Publications by authors named "V V Shlomin"

38 Publications

[Surgical treatment of a huge paraganglioma of the right common carotid artery bifurcation].

Angiol Sosud Khir 2020 ;26(4):155-159

Department of Training Physicians for the Navy, Military Medical Academy named after S.M. Kirov, Saint Petersburg, Russia.

Described herein is a clinical case report regarding successful surgical treatment of a female patient presenting with a large paraganglioma of the right common carotid artery. On admission, the woman had complained of a mass in her neck, having significantly enlarged within the previous 6 months, with the appearance of dysphagia and moderate pain syndrome. The findings of multislice computed angiography and ultrasonographic duplex angioscanning of the brachiocephalic arteries helped to verify the location, size, and topography of the tumour. Taking into account the diagnosed secondary foci in the lungs, it was decided to first perform embolization of the artery supplying the tumour, which was followed by biopsy of tissue of the neoplasm. After histological verification and ruling out malignancy, successful radical resection of the paraganglioma was performed.
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http://dx.doi.org/10.33529/ANGIO2020417DOI Listing
December 2020

[Hybrid treatment of a patient with dissecting thoracoabdominal aortic aneurysm and single kidney].

Angiol Sosud Khir 2020 ;26(3):173-178

Department of Surgical Diseases, National Medical Research Centre named after V.A. Almazov under the RF Ministry of Public Health, Saint Petersburg, Russia.

Presented herein is a clinical case report regarding a repeat intervention for a type II dissecting thoracoabdominal aortic aneurysm treated by means of a hybrid technique in a 76-year-old male patient with a single kidney, having 9 years previously endured resection of an aneurysm of the infrarenal aortic portion. The first stage consisted in prosthetic repair of the thoracoabdominal aortic aneurysm by an oblique anastomosis, with the second stage (7 days thereafter) being endoprosthetic repair of the descending thoracic aorta. The findings of check-up computed tomography at 16 months postoperatively demonstrated no negative dynamics.
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http://dx.doi.org/10.33529/ANGIO2020318DOI Listing
October 2020

[Surgical treatment of a patient with traumatic rupture of the aortic arch and late oesophageal perforation].

Angiol Sosud Khir 2020 ;26(2):175-182

Department of Vascular Surgery, Municipal Multimodality Hospital #2, Saint Petersburg, Russia.

Described herein is a clinical case report regarding a patient presenting with traumatic rupture of the aortic isthmus with the development of a pseudoaneurysm occupying virtually the entire posterior mediastinum and measuring 20?10 cm in size. He was immediately treated as an emergency to undergo prosthetic reconstruction of the portion of the aortic arch and descending thoracic aorta by means of temporary bypass grafting with a synthetic graft in order to protect the visceral organs. The postoperative period was complicated by oesophageal perforation with the formation of an oesophago-paraprosthetic fistula, infection of the vascular graft, accompanied by the development of pleural empyema and mediastinitis. A second operative procedure was performed, consisting of subclavian-iliac bypass grafting on the right with a polytetrafluoroethylene graft measuring 20 mm in diameter, exclusion of the intrathoracic portion of the oesophagus, creation of a gastro- and oesophagostoma, retrieval of the vascular graft followed by suturing of the aorta, pleurectomy, decortication of the lung, and removal of the empyemic sac on the left. There was no evidence of ischaemia of the spinal cord or visceral arteries. One month postoperatively, he underwent a traumatological stage and 4 months thereafter plasty of the oesophagus with an isoperistaltic gastric pedicle, extirpation of the thoracic portion of the oesophagus, to be later on followed by closure of the oesophagostoma. The patient experienced no difficulties either while walking or during other physical activities, with the ankle-brachial index amounting to 0.9. With time, he developed difficult-to-correct pulmonary hypertension. Unfortunately, the patient eventually died of acute cardiopulmonary insufficiency 9 years after right-sided extra-anatomical subclavian-iliac bypass grafting.
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http://dx.doi.org/10.33529/ANGIO2020219DOI Listing
September 2020

[Bypass grafting in patients with infected vascular grafts].

Angiol Sosud Khir 2020 ;26(1):148-156

Department of General Surgery, North-Western State Medical University named after I.M. Mechnikov, Saint Petersburg, Russia.

Analysed herein are the results of treating a total of 17 patients presenting with pathology of the aorta and lower-limb arteries, who from 2010 to 2018 required redo interventions due to infection of a previously implanted synthetic vascular graft. At admission, 3 patients were diagnosed as having an open infected wound, 11 were found to have a fistula, 2 had a false aneurysm in the area of the distal anastomosis of the branch of the bifurcation aortofemoral prosthesis, and 1 had thrombosis of the branch of the prosthesis with evidence of infection. As redo surgery, 4 patients underwent subclavian-femoral bypass grafting, 2 were subjected to crossover iliac-femoral bypass grafting, 8 to unilateral iliac-femoral bypass grafting, 3 to loop endarterectomy. In the majority of cases (14 of the 17) we used bypass grafting with creation of the tunnel through the muscular lacuna. Lethal outcomes were registered in 35% (n=6) of cases in the early postoperative period. Death was caused by acute renal failure in 6% (n=1), by acute mesenteric thrombosis in 12% (n=2), by gastrointestinal haemorrhage in 6% (n=1), and by multiple organ failure in 12% (n=2). Long-term mortality amounted to 33% (n=3) within 12 months. The main causes of death were increasing renal failure in 10% (n=1) and cardiovascular insufficiency on the background of heart diseases in 10% (n=1), as well as respiratory insufficiency in 10% (n=1). Reinfection in the remote period was diagnosed in 1 patient. A conclusion was drawn that bypass grafting is traumatic, however, it may be the only way to save the limb or patient's life in a complicated clinical situation. Using the superficial femoral vein as a shunt demonstrated good long-term results as to patency and resistance to surgical infection. Using a flap of the greater omentum, retroperitoneal fat, as well as wrapping of the prosthesis with a muscular flap ensured good tolerance of the zone of bypass grafting to reinfection.
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http://dx.doi.org/10.33529/ANGIO2020120DOI Listing
September 2020

[Elimination of late endoleak after endovascular repair of a dissecting thoracoabdominal aortic aneurysm].

Angiol Sosud Khir 2019 ;25(4):173-180

Department of Vascular Surgery, Municipal Multimodality Hospital #2, Saint Petersburg, Russia.

Described herein is a clinical case report regarding treatment of a 70-year-old male patient presenting with a late complication following endoprosthetic repair for a Stanford type B dissecting thoracic aortic aneurysm. The man was admitted to our hospital for persistent type IIb endoleak and an increased diameter of the aorta in its thoracic and thoracoabdominal portions. Two years previously, he had endured endoprosthetic repair of the thoracic aorta. The findings of computed tomography revealed negative dynamics manifesting as an increase in the diameter of the false channel of the arch and descending thoracic aorta with persistent type IIb endoleak. He was subjected to elimination of abdominal aortic dissection and type IIb endoleak with partial prosthetic repair of the descending thoracic portion of the aorta by means of prosthetic repair of the lower thoracic portion of the aorta between the stent graft and linear vascular Dacron prosthesis. The postoperative period was complicated by transient acute renal failure and paraparesis of the lower limbs. The patient was discharged on POD 14, with no endoleaks revealed on control computed tomography 3 months thereafter.
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http://dx.doi.org/10.33529/ANGIO2019413DOI Listing
January 2020