JOURNAL «ANGIOLOGY AND VASCULAR SURGERY»

The review article presents data on the structural organization of the endothelial glycocalyx and its function in health and endothelial dysfunction accompanying circulatory system pathology. Particular attention is paid to the possibilities and peculiarities of its visualization using various techniques, as well as modern trends in correcting disorders of its function and structure.

Funding. The study had no financial support.

Conflict of interest. The authors declare no conflicts of interest.

Authors’ contribution. Study conception and design – Stoiko Yu.M., Melkumyants A.M.; data collection and handling – Stoiko Yu.M., Gudymovich V.G., Yashkin M.N.; statistical processing – Yashkin M.N., Gudymovich V.G.; draft manuscript preparation – Melkumyants A.M., Gudymovich V.G.; manuscript revision – Shevchenko Yu.L., Stoiko Yu.M.

For citation: Shevchenko Yu.L., Stoiko Yu.M., Melkumyants A.M., Gudymovich V.G., Yashkin M.N. The importance of glycocalyx in the development of pathology of the cardiovascular system. Angiology and Vascular Surgery. Journal named after Academician A.V. Pokrovsky. 2025; 31 (1): 7–18. DOI: https://doi.org/10.33029/1027-6661-2025-31-1-7-18

Relevance. Surgery of arterial aneurysms in the Russian Empire began in St. Petersburg in the 1806-–1810s at the Medical and Surgical Academy under the leadership of I.F. Bush (Glossev S.P., Kryukov Yu.Yu., 2022). The further development of this area of surgery until the middle of the XIX century was described by Yu.Yu. Kryukov (2023) according to monographs and dissertations of that time. However, we believe that the periodical medical press, in particular, the medical newspaper “Friend of Health”, which was published from 1833 to 1869, played an important role in spreading knowledge about achievements in this field of surgery. However, there are very few studies on the history of the development of vascular surgery in this period based on the materials of the periodical press, and according to the newspaper “Friend of Health” there is not at all.

The purpose – to recreate and analyze the development of arterial aneurysm surgery in Russia in the XIX century. based on publications in the medical newspaper “Friend of Health”.

Material. From 1833 to 1869, the medical newspaper “Friend of Health” published 197 articles by foreign authors and 15 reports by Russian surgeons concerning surgery of arterial aneurysm.

Methods: the analysis of publications on aneurysms was carried out using historical, evolutionary-chronological and comparative methods.

Results and discussion. A content analysis of the following publications was carried out: N.S. Alexandrovsky (1855) “On hypertrophy of the right ventricle of the heart (Apeigisma activum Corvisar)”; I.V. Buyalsky “On ligation of the unnamed artery (Ligatura arteriae innominatae)” (1833), “On the first successful operations for ligation of popliteal aneurysms, conducted in St. Petersburg” (1850), “On ligation of the unnamed artery” (1854) and “Popliteal aneurysm, ruptured (Anevrisma poplitaeum ruptum), cured by ligation of the femoral artery” (1864); I.F. Geifelder “On the case of an aneurysm of the mandibular artery” (1856); H.J. Hubbenet “On the operation of a false aneurysm in the ulnar fold” (1855); K.I. Groom “On three ligations of unnamed arteries made in Russia in 1827 and 1833” (1834); “On the ligation of the artery in anevrysma arteriae Abrachialis spurium” (1836) and “On the speech of P.A. Naranovich with an anatomical analysis of the aneurysm of the superior ascending artery that burst into the right ventricle of the heart” (1842); V. Donetskiy “Popliteal aneurysm (Anevrisma poplitaeum), cured by injection)” (1843), K.I. Groom “Review of the work of Dr. I.F. Hildebrand “On the recognition and treatment of aneurysms and on the operation of ligation of arteries” (1843); N.I. Pirogov “On the possibility of ligature on the abdominal aorta” (1839) and “On ligation of the left common iliac artery due to traumatic aneurysm arteriae gluteae” (1852); I.V. Rklitsky “On ligation of the external iliac artery in the case of femoral artery aneurysm” (1852).

Conclusion. Arterial aneurysm in Russia in the nineteenth century was diagnosed quite successfully, but operations with this vascular lesion were isolated. Only 15 (2%) out of 197 reports were devoted to the description of clinical observations and surgical treatment of this disease in the newspaper “Friend of Health”, which may indicate both the difficulties of diagnosis and the high risk of aneurysm surgery. During these years, for the first time in Russia, an aneurysm of the unnamed artery was described (I.V. Buyalsky, 1833, 1834) and an aneurysm of the ascending aorta (K.I. Groom, 1842), a method of ligation of the abdominal aorta in an aneurysm of the iliac artery in an experiment (N.I. Pirogov, 1839). Operations for aneurysms performed after the discovery of anesthesia (1847) and before the introduction of antiseptics (1867) included ligation of arteries according to the methods of Antill, Filagrius, P. Brazdor, J. Gunther.

Research design: retrospective.

Funding. The study had no financial support.

Conflict of interest. The authors declare no conflicts of interest.

Authors’ contribution. Concept and design of the study – Glyantsev S.P.; collection and processing of material – Yalyshev M.R.; statistical processing – Yalyshev M.R.; writing the text – Yalyshev M.R.; editing – Glyantsev S.P.

For citation: Yalyshev M.R., Glyantsev S.P. On the development of artery aneurysm surgery in Russia in the XIX century (based on the materials of the medical newspaper “Friend оf Health”, published from 1833 to 1869). Angiology and Vascular Surgery. Journal named after Academician A.V. Pokrovsky. 2025; 31 (1): 19–33. DOI: https://doi.org/10.33029/1027-6661-2025-31-1-19-33

Background. Atherosclerosis of the brachiocephalic arteries is one of the leading causes of ischemic cerebrovascular disorders, which is based on a complex, multi–stage process regulated by epigenetic mechanisms. The latter, in particular, include changes in the expression of molecules such as microRNAs – small (on average, 22 nucleotides) non-coding RNA sequences that are heavily involved in most physiological and pathological processes.

