title: [Embolism of the aortic bifurcation and major arteries of limbs: lessons of the past and present-day trends in solving the problem concerned].
abstract: The works deals with a retrospective analysis of the medical records of the Clinic of General Surgery of the North-West State Medical University named after I.I. Mechnikov on treatment of patients presenting with embolism of the aorta and major arteries over 40 years. All in all, over the period from 1971 to 2010 a total of 3,110 patients with embolism of the aorta and major arteries underwent consultations and were operated on. To the present-day trends in surgery of embologenic arterial obstruction one should first of all refer a decrease in the number of patients with embolism of the aorta and major arteries of the limbs, which may be related to achievement in modern cardiology and cardiosurgery in treatment of patients with cardiovascular diseases - potential sources of arterial embolism. Besides, there occurred considerable changes in the structure of embologenic diseases, in favour of an increased number of people suffering from CAD, which to e certain degree modified the incidence of lesions of various vascular basins. Thus, the number of embolisms of proximal portions of the vascular bed decreased considerably. This is largely related to a decrease in the number of patients presenting with decompensated ischaemia of extremities. 86.9% of patients were subjected to emergency operations. An increased number of people with atherosclerosis of peripheral arteries required widening of indications for performing reconstructive-and-plastic operative interventions. Experience of the Clinic shows that a timely performed revascularizing operation, including a reconstructive on, application of modern methods of prevention of ischaemic syndrome, carrying out comprehensive rehabilitation measures in the postoperative period made it possible to considerably improve the immediate results of treatment. While during the first 20 years a total lethality rate amounted to 18.8% with the postoperative one equalling 17.1%, these parameters over the past 10 years were 8.8% and 6.9%, respectively.
authors.forename: M V
authors.initials: MV
authors.lastname: Mel'nikov
authors.forename: A E
authors.initials: AE
authors.lastname: Barsukov
authors.forename: A Iu
authors.initials: AIu
authors.lastname: Apresian
authors.forename: O V
authors.initials: OV
authors.lastname: Isaulov
mesh_terms: D001012:Aorta, Abdominal / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D001158:Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D003627:Data Interpretation, Statistical; D003935:Diagnostic Techniques, Cardiovascular / Q000639:trends; D017128:Embolectomy / Q000009:adverse effects / Q000379:methods / Q000639:trends; D004617:Embolism / Q000150:complications / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D005121:Extremities / Q000098:blood supply / Q000503:physiopathology; D006801:Humans; D007511:Ischemia / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data / Q000639:trends; D011183:Postoperative Complications / Q000453:epidemiology*; D012039:Regional Blood Flow; D012189:Retrospective Studies; D014463:Ultrasonography