occlusion diseases of branches of an aortic arch

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атеросклероз department of faculty and hospital surgery №1 occlusion diseases of branches of an aortic arch karimov sh.i. - 2014 * population of uzbekistan people ккr хорезм navoi bukhara kashkadarya сурхандарья фергана наманган андижан сырдарья джизак самарканд tashkent 29,775 million. goscomstat,2013 children 37,5% age higher then 65 4,3% age of 18-65 58,2% diseases of blood circulation system (to 100 000 population) 5065 5133 5464 ministry of health of republic of uzbekistan 2012 in 2012 in uzbekistan 64400 people had stroke!!! (gafurov b.g., 2012) ratio of ischemic and hemorrhagic stroke 4,8:1 hemorragic stroke 17,3% (11140) ischemic stroke 82,7% (53260) (gafurov b.g., 2012) reasons % types of lesion atherocclerosis 75-90 % pathological deformation (kinking, koyling) 11,6- 18,2% nonspecific aortoarteritis (takayasu disease) 7-12% fmd (fibrous-muscular displasy) extravasal compression 1- 2% reasons of defeat of aortic arch branches extra-intracranial anastomoses in most cases lesion is in bifurcation of common carotid artery the ratio of …

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%); - moderated (30-50 %); - expressed (50-69 %); - critical (70-99 %); - an occlusion (100 %). classification nascet and ecst, developed during the randomized researches in the usa and europe in 1991) stages of developing of plaque: cummulation of lipids on arterial wall hemmorage into the plaque intact artery mikroemboli emboli from ulcerated plaque in 50 % cases of the occlusion lesions of the brachiocephalic aortic arch branches proceed asymptomatic. at the asymptomatic current of disease patients of complaints don't show, signs vascular cerebral insufficiency is defined only during careful survey. at transitional ischemic attack become perceptible: headaches, giddiness disturbance of sensitivity with sensation numbness and crawlings of goose pimples, prickings, skins arising on limited sites extremities and the person. disturbance of impellent function (a paresis various degree). sight disturbance (veil occurrence before eyes, various photopsias, time loss visions on one or both eyes - амоврозис a land …

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herosclerotic plaques according to ultrasonic angioscanning 1. homogeneous echonegative type (a soft homogeneous plaque) 2. predominantly echonegative (a heterogeneous plaque). 3. predominantly echopositive (a heterogeneous plaque) i type ii type iii type iv type v type homogeneous plaques are clinically demonstrated in 22 % 4. homogeneous echopositive type (a dense homogeneous plaque). 5. calcinated plaque. stenoses ulcerated plaques research of morphological structure of atherosclerotic plaques ultrasonic duplex scanning of carotids histological studying of the plaques removed during operation coincidence of the data of duplex scanning with intraoperative the data makes 98 % computed tomography of a brain absence of a radial load and high sensitivity which allows to track a course large ekstra - and intracranial arteries concern advantages. mrt angiography of the bcb of the aorta critical (90 %) stenosis of a mouth of an internal carotid with an ulceration of an atherosclerotic plaque mrt angiography of the bcb …

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ere are neurologic symptoms of a lesion; 5) a stenosis more than 50 % at presence embolus plaques – at presence at least one episode of transitional ischemic attack operation kinds at stenosis ic classical carotid endarterectomy (ceae) with sewing patches eversional ceae resection with autovenouse or alloprosthesis ic рэв interventions classical carotid endarterectomy indications: low and critical degree of tolerance of a brain to an ischemia at diameter ic more than 6 mm to plastic ic the arteriotomyc aperture is closed by a continuous suture stages of classical carotid endarterectomy: the schematic image of stages of the eversional carotid endarterectomy: carotid endarterectomy by eversion technique prosthetics of an internal carotid ds after operation indications: the prolonged lesions and the expressed calcification of walls an ic ceae with use of the internal shunt aorta – bicarotid shunting at multilasion of bca aorta – common carotid– subclavian shunting extrathoracic operations: subclavian …

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от 60 % и более. * european heart journal indications for stenting of ica in symptomatic patients indications cea and cas are comparable in hihgt-risk patients. complications like stroke and mortality should not be greater then 6%!!! при симптомных поражениях (больные с тиа или после инсульта) операция показана при всех типах бляшек (гипоэхогенные, гетерогенные и гомогенные), суживающих просвет сосуда на 60 % и более, а также при изъязвленных бляшках от 50 % и более * с- and s- like deformations. kinking. coiling. other types classification of pathological deformations by p.o. kazanchan (2001): pathologic deformations different types of reconstructions for pathologic deformations * resection of ica with redressation and reimplantation system complications: myocardial infarction (4%) stroke and death (5.8%) hemorragic stroke local complications: hematoma, bleeding (5.5%) infection (3.4%) trombosis cranial nerve failure (7.6%): complications postoperative medication direct anticoagulants (heparin, fraxiparine) antiplatelet agents (aspirin, ticlopidine) with the development of cerebral edema for …

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атеросклероз department of faculty and hospital surgery №1 occlusion diseases of branches of an aortic arch karimov sh.i. - 2014 * population of uzbekistan people ккr хорезм navoi bukhara kashkadarya сурхандарья фергана наманган андижан сырдарья джизак самарканд tashkent 29,775 million. goscomstat,2013 children 37,5% age higher then 65 4,3% age of 18-65 58,2% diseases of blood circulation system (to 100 000 population) 5065 5133 5464 ministry of health of republic of uzbekistan 2012 in 2012 in uzbekistan 64400 people had stroke!!! (gafurov b.g., 2012) ratio of ischemic and hemorrhagic stroke 4,8:1 hemorragic stroke 17,3% (11140) ischemic stroke 82,7% (53260) (gafurov b.g., 2012) reasons % types of lesion atherocclerosis 75-90 % pathological deformation (kinking, koyling) 11,6- 18,2% nonspe...

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