Objective. The aim of the study was to evaluate the expression of miR–126-5p/-3p, miR-21-5p/-3p, miR-33a-5p/-3p, miR-29a-5p/-3p in relation to association with clinical cerebrovascular events and to identify differences in the expression pattern depending on the performed transluminal balloon angioplasty with carotid artery stenting for hemodynamically significant carotid stenosis.

Patients and methods. Our prospective study included 80 patients [average age – 66 years, men – 44 (55%)] with cerebral atherosclerosis of varying severity who were admitted to the vascular departments of the “Research Center of Neurology” (Moscow). Transluminal balloon angioplasty with stenting (TBAS) of the carotid artery was performed in 33 patients [in 14 (42%) patients – for symptomatic stenosis]. All patients underwent thorough clinical and neurological examination, laboratory and instrumental research methods, including isolation and analysis of microRNA expression (miR-126-5p/-3p, miR-21-5p/-3p, miR-33a-5p/-3p, miR-29a-5p/-3p).

Results. The microRNA expression pattern was significantly different in the patients who underwent TBAS: the levels of miR-126-5p/-3p and miR-29a-5p were statistically significantly lower, and those of miR-33a-5p/-3p higher compared with the patients who did not undergo angiosurgery. A multivariate linear regression model that included the expression of all the microRNAs studied identified miR-126-5p and miR-21-5p as statistically significant independent predictors of the degree of carotid artery stenosis.

Conclusion. The expression of a number of atherogenic microRNAs in patients who underwent transluminal angioplasty with carotid artery stenting appeared to be of a differentiated nature. The most significant biomarker was the expression level of miR-126-5p, which is associated, among other things, with the degree of carotid stenosis.

Funding. The study was financially supported by the grant of the Ministry of Science and Higher Education of the Russian Federation for large scientific projects on priority trends of scientific and technological development, agreement No. 075-15-2024-638.

Conflict of interest. The authors have no conflicts of interest to declare.

Authors’ contribution. Study conception and design – Tanashyan M.M., Raskurazhev A.A.; laboratory stage – Shabalina A.A.; data collection and handling – Annushkin V.A., Mazur A.S., Kuznetsova P.I..; statistical processing – Raskurazhev A.A.; draft manuscript preparation – Raskurazhev A.A., Tanashyan M.M., Mazur A.S.; manuscript revision – Tanashyan M.M.

For citation: Tanashyan M.M., Raskurazhev A.A., Shabalina A.A., Mazur A.S., Annushkin V.A., Kuznetsova P.I. Association of microRNAs with cerebral atherosclerosis progression: the role of endovascular interventions. Angiology and Vascular Surgery. Journal named after Academician A.V. Pokrovsky. 2025; 31 (1): 41–7. DOI: https://doi.org/10.33029/1027-6661-2025-31-1-41-47

Objective. The purpose was to study different types of the common carotid artery bifurcation, taking into account the characteristics of geometry and hemodynamics to predict the risk of developing atherosclerosis and postoperative restenosis.

Patients and methods. At the State Budgetary Healthcare Institution “Research Institute – Regional Clinical Hospital № 1 named after Professor S.V. Ochapovsky” with the support of the Kemerovo State University, a retrospective non-randomized single-center study was conducted, assessing the findings of multislice computed tomography of patients examined in the clinic from 2021 to 2022. The inclusion criteria were intact brachiocephalic arteries at the extracranial level. The study comprised a total of 85 bifurcations of the common carotid artery (CCA) with no atherosclerotic stenosis, dysplastic diseases, vasculitis, nor pathological tortuosity of the internal carotid artery (ICA). The following geometric data were studied: the diameters of the common and internal carotid arteries, the bifurcation angle of the common carotid artery, delta and diameter ratio, with the shape of the bulb of the internal carotid artery also assessed. Three-dimensional models of the bifurcation were constructed, the conditions of blood flow in these models were created, and, using specialized software, hemodynamic parameters responsible for the formation of conditions for the growth of an atherosclerotic plaque were calculated.

Results. Having analyzed the geometric and hemodynamic data in the area of the bifurcation of the common carotid artery in patients without pathology, we came to the conclusion that it is advisable to divide the entire variety of bifurcations of the CCA into groups according to the potential risk of developing atherosclerosis. Types of bifurcation with a high and low risk of atherosclerotic plaque formation were identified, with the bifurcations also divided into types depending on the location of risk zones.

Conclusion. Stratification of the risk of atherosclerosis is useful from the point of view of implementing a personalized approach to the management of patients with subclinical forms of atherosclerosis. The criteria making it possible to identify geometric signs of the risk of developing atherosclerosis can also be used in surgical decision-making in order to improve postoperative outcomes.

Финансирование. Исследование поддержано финансированием Кубанского научного фонда и частично реализовано за счет средств гранта Кубанского научного фонда в рамках проекта № НИП-20.1/22.11.

Конфликт интересов. Авторы заявляют об отсутствии конфликта интересов.

Вклад авторов. Концепция и дизайн исследования – Дербилова В.П., Виноградов Р.А.; разработка методологии – Захаров Ю.Н., Борисов В.Г., Дербилова В.П.; сбор и обработка материала – Хетеева Э.Э. Виноградова Э.Р., Тютюников П.К., Мещерякова О.М., Гагин В.А., Воронова И.Г.; статистическая обработка – Дербилова В.П.; написание текста – Дербилова В.П.; редактирование – Виноградов Р.А., Барышев А.Г.

