Porous nitinol plate germinated by nerve, connective tissue cells and capillaries is biomechanically and biophysically compatible with vein based on study above. It becomes a mechanical carcass to form a blood vessel wall in defect area, so designed technic provides fast and safe hemostasis with bloodstream recovery.
Presacral venous bleeding is a rare but potentially fatal complication in pelvic surgery. This type of bleeding is difficult to control. Existing methods are not without shortcomings, therefore, the search for a more reliable method. We are present a case of successful bleeding control using by plates of medium-porous nitinol (pore size of 300–450 μm, permeability of 12 × 10–9). Hemostasis was carried out by pressing a plate to the bleeding zone for 4 minutes.
Синдромом экстравазальной компрессии позвоночных артерий называют симптомокомплекс, возникающий в результате гемодинамически значимой частичной или полной обструкции позвоночных артерий экстравазальными структурами. В клинической практике данное состояние чаще всего называют синдромом позвоночной артерии. Компрессии может быть подвержен любой сегмент, но наиболее часто поражение определяют на уровне С1-С2. Отечественные авторы считают компрессию позвоночных артерий распространенной причиной широкого спектра жалоб пациента, включая головокружение, головные боли и субъективный шум в голове. В отдельных работах сообщают, что синдром позвоночной артерии развивается у 50% пациентов с дегенеративными изменениями шейного отдела позвоночника.В мировой литературе синдром компрессии позвоночных артерий, который чаще именуется «синдром лучника» (bow hunter′s syndrome), называют редкой патологией. Чем обусловлена столь выраженная разница частоты выявления компрессии позвоночных артерий в отечественной и мировой литературе? К возможным причинам указанного феномена могут быть отнесены: отсутствие единых диагностических критериев, низкая осведомленность об альтернативных диагнозах и неверная интерпретация жалоб пациента. Очевидным является необходимость коррекции указанных факторов с целью снижения вероятности гипердиагностики синдрома позвоночной артерии и повышения качества оказания медицинской помощи.Ключевые слова: синдром позвоночной артерии, компрессия, ультразвуковая диагностика, критерии, гипердиагностика.Конфликт интересов. Авторы декларируют отсутствие явных и потенциальных конфликтов интересов, связанных с публикацией настоящей статьи.
The purpose of the study was to analyze various methods of stopping bleeding from the presacral venous plexus.Material and Methods. Literature search was carried out using Elibrary, Medline, Embase databases from January 1960 to November 2018.Results. Bleeding from the presacral venous plexus is a rare but potentially life-threatening complication in pelvic surgery. The inferior vena cava, the veins of the presacral and internal spinal plexuses are dilated under general anesthesia, and act as a large venous “blood pool” in the pelvis because of the lack of functional valves. Hydrostatic pressure in this venous pool can reach two to three times the pressure of the inferior vena cava. Thus, rupture of even a small presacral vein may result in heavy bleeding. Among the many reported methods of stopping this bleeding, the most effective are as follows: mechanical tamponade; technique of pressing the bleeding site; ectrocoagulation; the use of hemostatic materials.Сonclusion. The variety of methods used for stopping bleeding from the presacral venous plexus indicate a need of searching for more effective methods.
Treatment of patients with peripheral artery diseases is one of the most difficult issues in vascular surgery. The overall prevalence of peripheral arterial disease varies from 3-10% among the population aged 40-59 years old and among people over 70 years old - up to 15-20%. In the majority of cases atherosclerosis is the main cause of peripheral arterial disease. Autovein is considered a prosthesis of choice and is the most commonly used graft in the bypass surgery. However, it has been deemed impossible in 30% of cases due to its diameter, length or varicose lesions. Despite the technical advances, has not yet developed an ideal vascular prosthesis. Thus, there is a need of search for new materials and modifications of available materials, with the goal of creating a prosthesis for properties close to ideal. In this article we present first case report in the world about usage xenograft with protective external tubular mesh made from superelastic shape-memory nitinol as bypass material. This case shows that the xenoprosthesis with external tubular nitinol mesh support for prophylaxis of aneurysm formation can be used as vascular conduits in bypass surgery. Further randomized controlled trials needed.
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