Online ISSN: 2515-8260

Keywords : comorbid pathology

Vascular Brain Malformations In Combination With Extracranial Brachiocephalic Artery Lesions

Aleksey Khripun; Aleksandr Pryamikov; Aleksey Mironkov; Sarkis Asratyan; Viktor Suryakhin; Ruslan Loluev; Lyubov Gulina

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 5, Pages 206-213

One of the unresolved problems in vascular surgery and neurosurgery is the
internal carotid artery ex tra and intracranial segments combined lesion, namely the
combination of the arterial aneurysm or vascular brain malformation with extracranial
brachiocephalic arteries lesions. Currently, there are no clear tactical approaches and
recommendations for the brachiocephalic arteries' comorbid pathology treatment. This
article show s the treatment experience of 55 patients with combined lesions of the internal
carotid artery intra and extracranial pool: a combination of the intracranial aneurysm or
vascular br ain malformation with brachiocephalic arteries stenotic lesions or
asymptomatic internal carotid artery pathological deformation at the cervical level.
Clinical cases were accumulated over 6 years (from 2013 to 2019). The incidence of
comorbid pathology wa s 3.5%. The bigger part of brain vascular malformations (53 of 55
patients or 96%) were asymptomatic. The majority of patients with comorbidity were
women 69% or 38 patients )). Surgical activity among the target group of patients was 40%,
22 o f 55 patients were operated on. Repeated ischemic stroke after asymptomatic internal
carotid artery stenting was beared by one patient (4.5%) in the early postoperative period.
Most aneurysms in the first group were localized in the anterior sections of the W illis circ le
(81% versus 11%, p <0.001), saccular aneurysms prevailed (41 patients or 95%). There is an
existing necessity of accumulation brachiocephalic vascular pool comorbid pathology
surgical treatment experience and major studies conduction that should help in the
development of therapeutic algorithms and optimization of surgical tactics for the
brachiocephalic pool combined vascular pathology.

Experience In The Treatment Of The Elderly And Additional Patients With Fractures Of The Femoral Neck With Account Of Comorbidal Pathology

Valiev Erkin Yuldashevich; Valiev Odil Erkinovich; Azizov Abror Mirxakimovich; Tilyakov Hasan Azizovich

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 7, Pages 5170-5179

Damage to the bone structures in the area of the hip joint refers to severe injuries of the musculoskeletal system for the elderly and senile, usually leading to an unfavorable outcome. One of the important problems of geriatric practice is comorbidity, which affects the prognosis for life, increases the likelihood of death.The aim of the work was to study the factors influencing the choice of tactics and methods of treatment of fractures of the femoral neck in elderly and senile people, taking into account the level and severity of comorbid pathology. The analysis of the incidence and level of comorbidity in 201 patients with fractures of the femoral neck was carried out, the mean age was 71.4 ± 7.1 g. The results of evaluating the comorbidity indices revealed its high rates, for example, the Charleston index averaged 9.12 ± 1.05 points, the CIRS index was 16.2 ± 3.9 points. The main contingent of treated patients - 147 (73.1%) - were people with a high level of physical activity.