Artificial intelligence in medicine: history, current status and future directions of research , A.V. Svetlikov, , O.О. Khudozhnikova, , V.S. Gurevich, , , A.V. Kebriakov, , , V.A. Ratnikov, , P.P. Yablonskii, , V.M. Melnikov, , , P.K. Yablonskiy, and Angiologiya I Sosudistaya Khirurgiya, 2025 The article is devoted to the use of artificial intelligence in medicine. The advantages, disadvantages, and prospects of its application, including in robotic surgery, are outlined. An excursion into the history of the origin and formation of artificial intelligence is also made.
Pseudoaneurysm temporary embolization as a new method for the management of catheter-related complication Temirlan Kh. Gamzatov, Aleksei V. Kebriakov, Alexei V. Svetlikov, Viktor A. Kashchenko, Vyacheslav A. Ratnikov, Victor S. Gurevich Journal of Vascular Surgery Cases Innovations and Techniques, 2023 A new minimally invasive method for the management of catheter-related pseudoaneurysms (PSAs) using percutaneous temporary guidewire embolization (TGE) is presented. We performed percutaneous insertion of a flexible 0.018-in. guidewire into the PSA cavity under ultrasound guidance. Once thrombosis of the PSA cavity was achieved, the guidewire was removed. In all seven cases, TGE was technically feasible and achieved complete thrombosis of the PSA. The time required for PSA thrombosis from insertion to removal of the guidewire ranged from 5 to 40 minutes. TGE is a highly effective, safe, and minimally invasive treatment of PSA.
Surgical tactics of treatment for chronic ischemia in patients with atherosclerotic lesions of the deep femoral artery and occlusion of the superficial femoral artery , A.V. Svetlikov, , T.Kh. Gamzatov, , A.V. Kebryakov, , A.V. Tishkov, , N.B. Margaryants, , I.E. Khardikov, , P.A. Galkin, , A.S. Shapovalov, , S.V. Lukin, , V.M. Melnikov, , G.G. Khubulava, , V.A. Kashchenko, , , V.A. Ratnikov, , , V.S. Gurevich, , , and Angiologiia I Sosudistaia Khirurgiia Angiology and Vascular Surgery, 2023 OBJECTIVE: The purpose of the study was to determine the tactics of surgical treatment of patients with lower limb ischemia and a hemodynamically significant lesion of the deep femoral artery and occlusion of the superficial femoral artery. PATIENTS AND METHODS: The study is based on the retrospective results of examination and treatment of 99 patients suffering from chronic arterial insufficiency of the lower extremities. Of these, 31 (31.3%) patients had trophic ulcers and/or necrosis corresponding to categories 5 and 6 of chronic arterial insufficiency according to the R. Rutherford classification. All patients had occlusion of the superficial femoral artery and a hemodynamically significant stenosis of the common femoral artery, involving the deep femoral artery. 50 (50.5%) patients had hemodynamically significant impairment of the patency of ipsilateral iliac arteries. Revascularization of the limb was in all cases performed through the deep femoral artery by open or endovascular restoration of patency of the common femoral artery and the deep femoral artery. In the case of a hemodynamically significant lesion of the iliac artery, the operation was supplemented by its stenting. A new modified method - flow-guided femoroprofundoplasty - was performed in 28 (28%) patients. Therapeutic outcomes were evaluated during hospitalization, in the early postoperative period (1 month after surgery) and in the late postoperative period (from 6 months to 5 years). RESULTS: In the early postoperative period, complications developed in 11 (11%) patients, including 1 (1%) death. 91 (93%) patients had clinical improvement in the postoperative period, with regression of trophic disorders observed in 26 (84%) out of 31 patients. The five-year patency of the operated segment was 97%, with the limb-salvage and survival rates amounting to 100% and 76.9%, respectively. A predictor of effective revascularization through the deep femoral artery for critical lower limb ischemia turned out to be the presence of a patent recipient zone (p<0.001). CONCLUSION: The results obtained indicate high efficiency of limb revascularization through the deep femoral artery. We do not recommend performing revascularization operations through the deep femoral artery in the absence of a recipient zone, as well as in the presence of trophic disorders corresponding to the 6th category of chronic arterial insufficiency according to R. Rutherford.