Для цитирования: Дербилова В.П., Виноградов Р.А., Захаров Ю.Н., Борисов В.Г., Хетеева Э.Э., Виноградова Э.Р., Тютюников П.К., Мещерякова О.М., Гагин В.А., Воронова И.Г., Зяблова Е.И., Барышев А.Г. Систематизация типов бифуркации общей сонной артерии с учетом геометрических и гемодинамических особенностей. Ангиология и сосудистая хирургия. Журнал имени академика А.В. Покровского. 2025; 31 (1): 48–57. DOI: https://doi.org/10.33029/1027-6661-2025-31-1-48-57

Presented in the article are the results of an international, multicenter, randomized, double-blind, two-stage, two-sequence cross-over comparative study of the efficacy and safety of arginine sodium succinate (Unifuzol^®) and pentoxifylline in the form of intravenous infusions in patients with stage II PAD according to the classification of A.V. Pokrovsky.

Objective. The study was planned to demonstrate superiority of treatment with arginine sodium succinate to pentoxifylline based on the absolute change in the maximum walking distance and pain-free walking distance on the day next to the end of the treatment compared to the baseline level.

Patients and methods. A total of 229 patients were randomized in a 1:1 ratio to each treatment sequence. The primary efficacy parameters were: absolute (in meters) and relative (in %) increase in maximal walking distance and pain-free walking distance in the treadmill test on the day next to completion of therapy with the study drugs compared with the baseline level.

Results and discussion. A comparative analysis revealed a significant difference in the increase of the maximum walking distance after a 12-day course of treatment with arginine sodium succinate and the comparative drug (29.4 and 19.6 m, respectively), with the absolute difference amounting to 9.8 m (95% CI 5.67–13.88). Thus, arginine sodium succinate turned out to be one and a half times more effective than pentoxifylline. The difference in pain–free walking distance, the average increase of which in the group treated with arginine sodium succinate was 23.9 m, and in the comparison group – 16.1 m, also showed higher efficacy of arginine sodium succinate.

Conclusion. According to the results of the analysis, for all parameters of effectiveness, a statistically significant superiority was shown in patients with stage II obliterating atherosclerosis of the vessels of the lower extremities treated with arginine sodium succinate compared to pentoxifylline.

Funding. The study was sponsored by the LLC “NTFF POLISAN”, Russia.

Conflict of interest. The authors have no conflicts of interest to declare.

Authors’ contribution. Study conception and design – Lukyanchikov V.V., Kovalenko A.L., Petrov A.Yu.; data collection and handling – Lukyanchikov V.V., Lukyanov Yu.V.; statistical processing – Lukyanchikov V.V.; draft manuscript preparation – Lukyanov Yu.V., Lukyanchikov V.V., Petrov A.Yu.; manuscript revision – Sokurenko G.Yu., Lukyanchikov V.V., Didenko Yu.P., Bogomolov M.S.

Acknowledgements. The authors would like to express their sincere thanks to the following employees of research centers participating in the study: MD, Professor I.A.Suchkov (Ryazan State Medical University of the RF Ministry of Health, Ryazan), F.Yu. Kopylov (First Moscow State Medical University named after I.M. Sechenov, Moscow), PhD in Medical Sciences A.S. Agafyina (“City Polyclinic № 40”, St. Petersburg), L.Ya. Odnopolozova (LLC “Alliance Biomedical – Ural Group”, Izhevsk), O.V. Orlikova (“Regional Clinical Cardiological Dispensary”, Saratov), D.V. Saenko (LLC “4D Ultrasound Clinic”, Pyatigorsk), A.T. Umbetzhanova (LLP “Medical Center of the Astana Medical University”, Astana, Kazakhstan), A.A. Seitkaliev (Republican State Enterprise “Medical Center Hospital” of the Administrative Directorate of the President of the Republic of Kazakhstan, Astana, Kazakhstan).

For citation: Lukyanov Yu.V., Sokurenko G.Yu., Petrov A.Yu., Kovalenko A.L., Lukyanchikov V.V., Didenko Yu.P., Bogomolov M.S. Efficacy of 1.4% solution for infusion arginine sodium succinate in patients with obliterating atherosclerosis of lower limbs (international clinical study). Angiology and Vascular Surgery. Journal named after Academician A.V. Pokrovsky. 2025; 31 (1): 58–68. DOI: https://doi.org/10.33029/1027-6661-2025-31-58-68

Background. Methods of endovascular treatment of patients with arterial lesions expand the possibilities for limb salvage. However, one of the main reasons for the reduced long-term effectiveness of these surgical interventions is restenosis. Endothelial-mesenchymal transition is considered one of the reasons for the development of restenosis.

Objective. The aim was to study the possibilities of predicting the development of restenosis after endovascular interventions on the main arteries of the lower extremities in patients with atherosclerotic peripheral artery disease (PAD) by assessing the levels of endothelial-to-mesenchymal transition biomarkers.

Patients and methods. The study included 50 patients divided into groups depending on treatment (operative or conservative). The mean age of the patients in the surgical group was 66.1±8.83 years and that in the conservative group 70±8.62 years. The groups were comparable in terms of gender, stage of the disease, side of the lesion, concomitant diseases and baseline values of the ankle-brachial index (ABI). The control group additionally comprised 10 apparently healthy volunteers with neither PAD nor other identified diseases.

Peripheral venous blood was collected to assess the level of EndMT markers (endothelial markers – PECAM-1, vWF, mesenchymal markers – vimentin, alpha-Anti-Actin Alpha 2 – antiACTIN, and integral EndMT marker – TGF-b1) in the apparently healthy subjects, as well as patients with stage IIb-IV PAD according to the classification of A.V. Pokrovsky–Fontaine before and after endovascular reconstructive interventions on the arteries of the lower extremities. All patients underwent duplex ultrasonography to assess restenosis at the site of the endovascular interventions performed, with the ABI also determined.

Results and discussion. Decreased values of the ABI in the post-operative period were associated with elevated levels of vimentin (VIM). Vimentin concentration above 2.98 ng/ml was associated with the development of restenosis 3 months after endovascular surgery.

