In acute injuries in a specialized ward arteriographically studies were performed in all patients necessarily, in the case of assistance on the road in district hospitals the study was not made due to the lack of conditions.
Segmental occlusion and stenosis of arteries a length of 10 cm was removed through open endarterectomy with subsequent restoration of the integrity of the arterial wall patches of autologous vein. Often used for this purpose, the long saphenous vein of the thigh. Our observations showed that the optimal are patches of rectangular shape, sewed in measured defects of the arterial wall.
Good and excellent results in the near term obtained from 40 people, occlusion of the operated artery segment was diagnosed in 7 patients, worsening ischemia occurred in 4 cases they performed the amputation of a limb. The main cause of early thrombosis in the surgical area was the error of a technical nature. In the remote period of observation thrombosis of the zone of surgical intervention occurred in 24 patients (without deterioration of vascularization of the limbs 18 and amputation was performed in 6).
Arteriovenous shunting was performed in the extension zone of occlusion over 10 cm, but passable peripheral direction. In all cases, the material length of the shunt served as the great saphenous vein of the thigh, the maximum length of the shunt was 27 cm, and the minimum 13 cm long saphenous vein often took on the affected side, using the incision.
When you use safely contralateral limb was isolated from the barrel separate transverse accesses. Tied lateral branches of the graft, then the ends of the vein was ligated and produced hydraulic dissection. Vienna, prepared for use as a prosthesis, reversible. The first imposes the proximal anastomosis.
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