeon and it requires operative treatment in hospital. There are several suggestions on the causes of acute appendicitis: infectious or neurovascular conditions, obturation of the orifice of vermiform appendix with a fecal bolus, and other versions. One of the rare causes of acute appendicitis is ischemia of vermiform appendix, which results in the development of primary gangrenous appendicitis. The clinical manifestation of this pathology may be atypical. We present a case report of a 65-year-old patient with acute gangrenous appendicitis complicated by localized purulent peritonitis. When admitted to the hospital, the patient was suspected of mesenteric thrombosis. MSCT angiography was performed about that, which diagnosed thrombosis of a. appendicularis and acute appendicitis. Treatment included laparotomy, appendectomy, sanitation, and abdominal drainage. In the paper, we discuss the incidence and results of treatment of acute appendicitis.

Comparative Study between Role of Multi Slice Computed Tomography Angiography and Doppler Ultrasonography in Evaluation of Patients with Lower Limb Arterial Diseases

Comparative Study between Role of Multi Slice Computed Tomography Angiography and Doppler Ultrasonography in Evaluation of Patients with Lower Limb Arterial Diseases

The relation between pericoronary fat thickness and density quantified by coronary computed tomography angiography with coronary artery disease severity

ObjectiveTo study the correlation between epicardial fat thickness (EFT), pericoronary fat thickness (PCFT), and pericoronary fat density (PCFD) with the existence and severity of coronary artery disease (CAD). MethodsThis cross-sectional study included 210 patients referred for multislice CT angiography. Group I normal CTCA, Group II patients had non-obstructive atherosclerosis, and Group III patients had obstructive atherosclerosis. All patients underwent a clinical examination, history taking, and multislice CT angiography. ResultsThe mean EFT was significantly greater in group III (10.43 ± 2.31 mm) compared to groups II (6.30 ± 1.61 mm) and I (5.06 ± 1.14 mm). The mean PCFT was significantly greater in group III (17.96 ± 2.89 mm) compared to group II (11.47 ± 2.51 mm) and group I (9.67 ± 1.99 mm). PCFD was significantly higher adjacent to the lesion (−80.47 ± 29.14) compared to the normal segment (−109.03 ± 35.24), higher in the obstructive group (−59.44 ± 20.10) compared to the non-obstructive group (−101.51 ± 20.23), but lower in calcified lesions (−89.58 ± 28.94) compared to non-calcified (−75.01 ± 29.20), and mixed lesions (−74.83 ± 26.90). EFT and PCFT cut-off values for predicting obstructive CAD were 8.3 and 12.4 mm, respectively, with 87.1% and 92.9% sensitivity and 92.9% and 86.4% specificity, respectively. ConclusionThere is a significant association between epicardial fat thickness, pericoronary fat thickness and density with the severity of coronary artery disease.

Retracted: Multislice Computed Tomography Angiography Imaging Diagnosis of Lower Extremity Arteriosclerosis in Patients with Hypertension and Its Correlation with the Level of High‐Sensitivity C‐Reactive Protein

Retracted: Multislice Computed Tomography Angiography Imaging Diagnosis of Lower Extremity Arteriosclerosis in Patients with Hypertension and Its Correlation with the Level of High‐Sensitivity C‐Reactive Protein

Effect of low density carotid plaque on the development of cerebral small vessel disease in patients with carotid stenosis

