Treatment of the new coronavirus infection (NCVI) is associated with high risks of hemorrhagic complications. This is due to the use of anticoagulants to prevent coagulopathy and thrombotic complications, which are the most frequent and severe complications of NCVI. The article presents the results of a retrospective analysis of 80 cases of spontaneous hematomas in patients with NCVI who were treated in a temporary infectious diseases hospital of the Republic of Clinical Hospital. Verification of the diagnosis was carried out using clinical data, ultrasound diagnostics, and computed tomography. The mean age of the patients was 62.4 ± 14.47 years. The most common localizations of spontaneous hematoma were: abdominal wall — 31.3%, retroperitoneal hematoma — 26.3%, chest hematoma — 16.3%, lower or upper limb — 8.8%, neck — 3.8%, combined hematomas — 5%. The number of small hematomas was 87.5%, large – 12.5%. The highest incidence of spontaneous hematomas (74%) and mortality (22%) was recorded in the group of patients receiving therapeutic doses of anticoagulants. X-ray endovascular diagnosis of the source of bleeding and its embolization was performed in 15 patients. The use of therapeutic doses in patients with NCVI is accompanied by a high risk of developing spontaneous hematomas and, as a result, increases the risk of death. X-ray endovascular embolization of spontaneous hematomas is an effective and safe method of treatment in patients with NCVI.

Mycotic (infectious) aneurysm is a rare pathology resulting from infectious destruction of the artery. Approximately 0.65-2% of aortic aneurysms in Europe are of infectious nature, in Asia this rate is higher. The most common pathogens are salmonellae (predominant in Asia) and staphylococci (predominant in European and North American patient populations) - about 40% of the total number of cultured organisms. Diagnosis is based on the clinical picture (pain, fever, sepsis), and laboratory tests include inflammatory markers. Characteristic morphological signs: baggy, sometimes multi-chambered arterial wall protrusion, perivascular edema, hematoma and/or fi brous tissue. The presence of perivascular gas and rapid aneurysm growth are pathognomonic symptoms. Currently, there is no international consensus on the optimal treatment of mycotic aneurysms, but the extremely unfavorable prognosis makes surgical treatment necessary regardless of aneurysm size. Two strategies are used - open aneurysm resection with in situ reconstruction or extraanatomic revascularization and stent-graft implantation. In both cases, prolonged antibiotic therapy is required. According to the literature, its duration should be at least 6-8 weeks, and possibly longer, up to lifelong. The main disadvantage of endovascular method is the lack of open surgical sanation of septic focus. Nevertheless, the available literature data suggest that the integral results of open surgery and X-ray endovascular techniques are comparable. It is impossible to draw statistically reliable conclusions due to the small number of observations - available clinical reports do not exceed dozens of cases. This article describes two cases of mycotic aneurysm of the infrarenal aorta. In the first case (male, 60 years old), aortic endoprosthesis was performed, followed by open sanation and drainage of retroperitoneal space and antibacterial therapy for 6 weeks (until clinical and laboratory signs of systemic infection normalized). There was no recurrence at 14 months follow-up. In the second observation (male, 62 years old), the diagnosis of mycotic aneurysm was not established. Endoprosthesis of a ruptured infrarenal aortic aneurysm was performed. Absence of massive antibiotic therapy resulted 3 months later in the manifestation of local infectious process with the development of fatal complication - aortoduodenal fistula with fatal bleeding.

Despite the widespread occurrence of ischemic diseases of the lower extremities, including atherosclerosis and diseases with an autoimmune component of their pathogenesis, the pathohistological signs of damage and concomitant chronic ischemia, compensatory tissue responses as intracellular and cellular regeneration remain out of the field of vision in researchers.OBJECTIVE:To assess the signs of damage (the extent of necrosis and apoptosis, capillary density (CD)) and regeneration (the cross-sectional muscle fiber area (CSMFA), the proportion of centrinucleated muscle fibers (CNMFs), and that of connective tissue), by using the gastrocnemius medial head biopsy specimens obtained from patients with heterogeneous forms of chronic lower limb obliterating diseases (CLLODs).SUBJECTS AND METHODS:The investigation included the biopsy specimens obtained from 44 men under 65 years of age (their mean age was 54±9.8 years) with Stage IIB-IV chronic limb ischemia (according to the A.V. Pokrovsky-Fontaine classification) with its history of at least six months. The nosological entities were atherosclerotic lesion in 33 patients (distal atherosclerosis n=13), multistage lesion (n=8), and Leriche's syndrome (n=12); autoimmune-mediated vascular injury in 11 patients (Buerger's disease (n=7) and nonspecific aortoarteritis (n=4)). The similar muscle fragments obtained during autopsy from the deceased without obvious signs of cardiovascular system diseases were examined as a control.RESULTS:It was found that there was a statistically significant difference between the nosological entities, as compared to the control in terms of CD and CSMFA (a decrease), the proportion of CNMFs and that of connective tissue (an increase). No substantial differences were found in the studied parameters between the nosological entities.CONCLUSION:The findings may suggest the universal mechanism for damage to striated muscle tissue because of circulatory hypoxia, regardless of its etiology and the common character of tissue compensatory-adaptive responses (regeneration).

