Репозиторий Университета

© 2020 The Authors Congenital malformations of blood vessels, including arteriovenous malformations (AVMs), are a less common pathology, which remains one of the most diagnostically and therapeutically complex diseases for treatment. Patients with vascular abnormalities often receive an erroneous diagnosis and inadequate treatment. Depending on the abnormality, such improper treatment can lead to potential long-term functional and cosmetic consequences. Existing treatment options include surgical resection, endovascular embolization, and a combination of these methods. To date, there is no pharmacotherapy available that allows you to radically treat this pathology. Despite recent advances, AVMs are rarely cured and may require multi-stage therapy throughout life. The article presents a clinical case of successful endovascular treatment of extra-intracranial arteriovenous malformation of the frontoparietal region in a young girl with a more pronounced extracranial component of AVM on the front and frontoparietal region with cosmetic and functionally significant defect. We performed double-stage embolization of AVMs with a combination of non-adhesive liquid embolic agents with high and low viscosity. We got good angiographic, clinical and cosmetic treatment results.

AIM: To define optimal terms of surgery for acute adhesive non-strangulatory small bowel obstruction.MATERIAL AND METHODS: The analysis included 703 publications from e-LIBRARI.RU (342 works) and NCBI (361 works) databases for acute adhesive intestinal obstruction. The vast majority of articles presented retrospective analysis of single-center experience.RESULTS: It has been established that short course of medication is predominantly used for acute adhesive intestinal obstruction in the Russian Federation. International studies point 2-5 days for conservative treatment. The advantages and disadvantages of short and long courses of medication were analyzed. Therefore, multicenter, prospective, randomized trial 'Comparison of early operative treatment (12-hour medication) and long-term conservative treatment (48 hours) for acute adhesive small bowel obstruction' (COTACSO) was planned and registered (Unique Protocol ID: 14121729). The study protocol involves clinical, laboratory and instrumental exclusion of strangulation, randomization and conservative treatment of 2 groups of patients for 12 and 48 hours. Patients will undergo surgical interventions if obstruction will be present by that date. The main endpoint is mortality rate in both groups. The end of the study is December 2020.