Conclusion. At this stage of the study, it is only possible to assess the role of the mesenchymal parameter vimentin as a potential marker for predicting the development of restenosis after endovascular interventions on lower extremity arteries.

Funding. Budget of the “Ryazan State Medical University named after Academician I.P. Pavlov” of the RF Ministry of Public Health.

Conflict of interest. The authors have no conflicts of interest to declare.

Authors’ contribution. Study conception and design – Kalinin R.E., Suchkov I.A., Surov I.Yu., Pshennikov A.S., Mzhavanadze N.D.; data collection and handling – Surov I.Yu., Nikiforov A.A.; statistical processing – Surov I. Yu., Povarov V.O.; draft manuscript preparation – Surov I.Yu.; manuscript revision – Kalinin R.E., Suchkov I.A., Surov I. Yu., Pshennikov A.S., Mzhavanadze N.D.

For citation: Surov I.Yu., Kalinin R.E., Pshennikov A.S., Mzhavanadze N.D., Nikiforov A.A., Povarov V.O., Suchkov I.A. Vimentin as a potential marker of restenosis after endovascular procedures on lower extremity arteries. Angiology and Vascular Surgery. Journal named after Academician A.V. Pokrovsky. 2025; 31 (1): 69–75. DOI: https://doi.org/10.33029/1027-6661-2025-31-1-69-75

Background. Conservative management of patients after reconstructive vascular operations remains an important and widely discussed problem of modern medicine.

Objective. This study was aimed at evaluating efficacy and safety of combined administration of aspirin and low-dose rivaroxaban in patients with atherosclerosis who underwent reconstructive operations on arteries below the inguinal ligament for chronic critical lower limb ischemia.

Patients and methods. Our prospective cohort study included a total of 182 patients with atherosclerosis and chronic critical lower limb ischemia. The patients’ age ranged from 40 to 95 years (mean age 65.3±8.1 years). The period of the study was from 2018 to 2021. All patients underwent femoropopliteal bypass graft surgery with a distal anastomosis both above and below the knee-joint fissure, with either a reversed autovein or a synthetic graft used as a shunt. The patients were divided into 4 groups depending on the type of operation and prescribed therapy in the postoperative period. Control was carried out by means of clinical examination and duplex ultrasound angioscanning of lower-limb arteries after 30 days, as well as at 3, 6 and 12 postoperative months.

Results. An unfavorable clinical outcome was defined as the development of either single or various combinations of such conditions as acute limb ischemia, major amputation, shunt thrombosis, acute myocardial infarction, acute cerebrovascular accident, cardiovascular death. They were reveled in the remote period after surgery (from 30 days to 12 month) in 4 (8.3%) Group 1 patients, 6 (13.6%) Group 2 patients, 6 (13.3%) Group 3 patients and in 11 (24.4%) Group 4 patients. Besides, there was 1 (2.6%) major gastrointestinal bleeding in Group 2, with no significant hemorrhagic events revealed in other groups (p=NS).

Conclusion. Low-dose rivaroxaban combined with aspirin proved effective in preventing major adverse limb events and safe as to hemorrhagic complications compared with a combination of aspirin and clopidogrel in patients after revascularization of lower extremities for chronic critical limb ischemia.

Funding. The study had no financial support.

Conflict of interest. The authors declare no conflicts of interest.

Authors’ contribution. Study conception and design – Virgansky A.O., Panfilov V.A., Muravyov M.N.; data collection and handling – Muravyov M.N., Romanenko K.V.; statistical processing – Muravyov M.N.; draft manuscript preparation – Muravyov M.N., Panfilov V.A.; manuscript revision – Virgansky A.O., Panfilov V.A., Kuznetsov M.R.

For citation: Muravyov M.N., Panfilov V.A., Romanenko K.V., Kuznetsov M.R., Virgansky A.O. Conservative treatment of patients after peripheral arterial reconstruction for chronic critical limb ischemia. Angiology and Vascular Surgery. Journal named after Academician A.V. Pokrovsky. 2025; 31 (1): 76–85. DOI: https://doi.org/10.33029/1027-6661-2025-31-1-76-85

Background. The problem of atherosclerotic lesions of lower limb arteries and chronic critical ischemia is currently important, requiring the development and implementation into clinical practice of modern, safe and accurate methods of examination, thus making it possible to more precisely plan and evaluate the outcomes of the operations performed.

Objective. This study sought to determine the possibility of using the technique of ultrasound examination (duplex scanning) of the pedal arteries, measuring dopplerographic parameters of quantitative assessment of blood flow in the angiosomes of the foot in patients with chronic critical lower limb ischemia, depending on severity, and alterations therein following revascularization.

Patients and methods. We examined 31 patients with atherosclerotic occlusive lesions of lower extremity arteries. Of these, 3 patients had III stage chronic limb ischemia according to the Fontaine–Pokrovsky classification and 28 had IV stage ischemia. Twelve patients were diagnosed as having type 2 diabetes mellitus. The patients’ age ranged from 56 to 93 years, with a male-to-female ratio of 26:5.

The main dopplerographic parameters assessed were as follows: pulse waveform, ante- or retrograde blood flow in the artery examined, peak systolic blood flow velocity, maximal systolic acceleration, and acceleration time.

Results. We consider that the main advantage of using duplex scanning of the pedal arteries with measuring the maximal blood-flow acceleration is a possibility to assess namely the severity of foot ischemia. A strong inverse correlation was found between the maximum acceleration measured in pedal arteries and the severity of lower limb ischemia, as assessed according to the modified Rutherford scoring scheme (R²=0.78). It was shown that the proposed method of diagnosis is accurate and non-invasive, making it possible without additional devices and preparations to assess the result of revascularization in the operating room immediately after surgery.

Conclusion. This pilot study allows us to conclude that duplex scanning of the pedal arteries with the measurement of the maximum blood flow acceleration is a promising rapid alternative method of diagnosing peripheral artery disease and assessing efficacy of revascularization performed, especially in patients with uninformative values of the ankle-brachial index and impossibility to measure the finger pressure index.