Successful isolated limb revascularization through the deep femoral artery in a patient with a high risk of amputation (case report) , T.Kh. Gamzatov, A.V. Kebryakov, , A.V. Svetlikov, , , V.A. Kashchenko, , , V.A. Ratnikov, , , V.S. Gurevich, , and Angiologiya I Sosudistaya Khirurgiya, 2023 This clinical case demonstrates an example of successful isolated repeat revascularization of the deep femoral artery using surgical and endovascular methods in a patient with rapidly progressive atherosclerosis and renal failure. Multiple attempts at direct revascularization for critical limb ischemia of the collateral lower limb for less than 2 years had resulted in amputation at the level of the thigh. With the development of critical ischemia of the contralateral limb, the tactics of indirect restoration of blood flow through the deep femoral artery made it possible to achieve regression of critical ischemia and save the limb. We consider it expedient to perform surgical treatment in patients with widespread atherosclerotic lesions of the distal segment, starting with isolated revascularization of the limb through the deep femoral artery.
Staged surgical treatment (laparoscopic and endovascular) of a patient with extravasal compression and atherosclerotic stenosis of the celiac trunk , M.K. Moiseev, T.Kh. Gamzatov, , A.V. Lodygin, , , A.V. Svetlikov, , , V.A. Ratnikov, , , V.S. Gurevich, , , , V.A. Kashchenko, , , A.V. Kebryakov, and Angiologiya I Sosudistaya Khirurgiya, 2023 We herein report a clinical case concerning successful staged (laparoscopic and endovascular) treatment of an elderly patient with tandem celiac trunk stenosis due to extravasal compression (Dunbar syndrome) and atherosclerotic lesion. A 65-year-old male patient was admitted to the Angiosurgical Department in July 2019 with complaints of episodes of loss of consciousness occurring after meals, lasting up to a minute and followed by a spontaneous complete recovery. On examination (ultrasound duplex scanning of the iliac trunk, MSCT angiography of the thoracic and abdominal aorta), he was diagnosed as having a hemodynamically significant stenosis (up to 80%) of the ostial segment of the celiac trunk caused by compression of the median arcuate ligament of the diaphragm, as well as an atherosclerotic lesion of the ostium of the celiac trunk (up to 70%). A decision was made to perform two-stage surgical treatment - laparoscopic decompression of the celiac trunk by dissection of the arcuate ligament, followed by delayed stenting of the celiac trunk in the area of the atherosclerotic lesion, with a positive clinical effect obtained in the form of complete relief of symptoms. Four years later, the patient's control examination revealed asymptomatic in-stent restenosis (up to 60%) managed by endovascular angioplasty with a drug-coated balloon catheter. In the presented clinical case, staged minimally invasive treatment (laparoscopic and endovascular) made it possible to avoid traumatic surgical procedures (laparotomy, direct dissection of the arcuate ligament of the diaphragm, and direct endarterectomy of the celiac trunk with patch plasty), hence decreasing the risks of intra- and postoperative complications and contributing to the reduction of rehabilitation time and rapid return of the patient to his usual way of life.
Surgical Treatment of Hypoplastic Common Femoral Vein T.Kh. Gamzatov, A.V. Kebryakov, O.A. Payvin, A.V. Svetlikov Flebologiya, 2022 <h3></h3> В статье представлено клиническое наблюдение хирургического лечения врожденной гипоплазии общей бедренной вены. У пациентки эта патология длительное время протекала под видом вторничного расширения подкожных вен в бассейне большой подкожной вены с начальными проявлениями хронической венозной недостаточности. Операция, выполненная в другом лечебном учреждении по поводу варикозного расширения вен, значительно ухудшила симптоматику венозной недостаточности, существенно снизив качество жизни. Оперировавший хирург самостоятельно не проводил дуплексное сканирование вен перед операцией, ориентируясь на ранее проведенное исследование специалистом ультразвуковой диагностики. Было произведено протезирование общей бедренной вены аутовенозным кондуитом с регрессом симптомов венозной недостаточности. Представленное клиническое наблюдение демонстрирует важность включения в программу предоперационной подготовки дуплексного сканирования, реализованным опытным специалистом, предпочтительно лечащим врачом.
