Year 2021 Vol. 29 No 6

CASE REPORTS

R.E. KALININ 1, I.A. SUCHKOV 1, V.V. KARPOV 2, A.A. EGOROV 1, 2, A.S. PSHENNIKOV 1, 2, D.V. KARPOV 1, 2, A.A. KRYLOV 1, 2

POSSIBILITIES OF VASCULAR TRANSPLANTATION IN URGENT SURGERY OF MAIN ARTERIES

I.P. Pavlov Ryazan State Medical University 1,
Regional Clinical Hospital 2, Ryazan,
Russian Federation

The article presents the experience of using allografts from a postmortem donor in emergency surgery of the main arteries of the lower extremities. Possible tactical methods of combined use of alloartery and allovein from various donors in urgent surgery have been demonstrated. High risks of interventions aimed at relieving early and late complications of vascular reconstructions remain an actual problem in angiosurgery. Very often, operations are performed in the presence of extensive necrosis and trophic ulcers (stage IV according to the Fontaine-Pokrovsky classification). Autovenous conduit from the great saphenous vein (type of arterial bed lesions C, D according to TASS II) was and remains the gold standard for choosing a shunt for reconstructive operations on infrainguinal arteries. In case of repeated reconstructions in the absence of a suitable autovein, in the presence of trophic ulcers and necrosis, an infectious process in the area of the vascular prosthesis, it is not always possible to use a synthetic prosthesis as a reliable alternative. Unsatisfactory results of using such materials dictate the need to choose a suitable graft. The problem of using allografts requires further advanced study. In this regard, the experience of using allografts in two non-standard urgent clinical situations is presented. The conclusion is made about the possibility of effective use of allografts from a postmortem donor in patients with bleeding after endovascular treatment of critical limb ischemia with trophic changes in the staged surgical treatment, as well as in patients with thrombosed anastomotic false aneurysms after previously performed surgical interventions.

Keywords: allograft, transplantation of the vessel, thrombosed false aneurysm of anastomosis, graft, autologous vein
p. 747-753 of the original issue
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Address for correspondence:
390026, Russian Federation,
Ryazan, Vysokovoltnaya Str., 9,
I.P. Pavlov Ryazan State Medical University,
the Department of Cardiovascular,
X-ray Endovascular, Operative Surgery
and Topographic Anatomy,
e-mail: suchkov_med@mail.ru
Suchkov Igor A.
Information about the authors:
Kalinin Roman E., MD, Professor, Head of the Department of Cardiovascular, X-ray Endovascular, Operative Surgery and Topographic Anatomy, I.P. Pavlov Ryazan State Medical University, Ryazan, Russian Federation.
https://0000-0002-0817-9573
Suchkov Igor A., MD, Professor of the Department of Cardiovascular, X-ray Endovascular, Operative Surgery and Topographic Anatomy, I.P. Pavlov Ryazan State Medical University, Ryazan, Russian Federation.
https://0000-0002-1292-5452
Karpov Vyacheslav V., PhD, Physician of the Vascular Surgery Unit, Regional Clinical Hospital, Ryazan, Russian Federation.
https://0000-0001-5523-112Õ
Egorov Andrey A., PhD, Associate Professor of the Department of Cardiovascular, X-ray Endovascular, Operative Surgery and Topographic Anatomy, I.P. Pavlov Ryazan State Medical University, Head of the Vascular Surgery Unit, Regional Clinical Hospital, Ryazan, Russian Federation.
https://0000-0003-0768-7602
Pshennikov Alexander S., MD, Associate Professor of the Department of Cardiovascular, X-ray Endovascular, Operative Surgery and Topographic Anatomy, I.P. Pavlov Ryazan State Medical University, Ryazan, Russian Federation.
https://0000-0002-1687-332X
Karpov Dmitry V., PhD, Associate Professor of the Department of Surgery, Obstetrics And Gynecology, I.P. Pavlov Ryazan State Medical University, Head of Urology and Transplantation Unit, Regional Clinical Hospital, Ryazan, Russian Federation.
https://0000-0002-6097-5737
Krylov Andrew A., PhD, Assistant of the Department of Cardiovascular, X-ray Endovascular, Operative Surgery and Topographic Anatomy, I.P. Pavlov Ryazan State Medical University, Ryazan, Russian Federation.
https://0000-0002-2393-0716
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