Funding. The study had no financial support.

Conflict of interest. The authors declare no conflicts of interest.

Authors’ contribution. Study conception and design – Timina I.E., Pyatkova I.I., Mitish V.A.; data collection and handling – Timina I.E., Pyatkova I.I., Ushakov A.A., Varava A.B., Kadyrova M.V.; statistical processing – Sterlikov S.A.; draft manuscript preparation – Timina I.E., Pyatkova I.I.; manuscript revision – Alekyan B.G.

For citation: Timina I.E., Pyatkova I.I., Mitish V.A., Ushakov A.A., Varava A.B., Kadyrova M.V., Alekyan B.G., Sterlikov S.A. Ultrasonographic examination of hemodynamics in the feet of patients with chronic critical limb-threatening ischemia for planning and assessment of the outcomes of endovascular revascularization. Angiology and Vascular Surgery. Journal named after Academician A.V. Pokrovsky. 2025; 31 (1): 86–99. DOI: https://doi.org/10.33029/1027-6661-2025-31-1-86-99

Objective. The aim of this study was to investigate changes in the distal aorta after surgical treatment of patients with acute type A aortic dissection in the remote postoperative period.

Patients and methods. Our prospective study included a total of 116 patients presenting with acute type A aortic dissection and operated on at the Samara Regional Clinical Cardiological Dispensary named after V.P. Polyakov (54 patients subjected to prosthetic repair of the ascending aorta either alone or in a combination with aortic hemiarch replacement – Group 1) and at the Petrovsky National Research Center of Surgery (62 patients undergoing hybrid surgery – Group 2) from 2013 to 2022. The condition of the distal aorta was studied before and in the remote period after surgery (48.7±30.1 months).

Results. In the late postoperative period, thrombosis of the false lumen most often occurred in the proximal descending aorta, observed in 21% and 67% of Group 1 and Group 2 patients, respectively (p<0.01). Negative remodeling of the descending aorta in the remote period occurred in 59% of Group 1 patients, with no negative remodeling observed in Group 2 patients (p<0.001). Group 2 patients were found to have only positive remodeling or maintain the stable condition. Risk factors for false lumen functioning in the remote postoperative period, regardless of the type of surgery, were as follows: patient age <50 years (p=0.002) for the thoracic descending aorta, the number of secondary fenestrations greater than 5 in the abdominal aorta (p=0.001), as well as extension of dissection to branches of the aortic arch for the thoracic aorta after proximal “limited” aortic reconstruction (p=0.002).

Conclusions. In patients with acute type A aortic dissection, hybrid operations more often result in thrombosis of the false lumen in the thoracic descending aorta and are not accompanied by negative remodeling. Risk factors for false lumen functioning in the thoracic aorta after surgery are as follows: patient age under 50 years, propagation of dissection to branches of the aortic arch (after proximal “limited” aortic reconstructions); in the abdominal aorta – the number of secondary fenestrations in this section >5.

Funding. The study had no financial support.

Conflict of interest. The authors declare no conflicts of interest.

Authors’ contribution. Study conception and design – Charchyan E.R., Kuznetsov D.V.; data collection and handling – Kuznetsov D.V., Zybin A.A., Chakal D.A., Khovrin V.V., Sukhinina E.M.; statistical processing – Kuznetsov D.V.; draft manuscript preparation – Kuznetsov D.V.; manuscript revision – Charchyan E.R.

For citation: Charchyan E.R., Kuznetsov D.V., Chakal D.A., Zybin A.A., Khovrin V.V., Sukhinina E.M. Changes in the distal aorta after various operations in patients with acute type A aortic dissection. Angiology and Vascular Surgery. Journal named after Academician A.V. Pokrovsky. 2025; 31 (1): 100–8. DOI: https://doi.org/10.33029/1027-6661-2025-31-1-100-108

Objective. This study aimed to analyze the results of using custom-made fenestrated stent grafts and physician-modified stent grafts.

Patients and methods. We retrospectively analyzed a total of 26 patients with unfavorable neck anatomy operated on in the Republican Cardiological Center of Ufa and the Federal State Budgetary Institution “Clinical Hospital” of the Administrative Directorate of the President of the Russian Federation. The patients were divided into 2 groups according to the method of fenestration formation: Group I receiving a custom-made device (n=12) and Group II receiving a physician-modified device (n=14).

Results. The average number of fenestrations in the first group was 2.7±0.6 per patient and in the second group 1.5±0.7 per patient. The success rate of implantation of the aortic component was 100% in both groups. In the first group, bridge graft implantation success was 96.3% (26 out of 27). Bridge graft implantation success in the second group was 95.4% (21 out of 22). Control MSCT revealed 2 endoleaks (16.7%) in the first group and 1 endoleak (7.1%) in the second group. In the first group, type IV endoleak was encountered in one case and type Ib endoleak in another.

Conclusion. The first results of using custom-made and physician-modified fenestrated stent grafts showed the data comparable with those from other clinics and indicated common complications and causes of repeat interventions.

Funding. The study had no financial support.

Conflict of interest. The authors declare no conflicts of interest.

Authors’ contribution. Study conception and design – Khafizov T.N., Epifanov S.Yu.; surgical interventions – Khafizov T.N., Idrisov I.A., Kataev V.V., Epifanov S.Yu., Dudkin N.I.; choice of consumables – Khafizov T.N., Epifanov S.Yu.; statistical processing – Khafizov T.N., Kataev V.V.; draft manuscript preparation – Khafizov T.N., Epifanov S.Yu., Kataev V.V.; manuscript revision – Kataev V.V.

