Pages: 58 - 64
Authors: Zayniddin N., Bakhriddinov F.
Abstract: The study of problem shows that for today such aspects as clinical picture, diagnosis, methods of surgical treatment and their consequences in the difficult localization of vascular injuries (aneurisms and fistulas) have been studied insufficiently well. We performed 45 surgeries in patients with TAA and TAVF. Of them 28 (62,2%) patients with TAA; 17 (37,7%) patients with TAVF. Before their admission to our center they were performed primary surgical debridement (PSD) of the wounds in the regional hospitals. The examination of the patients showed that there was not kept up alertness in relation to injuries of the main vessels; activity of surgical tactics in treatment of bleedings; in performance of more careful revision of the wound canal in order to achieve complete hemostasis. In each concrete case the tactics of surgical treatment depends on, first of all, the accuracy of preoperative diagnosis including data of angiography, multispiral computed tomography (MSCT). On the basis of data obtained there was reliably revealed localization of fistulas and aneurisms, their types, forms, anatomic and technical conditions for carrying out various kinds of vessel reconstructions. The surgeon need in improvement of the knowledge and experience of liquidation of complex difficult for access of the injuries of vessels as well as special learning for performance of surgical restoration or reconstruction of the vascular injury consequences. The purpose of this article is diagnosis and optimization of the surgical treatment of TAA, TAVF in difficult to access localization
Keywords: vascular injury, traumatic arterial aneurysm (TTA), traumatic arterio–venous fistula (TAVF), difficult localization, diagnosis, surgery.
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