Objective: To investigate the correlation between cerebral small vessel disease (CSVD) and carotid low-density plaque on multi-slice spiral CT angiography (MSCTA) in patient with carotid stenosis. Methods: The clinical data of 221 patients with carotid stenosis who admitted to Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, from January 2016 to January 2021 were retrospectively analyzed. There were 195 males and 26 females, with the age of (70.0±8.4) years (range: 48 to 88 years). According to MRI, the patients were divided into carotid stenosis combined with CSVD group (the CSVD group) and carotid stenosis without CSVD group (the non-CSVD group). Lowest density in the carotid atherosclerotic plaque area (CAPALD) was analyzed by MSCTA. The t-test, Mann-Whitney U test and Chi-square test were used for comparison between the two groups. Univariate and multivariate Logistic regression analysis were performed on CAPALD and other clinical indicators with CSVD. Receiver operating characteristic (ROC) curves of CAPALD and CAPALD combined with the demographics (sex, age and body mass index) were plotted for predicting CSVD, and the area under the curve (AUC), sensitivity and specificity were calculated. Results: There were 169 patients in the CSVD group and 52 patients in the non-CSVD group. In the CSVD group, 88.8% (150/169) were males and 11.2% (19/169) were females, with the age of (70.5±8.2) years (range: 48 to 88 years). In the non-CSVD group, 86.5% (45/52) were males and 13.5% (7/52) were females, with the age of (68.4±9.1) years (range: 51 to 85 years). CAPALD and the score of Montreal cognitive assessment were lower in the CSVD group than those in the non-CSVD group (21.0 HU vs. 35.0 HU, Z=-3.760, P<0.01; 22.6±3.9 vs. 24.8±3.3, t=-2.064, P<0.05). Multivariate Logistic regression analysis showed that CAPALD was an independent factor for CSVD (OR=1.044, 95%CI:1.020 to 1.070, P<0.01). The AUC of the ROC curve for CAPALD predicting carotid stenosis with CSVD was 0.672 (P<0.01), with cut-off value of 34.5 HU, sensitivity of 82.8%, and specificity of 50.0%. The AUC of ROC curve for CAPALD combined with the demographics predicting CSVD was 0.733 (P<0.01), with sensitivity of 82.9% and specificity of 64.0%. Conclusions: The decreased CAPALD is a risk factor for CSVD in patients with carotid stenosis. The analysis of carotid plaque density by MSCTA may help to identify the patients at high risk of CSVD.

Successful throb endarterectomy in a patient with occlusion of the internal carotid artery

Strokes account for 15–25 % of confirmed cases internal carotid artery (ICA) occlusion. The frequency of ICA occlusion in asymptomatic patients is unknown. The strategy of treatment patients with symptomatic ICA occlusion has not been determined. A clinical observation is presented with the stage of surgical treatment of a 67‑year-old patient with a developed stroke in the basin of the left middle cerebral artery. The examination according to MSCT angiography revealed occlusion of the left ICA. To assess the brain perfusion, a single-photon emission computed tomography (SPECT) with 99mTc was performed. Throb endarterectomy of the left internal carotid artery was performed, with a control ultrasound examination on the 6th day after the operation and after 6 months the blood flow through the internal carotid artery was preserved. Control SPECT with 99mTc was performed, in comparison with the previous study, a significant improvement perfusion on both hemispheres is determined. Improvements in the neurological status were noted in the form of a complete regression of neurological symptoms. On the sixth day after surgical treatment, the patient was discharged in a satisfactory condition. During the hospital stay, the patient was “examined” using a questionnaire for assessing the quality of life – The Short Form‑36 (SF‑36) and MoCA (Montreal Cognitive Impairment Assessment Scale). The survey was conducted on the 15th day of inpatient treatment, before surgery, and on the 6th day after surgery. After 6 months, the patient was re-interviewed. The results obtained indicate a correlation between the improvement of brain perfusion and cognitive impairment, as well as a positive effect of revascularization of the internal carotid artery on the patient’s quality of life. The presented results indicate not only the possibility, but also the high efficiency of surgical treatment of occlusive lesions of the internal carotid artery. Surgical treatment in the early stages after occlusion against the background of the collapse of atherosclerotic plaque and thrombosis of the lumen is a determining factor in the successful restoration of blood flow, improvement of brain perfusion.

Multislice CT angiography as a roadmap for pedicle selection prior to breast reduction surgery

BackgroundAccurate knowledge of breast arterial supply on individual basis is crucial prior to breast reduction surgery to minimize the risk of post-operative necrosis of nipple-areola complex which is a well reported complication. The purpose of this cross-sectional study was to test the ability of multislice CT angiography to delineate the dominant arterial supply of nipple-areola complex to facilitate accurate breast pedicle selection to improve patient outcome.ResultsTwelve patients underwent multislice CTA of both breasts to delineate dominant arterial supply to NAC, internal mammary artery was the dominant arterial supply in most of breasts (87.5%) based on CTA findings and hence superomedial pedicle was the commonest pedicel chosen. None of patients experienced NAC necrosis postoperatively while minority of patients (16.6%) exhibited decreased NAC sensation bilaterally.ConclusionsMultislice CT angiography is a useful pre-operative tool to minimize the risk of post-operative necrosis of nipple-areola complex in patients undergoing breast reduction surgery.