For citation: Khafizov T.N., Idrisov I.A., Kataev V.V., Epifanov S.Yu., Dudkin N.I. Use of fenestrated stent grafts in the treatment of juxtarenal aneurysms. Angiology and Vascular Surgery. Journal named after Academician A.V. Pokrovsky. 2025; 31 (1): 109–15. DOI: https://doi.org/10.33029/1027-6661-2025-31-1-109-115

Background. The incidence of primary dysfunction of arteriovenous fistulas (AVF) created as a permanent vascular access (PVA) for maintenance hemodialysis (HD) remains high, reaching 20–30%. Various risk factors lead to AVF delayed maturation and thrombosis.

Objective. We aimed to identify risk factors for the development of such variants of primary AVF failure as delayed maturation and thrombosis.

Patients and methods. Our retrospective cohort study included a total of 1595 adult patients first starting maintenance HD treatment. Primary AVF dysfunction was defined as failure of successful double-needle puncture for standard HD or hemodiafiltration, insufficient blood flow into the extracorporeal circuit three months after the permanent vascular access had been created, or the development of AVF thrombosis before its first successful use.

Results and discussion. The mean age of the patients was 49.1±8.6 years, ranging from 22 to 81 years. There were 720 (45.1%) females and 875 (54.9%) males. The average body mass index amounted to 28.4±3.7, ranging from 17.5 to 40.7 kg/m². Primary AVF failure was found to occur in 369 patients (23.1% of 1595). Of these, 127 (34.4% of 369, 8.0% of 1595) had AVF delayed maturation and 242 (65.6% of 369, 15.2% of 1595) had thrombosis.

The risk factors for thrombosis were as follows: persistent hypotension, polycystic kidney disease, and systemic processes (vasculitis, multiple myeloma, HIV-associated nephropathy, etc.): RR=2.2 [95% CI 1.6; 3.1], p<0.001; RR=3.2 [95% CI 2.5; 4.2], p<0.001; RR=5.3 [95% CI 4.4; 6.5], p<0.001, respectively. The risk factors for delayed maturation included female sex, persistent hypotension, diabetes mellitus, polycystic kidney disease, and excess body weight: RR=2.7 [95% CI 1.9; 3.9], p<0.001; RR=2.8 [95% CI 1.8; 4.4], p<0.001; RR=3.3 [95% CI 2.4; 4.6], p<0.001; RR=7.1 [95% CI 5.3; 9.6], p<0.001; RR=2.3 [95% CI 1.3; 3.8], p=0.002, respectively.

A preoperative ultrasound examination performed by or in the presence of the operating surgeon was an important factor contributing to a decrease in the incidence of both variants of dysfunction. Formation of a permanent vascular access within 4 weeks before HD and within two weeks thereafter was associated with an increased risk of thrombosis.

Conclusion. AVF thrombosis and delayed maturation, as types of primary failure are influenced by different risk factors. The surgeon-performed preliminary examination should be supplemented with Doppler ultrasonography of the zone of AVF creation to select an optimal vascular access.

Funding. The study had no financial support.

Conflict of interest. The authors declare no conflicts of interest.

Authors’ contribution. Study conception and design – Zulkarnaev A.B.; data collection and handling – Bylov K.V., Stepanov V.A.; statistical processing – Bylov K.V.; draft manuscript preparation – Bylov K.V.; manuscript revision – Zulkarnaev A.B.

For citation: Bylov K.V., Zulkarnaev A.B., Stepanov V.A. Risk factors for the development of different variants of primary arteriovenous fistula dysfunction in patients on maintenance hemodialysis. Angiology and Vascular Surgery. Journal named after Academician A.V. Pokrovsky. 2025; 31 (1): 116–25. DOI: https://doi.org/10.33029/1027-6661-2025-31-1-116-125

Background. Venous thromboembolic complications (VTE) represent a serious problem for neurosurgical patients, especially after brain tumor resection surgeries. Due to the specific nature of neurosurgical diseases, the risk of these complications significantly increases.

Objective. This study aimed to assess the effectiveness of implementing a systematic approach to VTE prophylaxis in patients undergoing brain tumor resection, using risk stratification algorithms and early administration of low molecular weight heparin.

Patients and methods. The study was conducted at the Federal Center of Neurosurgery in Novosibirsk, using a retrospective analysis of data from 3486 brain tumor resection surgeries. By means of propensity score matching, the patients were divided into two groups: the control group (1002 patients who underwent surgery before the implementation of the new prophylactic algorithm) and the study group (1002 patients who underwent surgery with the application of a systematic approach to VTE prophylaxis). The results of VTE risk stratification, early administration of low molecular weight heparin, and their association with the frequency of complications were evaluated.

Results. The obtained findings showed that the application of the new prophylactic algorithm significantly reduced the incidence of clinically significant pulmonary embolism to 0.2 vs 0.6% in the control group. No fatalities from pulmonary embolism were recorded in the study group. However, there was a slight increase in cases of intracranial hemorrhage (1.8 vs 1.3%).

Conclusion. Preoperative risk stratification for VTE and early administration of prophylactic doses of low molecular weight heparin can reduce the frequency of thromboembolic events with comparable risks of intracranial hemorrhage.

Funding. The study had no financial support.

Conflict of interest. The authors declare no conflicts of interest.

Authors’ contribution. Study conception and design – Karpenko A.A., Rzaev D.A., Bervitsky A.V.; data collection and handling – Bervitsky A.V., Guzhin V.E., Moisak G.I.; statistical processing – Amelina E.A.; draft manuscript preparation – Bervitsky A.V.; manuscript revision – Karpenko A.A., Rzaev D.A., Moisak G.I.

For citation: Bervitsky A.V., Guzhin V.E., Moisak G.I., Amelina E.A., Karpenko A.A., Rzaev D.A. Prevention of postoperative thromboembolic complications in patients with brain tumors. Angiology and Vascular Surgery. Journal named after Academician A.V. Pokrovsky. 2025; 31 (1): 126–32. DOI: https://doi.org/10.33029/1027-6661-2025-31-1-126-132

The authors herein share their experience with surgical treatment of arteriovenous fistulas (AVF), describing standard diagnostic measures and possible methods of management of this pathology, as well as analyzing the known methods of treatment of post-traumatic AVFs in a specialized vascular hospital.