Clinical and morphological data of «Neovaskulgen» therapy in patients with peripheral arterial disease were presented. Twice repeated intramuscular injections of Neovaskulgen (according to the manufacturer's instructions) were performed to 10 patients with ischemia IIb-III grade by Pokrovsky-Fontaine. Standart tredmill test, ankle-brachial index estimation were performed. Injured muscle biopsies taken before and 3 months after injection was histologically studied. Pain-free walking distance increase to 31.74% at 3 months and no limits to walk at six months were detected. There were ankle-brachial index increase to 64.7% at 6 months. In intact muscles therapy with Neovaskulgen leads to increase of mean cross-sectional muscle fiber area without significant angiogenic effect. In muscles with decreased capillary density this therapy leads to blood supply improvement promoting regeneration of muscles by myosatellites proliferation and increase of mean cross-sectional muscle fiber area and connective tissue degradation.

5000 extracranial arteries CDS protocols for the period from 2010 to 2012 were analyzed. The age ranged from 40 to 90 years old (average age 58,9±0,15 years). Among them there were 2550 men and 2450 women. 4104 patients (82,1%) had no stenotic disease, 445 (8,9%) patients had small, 329 (6,6%) moderate and 106 (2,1%) patients significant ICA stenoses. 16 (0,3%) patients had ICA occlusion. CCA IM-thickness of less than 0,1 cm had 29,7% of patients, CCA IMT 0,11-0,14 cm 50,6%; 0,15-0,19 cm had 16,9% patients, thickness of 0,2-0,24 cm had 2,5% of patients, and more than 0.25 cm CCA IMT had 0.2% of patients. There was revealed a significant positive correlation between the average thickness of CCA IMT and the degree of stenosis of the internal carotid artery (r=0,46; t=6,57; p

15 769 color duplex scanning (CDS) protocols of the extracranial arteries (8061 men, 7168 women) were analyzed. Stenosis of the internal carotid arteries of various gradations were identified in 27,3% of cases (38,0% men and 15,5% women). 2,4% of patients (3,6% of men, 0,9% women) had significant stenosis. In all age groups, except those younger than 40 and older than 80 years old, stenosis was significantly more prevalent in men. Abnormal deformation was detected in 24.5% of cases (20,1% of men, 29,9% of women; p

The aim was to elucidate impact of gene therapy with plasmid encoding vegf165 on the muscle tissue pathohistology of patients with peripheral arterial diseases. Twice repeated intramuscular injections of plasmid («Neovaskulgen», RN LP-000671 from 28.09.2011) were performed to 6 patients (ischemia grade IIb-III by Pokrovsky-Fontaine) according to specification. Standart tredmill test, ankle-brachial index estimation were performed. Histological study of injured muscle biopsies taken before and 3 months after injection was performed. In intact muscles therapy with vegf165 leads to increase of mean cross-sectional muscle fiber area without significant angiogenic effect. In muscles with decreased capillary density this therapy leads to blood supply improvement promoting regeneration of muscles by myosatellites proliferation and increase of mean cross-sectional muscle fiber area and connective tissue degradation. Treadmill test showed painless walking distance increased by 31,74% on average (from 94,96±49,79 m to 139,11±60,78 m, p

The aim was to elucidate impact of gene therapy with plasmid encoding vegf165 on the muscle tissue pathohistology of patients with peripheral arterial diseases. Twice repeated intramuscular injections of plasmid («Neovaskulgen», RN LP-000671 from 28.09.2011) were performed to 6 patients (ischemia grade IIb-III by Pokrovsky-Fontaine) according to specification. Standart tredmill test, ankle-brachial index estimation were performed. Histological study of injured muscle biopsies taken before and 3 months after injection was performed. In intact muscles therapy with vegf165 leads to increase of mean cross-sectional muscle fiber area without significant angiogenic effect. In muscles with decreased capillary density this therapy leads to blood supply improvement promoting regeneration of muscles by myosatellites proliferation and increase of mean cross-sectional muscle fiber area and connective tissue degradation. Treadmill test showed painless walking distance increased by 31,74% on average (from 94,96±49,79 m to 139,11±60,78 m, p<0,05) in all patients. There was correlation of pathohistological analysis with clinical data.