Multislice Computed Tomography Angiography Imaging Diagnosis of Lower Extremity Arteriosclerosis in Patients with Hypertension and Its Correlation with the Level of High-Sensitivity C-Reactive Protein.

The aim of this study was to investigate the relationship between multislice computed tomography (CT) angiography (MSCTA) imaging and high-sensitivity C-reactive protein (hs-CRP) in patients with hypertension and lower extremity arteriosclerosis. 68 hypertensive patients with lower extremity arteriosclerosis were selected as the observation group, and 68 healthy volunteers were selected as the control group to compare the differences in hs-CRP. According to the degree of stenosis, the patients were further divided into five grades: no obvious stenosis, mild stenosis, moderate stenosis, severe stenosis, and occlusion. The correlation between the degree of stenosis and the content of hs-CRP was compared. The changes of hs-CRP content before and after treatment were compared, and the difference of images before and after surgical treatment and the difference of hs-CRP expression in patients with occlusion were compared. Compared with the control group, the content of hs-CRP in the observation group was significantly higher (P < 0.05), and the degree of stenosis was positively correlated with the content of hs-CRP. After two weeks of treatment, the hs-CRP levels of patients with severe stenosis and occlusion were significantly lower than those before treatment (P < 0.01). The level of hs-CRP in patients with occlusion after arterial stent intervention was significantly lower than before, and the images also showed that the blood vessels were significantly expanded. The degree of stenosis in patients with lower extremity arteriosclerosis diagnosed by MSCTA imaging was closely related to the expression of hs-CRP in the patient, and a sustained high concentration of hs-CRP corresponded to a more severe degree of vascular occlusion. In conclusion, the hs-CRP can be used as one of the factors to predict and evaluate the occurrence of cardiovascular and cerebrovascular diseases.

Radiation methods in the diagnosis of gastric doubling in children

Introduction. Stomach doubling is one of the rarest types of gastrointestinal doubling in the system of pathology of abdominal organs in children. Stomach doubling occurs in 4–8% of cases of gastrointestinal doubling. To a greater extent, it is diagnosed in girls. The rarest localization of doubling is a small curvature of the stomach — 7%.The purpose of the study: to present the informative value of radiation methods in the diagnosis of gastric doubling by the example of a clinical case.Material and methods. The work is based on the analysis of clinical data, instrumental, histological studies performed in a children’s hospital in St. Petersburg.Results: An 8-year-old patient was hospitalized for further examination for cystic formation of the abdominal cavity, detected antenatally at 36 weeks of gestation. At the age of 2 years, MSCT angiography of the abdominal cavity was performed and a differential series between a liver cyst and a doubling of the stomach was exposed. At the control ultrasound, further negative dynamics in size. An MRI revealed that the picture most likely corresponds to a cystic doubling of the stomach. Indications for surgical treatment are exposed. Histologically confirmed variant of stomach doubling.Conclusion. The multimodal approach allows timely diagnosis of the presented pathology, differential diagnosis of gastric doubling with rare localization and determination of indications for surgical treatment.

Complex and Successful Management of a Symptomatic Isolated Abdominal Aortic Aneurysm in a Pregnant Woman with Marfan Syndrome.

Aortopathies associated to Marfan syndrome (MFS) are important causes of maternal death during pregnancy. We present a 27-year-old and 24-week pregnant MFS woman who arrived to the emergency department with increasing abdominal pain; an obstetric ultrasound showed an Abdominal Aortic Aneurysm (AAA), a multislice computed tomography angiography (CTA) confirmed and demonstrated a 7.3centimeter (cm) infrarenal AAA without evidence of dissection. A multidisciplinary committee determined that an open repair would lead to a significantly high maternal-fetal morbidity and mortality. Although endovascular repair (EVAR) in MFS patients remains controversial, an urgent bridge therapy was considered to be the best option. She was transferred to the angiography suite for EVAR to prevent AAA rupture and ensure a satisfactory pregnancy. The patient and fetus presented no complications during the procedure and were discharged 3days later. She continued her pregnancy without eventualities and an elective C-section was performed on week 36. A CTA imaging at 12months revealed type 1A and 3 endoleaks, we decided to perform endograft explant and a definitive open repair, there were no complications during the procedure, the patient is currently asymptomatic. Our case illustrates a complex decision and management that successfully avoid morbidity and mortality of a MFS mother and her product; additionally, this experience reinforces the need for lifelong and close surveillance in these patients.