Objective. To determine the most effective method of surgical treatment of patients with posttraumatic AVFs in the early period of wound disease.

Patients and methods. From 2021 to 2023, a total of 58 patients with posttraumatic AVFs of the extremities were treated in the vascular centers of the National Medical Research Center of Surgery named after A.V. Vishnevsky and National Medical Research Center of High Medical Technologies – Central Military Clinical Hospital named after A.A. Vishnevsky”. Of these, 51 (88%) patients were diagnosed as having lower-limb vascular pathology and 7 (12%) had upper-limb pathology. 29 (50%) patients underwent X-ray endovascular methods of treatment, 26 (44.8%) patients were subjected to open surgical intervention, and 3 (5.2%) victims were found to have spontaneous closure of the AVF.

Results. Endovascular methods of treatment included: implantation of stent grafts in 20 (34.5%) patients, embolization with microcoils in 7 (12%) cases, and “multilayer” stenting of the AVF zone in 2 (3.4%). Open surgical methods of treatment were as follows: arterial prosthetic repair in 20 (34.5%) patients, ligation of the arteriovenous fistula itself in 3 (5.1%) patients, autovenous plastic surgery of the arterial defect in 1 (1.7%) case, fistula disconnection with single-suture closure of the venous wall in 1 (1.7%), and resection of the damaged segment of the popliteal artery with an end-to-end anastomosis in 1 (1.7%).

During the postoperative follow-up period, 3 complications developed in each study group. After endovascular treatment, these were “local” complications in the form of thrombosis and implant dislocation in 2 patients and a recurrence of the functioning AVF in 1 case. After open surgery: wound suppuration in 1 patient, arrosive bleeding in 1 patient (with the resulting limb amputation), and a relapse of the AVF in 1 case.

Conclusion. Each case of posttraumatic arteriovenous fistula has an individual approach to treatment. Surgical decision-making depends on such factors as the duration of AVF, diameter, localization, level of arterialization of venous blood flow, severity of changes in the walls of the affected arteries and veins. All posttraumatic arteriovenous fistulas should be treated surgically in a specialized vascular center with all modern technologies.

Funding. The study had no financial support.

Conflict of interest. The authors declare no conflicts of interest.

Authors’ contribution. Study conception and design – Yamenskov V.V., Chupin A.V., Chernov G.A., Pinchuk O.V.; data collection and handling – Chernov G.A., Yamenskov V.V., Kryzhov S.N., Golovyuk A.L.; statistical processing – Chernov G.A.; draft manuscript preparation – Chernov G.A., Yamenskov V.V., Golovyuk A.L.; manuscript revision – Pinchuk O.V., Obraztsov A.V.

For citation: Chernov G.A., Chupin A.V., Yamenskov V.V., Golovyuk A.L., Pinchuk O.V., Obraztsov A.V., Kryzhov S.N. Diagnosis and treatment of post-traumatic arteriovenous fistulas of the upper and lower extremities. Angiology and Vascular Surgery. Journal named after Academician A.V. Pokrovsky. 2025; 31 (1): 133–41. DOI: https://doi.org/10.33029/1027-6661-2025-31-1-133-141

A clinical case of massive arterial bleeding from the brachiocephalic trunk in the tracheostomy area against the background of the formation of a tracheoarterial fistula is presented.

Issues under discussion: the choice of examination methods and surgical treatment tactics in a multidisciplinary hospital as part of a multidisciplinary team in patients with such a life-threatening complication.

Funding. The study had no financial support.

Conflict of interest. The authors declare no conflicts of interest.

Authors’ contribution. Study conception and design – Khubulava G.G., Kozlov K.L., Sazonov A.B., Lukyanov N.G., Zavatsky V.V.; surgical treatment – Yakovlev N.N., Tyumenev A.B., Kudryavtsev O.I., Fomin V.S.; analysis of the received data – Yakovlev N.N.; literature review – Zavatsky V.V., Magafurov V.L.; draft manuscript preparation – Tyumenev A.B., Kudryavtsev O.I., Tserakh A.V.; manuscript revision – Yakovlev N.N.

For citation: Yakovlev N.N., Kozlov K.L., Sazonov A.B., Tyumenev A.B., Kudryavtsev O.I., Lukyanov N.G., Zavatsky V.V., Magafurov V.L., Fomin V.S., Tserakh A.V., Khubulava G.G. Successful of surgical treatment of arrosive bleeding from the brachiocephalic trunk against the background of a long-term functioning tracheostomy (case report). Angiology and Vascular Surgery. Journal named after Academician A.V. Pokrovsky. 2025; 31 (1): 142–8. DOI: https://doi.org/10.33029/1027-6661-2025-31-1-142-148

Acute aortic dissection belongs to life-threatening conditions, requiring thorough diagnosis and selection of individual therapeutic policy depending on peculiarities of the pathology course. Although at the moment, the main method of treatment of a patient with stable DeBakey type III acute aortic dissection is conservative management, we would like to present a clinical case of hybrid surgical treatment using a stent graft for correction of a dissecting aneurysm as an alternative option to major open aortic replacement and endovascular stenting.

Funding. The study had no financial support.

Conflict of interest. The authors declare no conflicts of interest.

Authors’ contribution. Study conception and design – Marchenko A.V., Belov V.A.; data collection and handling – Myalyuk P.A., Petrishchev А.А., Samoshina F.B.; statistical processing – Samoshina F.B.; draft manuscript preparation – Samoshina F.B.; manuscript revision – Myalyuk P.A., Samoshina F.B.