Analyzed herein are the outcomes of 1,079 reconstructions of the aortofemoral segment, performed for Leriche s syndrome using polytetrafluoroethylene grafts "Ecoflon" during the period from 1997 to 2012. Hospital lethality amounted to 3.1%, frequency of thromboses was 0.53% and that of amputations equalled 0.53%. The patients were followed up at terms varying from 6 to 180 months. Cumulative patency of the bypass grafts at 1 year amounted to 99.3±0.2%, at 5 years to 97.3±0.6%, at 10 year to 91.9±1.9%, and to 90.0±2.7% after 15 years. Primary patency amounted to 97.6±0.4%, 90.9±1.1%, 75.9±2.7% and 71.4±4.1%, respectively. Grafts infection occurred in 1.3% of cases (0.2% in the early, and 0.83% in the remote postoperative periods). False aneurysms of distal anastomoses were registered in 0.5% of cases. A total of 137 reoperations were performed (104 for graft thromboses, 9 for pseudoaneurysms of anastomoses, and 7 for graft infection). Seventeen operations were carried out for ischaemia relapse due to progression of the occluding process in patent grafts. The amputation rate amounted to 6.6%. Based on the obtained findings a conclusion is drawn that polytetrafluoroethylene grafts "Ecoflon" comply with the current standards of quality.

The aim of our work was to assess long-term results of autologous peripheral blood hematopoietic stem cell application in patients with peripheral arterial diseases. Peripheral blood hematopoietic stem cells mobilized by granulocyte colony-stimulating factor were transplanted intramuscularly to 30 patients with peripheral arterial diseases (Ilb stage by Pokrovsky). Standart tredmill test, ankle-brachial index estimation and ankle-brachial index restoration time estimation after loading were performed on 0, 3, 6, 12 and 60 months after transplantation. Immunohistochemical study of injured gastrocnemius muscle biopsies taken before peripheral blood hematopoietic stem cells transplantation and 3 months after the procedure was performed. Peripheral blood hematopoietic stem cells transplantation increases capillary density (22,4%, p = 0,0005). Ankle-brachial index increased by 18,1% on month 6 after transplantation without a tendency to change on month 12. 60 months after transplantation initial to hematopoietic stem cells transplantation ankle-brachial index rates were marked. Painless walking distance was increasing at all times of observation progressively, on month 60 no walking distance limitation was marked by most patients. Ankle-brachial index restoring time shows positive trend of the functional state of limb during the first year after transplantation, 60 months after transplantation it showed no «walking reserve» limitation in most patients. 5-years survival was 79%, death causes were stroke, cardiac pathology (3 cases), lung cancer. So, peripheral blood hematopoietic stem cells transplantation allows eliminating peripheral arterial diseases symptoms and preserving limb in long-term period. Autologous transplantation of peripheral blood hematopoietic stem cells has no complications and is safe for therapy of patients with peripheral arterial diseases II stage.

The article shows the results of using the double cassette expression plasmid vector pBud-VEGF165-FGF2 for patients with peripheral arterial diseases (PAD): 10 men with PAD experienced intramuscular injection of studied medication to the affected limb. Foe explaining the findings was used the measurement of ankle-brachial index (ABI), treadmill test, recovery period of initial ABI after pressure, immunohistochemical study. Was recorded an improvement in functional status of limbs after using treatment by 19% according to ABI, an increase in walking distance twice, reduced time to restore the original LPI by 38%. According to immune histochemical study was recorded an increase in density of capillary network up to 47.9%.

Cardiovascular diseases are the main cause of disability and mortality in developed countries. Identifying patients for primary prevention is not conducted in time today. Therefore, searching the methods that allow making a selection of patients for high-tech diagnostic methods seems to be very important. The authors conducted pathology screening of magistral arteries in an industrial organization. In total, were surveyed 991 patients of both sexes aged over 45 years (mean age — 55,6±0,16 years). As a result of screening, were identified 58 patients (5.8%) with a decrease of ankle-brachial index (ABI) (of them 42 people — 72,4% with subclinical course of disease), 7 patients (0,7%) with carotid stenosis or occlusion, and 3 patients (0,3%) with indications for coronary angiography.