Multislice Computed Tomography Angiography Imaging Findings Of Pathologies That May Mimic Pulmonary Embolism

Aim: We aimed to detect lesions that can mimic this clinical picture, except embolism, in patients with a preliminary diagnosis of pulmonary embolism, and no embolism was detected in multislice computed tomography angiography (MDCTA) examination. Material and Methods: Turkey Yuksek Ihtisas Hospital Radiology Department, in our CT unit; between January 2007 and July 2008, from the emergency service and other clinics; A total of 180 cases, 86 males and 94 females, mean age 55, who were referred to our clinic with the suspicion of pulmonary thromboembolism (PTE) based on history, physical examination, chest radiography, and laboratory findings, and who underwent pulmonary angiography with multislice computed tomography, were analyzed. Cases found to have pulmonary embolism were excluded from the study. Multislice computed tomography angiography examinations (Lightspeed 16, General Electric Medical Systems, Milwaukee, Wis., USA) were performed in all patients using a 16 detector Computed tomography device. Patients who may be confused with PTE clinically in the mediastinal window; pleural effusion, pericardial effusion, and parenchyma window; Pneumonic infiltration-consolidation, mass, emphysema, presence of fibrotic structures were evaluated. Results: CT scans were normal in 18 (12.5%) of 143 patients presented with pulmonary embolism, and no embolism was found. Interstitial fibrosis in 94 cases (65.7%), atelectasis in 53 cases (37.06%), emphysema in 53 cases (37.06%), ice glass in 38 cases (26.5%), pleural effusion in 34 cases (23.7%), consolidation in 22 cases (15.3%), Pericardial effusion was detected in 14 cases (9.7%) and a mass in the lung in 10 cases (7.6%). Conclusion: In patients without pulmonary embolism, the group of diseases that should be considered primarily in the differential diagnosis are Interstitial Lung Disease and Chronic Obstructive Lung diseases. Keywords: Multislice computed tomography angiography, pulmonary embolism, interstitial lung disease

Prekid arterijske kolateralne mreže kao uzrok amputacije potkolenice nakon konkvazacije uzrokovane motokultivatorom - studija slučaja

Introduction. Leg conquassation caused by petrol tiller is one of the most severe injuries in bone and joint traumatology. Firm strokes by sharp tiller blades produce strong force that easily damages both soft tissues and bones. Since tillers are used in soil processing, the wounds are highly contaminated with dirt and fertilizers, hence the anaerobic spore-forming bacilli, such as tetanus and gas gangrene pathogens. Case report. This paper presents the treatment of a 69 years old man with chronic arterial insufficiency of the lower extremities who suffered severe injury of the lower leg (IIIB open tibial fracture according to Gustillo) by petrol tiller while performing agricultural work. Due to the absence of pulsations, Multislice CT angiography and arteriography were performed. Arteriography of the injured leg confirmed chronic occlusion of the anterior tibial artery and numerous stenotic lesions of the peroneal and posterior tibial arteries. Posterior tibial artery was chronically occluded in its distal part and connected to the foot with moderately developed collateral arteries which provided the viability of the injured leg. Despite undertaken basic principles of treatment of this serious injury (primary surgical treatment of wounds, external fixation, reconstruction of soft tissue, antibiotic and anti-tetanus prophylaxis) due to infection and gangrene the treatment ended with lower leg amputation. Conclusion. Leg amputation can be expected in this type of injuries in cases of extensive destruction of tissue in the field of existing chronic arterial insufficiency in elderly patients, even in the absence of injury of main blood vessels due to traumatic disconnection of collateral in such patients.

Первый опыт эндоваскулярного лечения острого расслоения аорты типа в по Стенфорду

Despite a large body of knowledge about acute thoracic aortic pathology, most physicians do not feel confidentin diagnosing and treating patients with this group of diseases characterized by high mortality. The emergenceof modern high-tech diagnostic methods, such as MSCT angiography, contributed to the early detection of bothacute and latent course of aortic pathology, as well as clearly determine the further treatment tactics. Currently,endovascular techniques are preferred in the treatment of acute thoracic aortic syndrome. This article presentsa case of successful endovascular treatment of acute aortic syndrome in our Republic.