For citation: Marchenko A.V., Myalyuk P.A., Petrishchev А.А., Porodikov A.A., Samoshina F.B., Belov V.A. Hybrid surgery using a stent graft for DeBakey type III acute aortic dissection (case report). Angiology and Vascular Surgery. Journal named after Academician A.V. Pokrovsky. 2025; 31 (1): 149–56. DOI: https://doi.org/10.33029/1027-6661-2025-31-1-149-156

Presented herein is a clinical case concerning a hybrid approach to the treatment of a 67-year-old patient with terminal abdominal aortic stenosis and prolonged occlusion of the femoral-popliteal segment of the left lower limb with the development of stage 4 chronic limb ischemia.

The patient underwent a hybrid surgical procedure: complex endovascular reconstruction of the terminal aorta and iliac arteries (CERAB) with simultaneous left-sided autovenous femoral-tibial bypass grafting with good immediate and medium-term results.

Funding. The study had no financial support.

Conflict of interest. The authors declare no conflicts of interest.

Authors’ contribution. Study conception and design – Zatevakhin I.I., Mustafin A.Kh., Frantsevich A.M.; data collection and handling – Bogomazov I.Yu., Korzunov S.S.; draft manuscript preparation – Mustafin A.Kh., Frantsevich A.M.; manuscript revision – Shipovsky V.N.

For citation: Zatevakhin I.I., Frantsevich A.M., Mustafin A.Kh., Shipovsky V.N., Bogomazov I.Yu., Korzunov S.S. Complex reconstruction of the terminal aorta with simultaneous femoral-tibial bypass grafting in a patient with critical limb ischemia and multilevel atherosclerotic disease (case report). Angiology and Vascular Surgery. Journal named after Academician A.V. Pokrovsky. 2025; 31 (1): 157–63. DOI: https://doi.org/10.33029/1027-6661-2025-31-1-157-163

Acute kidney injury is the most common complication after open abdominal aortic aneurysm repair, thus significantly deteriorating the postoperative period. Traditionally, preoperative and intraoperative factors are considered as risk factors for the development of acute kidney injury. Intraoperative risk factors are recognized by many authors as determining factors in the development of this complication after abdominal aortic aneurysm repair. To date, there is no scientifically based strategy for the prevention of acute renal dysfunction in open abdominal aortic surgery that would reduce the risk of this complication.

This article presents a review of Russian and foreign literature dedicated to acute kidney injury after open abdominal aortic aneurysm repair. The modern classifications of this complication, as well as the evolution of their formation are given.

The main preoperative and intraoperative risk factors for the development of acute kidney injury are considered in detail. It is noted that in many studies factors of surgical and anesthesiologic “aggression” were the most significant in influencing postoperative renal function.

Clinical guidelines, systematic reviews and meta-analyses regarding the prevention of acute kidney injury after open abdominal aortic aneurysm repair were analyzed in detail. It was concluded that at present there is no sustainable strategy for preventing this complication after open surgery, with most protective procedures performed empirically.

Funding. The study had no financial support.

Conflict of interest. The authors declare no conflicts of interest.

Authors’ contribution. Study conception and design – Vachev A.N.; data collection – Kozin I.I., Frolova E.V.; draft manuscript preparation – Kozin I.I., Frolova E.V.; manuscript revision – Vachev A.N.

For citation: Kozin I.I., Frolova E.V., Vachev A.N. Acute kidney injury in open abdominal aortic aneurysm repair (literature review). Angiology and Vascular Surgery. Journal named after Academician A.V. Pokrovsky. 2025; 31 (1): 164–74. DOI: https://doi.org/10.33029/1027-6661-2025-31-1-164-174

Objective. Updating of modern methods of diagnostics and treatment of Budd–Chiari syndrome (BCS), endovascular treatment tactics (balloon angioplasty, TIPS, DIPS, etc.) in order to raise awareness of this pathology among general practitioners, hepatologists, X-ray surgeons and doctors of other specialities.

Material and methods. We analysed full-text publications included in the abstract systems eLibrary, Cyberleninka, PubMed, Google Scholar mainly for the last 5 years (69%). The main focus was on diagnosis (ultrasound, CT, MRI) and treatment (anticoagulants, thrombolytics, balloon angioplasty, TIPS, liver transplantation).

Results. BCS is a rare disease associated with impaired venous outflow from the liver resulting in suprahepatic portal hypertension. Etiology includes thrombosis, myeloproliferative diseases and congenital vascular anomalies. Epidemiology is variable, with a higher prevalence in Asia. The clinical picture varies from asymptomatic course to fulminant hepatic failure. The main manifestations are variceal haemorrhage and refractory ascites. Without treatment, survival is poor, with fatal outcome occurring within three years. The modern strategy implies a stepwise approach: drug therapy (anticoagulants, thrombolytics), balloon angioplasty, TIPS and radical treatment – liver transplantation.

Conclusion. Modern diagnostic methods and staged strategy of BCS have significantly improved treatment outcomes, based on endovascular approach and new technologies (stent grafts, intraoperative use of ultrasound, etc.). However, further research is needed to optimise approaches to early diagnosis and individualisation of therapy.

Funding. The study had no financial support.

Conflict of interest. The authors declare no conflicts of interest.

Authors’ contribution. Study conception and design – Shipovskiy V.N., Zabadaeva O.B., Kiselev R.O.; data collection and handling – Shipovskiy V.N., Zabadaeva O.B., Kiselev R.O.; statistical processing – Shipovskiy V.N., Zabadaeva O.B., Kiselev R.O.; draft manuscript preparation – Shipovskiy V.N., Zabadaeva O.B., Kiselev R.O.; manuscript revision – Shipovskiy V.N., Zabadaeva O.B., Kiselev R.O.

For citation: Shipovskiy V.N., Zabadaeva O.B., Kiselev R.O. Diagnosis and treatment of Budd–Chiari syndrome (literature review). Angiology and Vascular Surgery. Journal named after Academician A.V. Pokrovsky. 2025; 31 (1): 175–81. DOI: https://doi.org/10.33029/1027-6661-2025-31-1-175-181