Novosti
Khirurgii
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Year 2011 Vol. 19 No 3

GENERAL AND SPECIAL SURGERY

CHERNUKHA L.M., NIKULNIKOV P.I., KASHIROVA O.V., VLAYKOV G.G., ALTMAN I.V., GUCH A.A., MATYASHCHUK A.S.

POSSTRAUMATIC ARTERIOVENOUS FISTULAS: TREATMENT EXPERIENCE

Objectives. To improve the outcomes of surgical treatment in patients with chronic posttraumatic arteriovenous vascular lesions (PAVL) on the basis of etiology and pathogenesis of the condition studying.
Methods. 18 patients with PAVL were examined for the period from 2005 to 2009; 16 of them were males, 2 females; aged 25-59 years, 50% of the subjects were aged 25-40 years. The systemic hemodynamic changes according to echocardiography data before and after surgery were analyzed in 2 patients with PAVL of the femoral, posterior tibial vessels.
Results. Mainly the damage of the lower extremities arteries (in 10 patients) were observed; 8 of them (66, 7%) needed reoperation, the duration of disease ranged from 3 months to 36 years. In this group ligation of the arteriovenous fistula was conducted in 2 patients, end-to-end arterial anastomosis in 1, lateral suture of artery in 1 patient, artery replacement with explants in 3; endovascular embolization in 1, stent-grafting of arteriovenous arteriovenous fistula with following surgical removal of pseudoaneurysm - 1.
Conclusions. The outcome of surgical treatment depends on the timeliness of special surgery done. Radical reconstructive surgery in patients with PAVL contributes to normalization of the general hemodynamic in early postoperative period. Combined use of surgical and endovascular methods allow decreasing considerably the intraoperative hemorrhage risk and surgical trauma in patients with chronic PAVL.

Keywords: chronic posttraumatic arteriovenous lesions, systemic hemodynamic disturbances, echocardiography, radical reconstructive surgery, endovascular, combined treatment
p. 63 – 69 of the original issue
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