Metastaza malignog ameloblastoma na vratu - radiološka i patohistološka dilema

Introduction. Ameloblastomas are odontogenic epithelial, locally invasive tumors of slow growth and mostly of benign behavior. Their frequency is low (they account for 1% of all head and neck tumors and about 11% of tumors of dental origin). Malignant variations of ameloblastoma are malignant ameloblastoma and ameloblastic carcinoma. They constitute less than 1% of all ameloblastomas. We presented a case of malignant ameloblastoma of the mandible with neck metastasis. Case report. A patient, aged 72, presented with the following symptoms: pain in the lower jaw, swelling in the left submandibular area and difficult mouth opening. The patient was admitted to the Department of Oral and Maxillofacial Surgery, Clinical Center of Montenegro, two months after he had noticed the symptoms. Panoramic radiography (OPG) showed that both jaws were partially toothless with terminal stage of periodontitis of the remaining teeth. Also, OPG showed sharply limited semicircular defect in the retromolar region and along the front edge of the mandible rami. Conventional histopathologic examination of the neck masses showed malignant ameloblastoma which contained central fields of squamous differentiation. Immunoreactivity of several markers was determined using immunohistochemical analyses. After these diagnostic methods a definite histopathology diagnosis was made: Ameloblastoma metastaticum in textus fibroadiposus regio colli (typus acanthomatosus). Conclusion. It is not possible to distinguish conventional, ie intraosseous, ameloblastoma from malignant ameloblastoma according to histopathologic features. It is necessary to pay special attention, especially in elderly patients, and to carry out further clinical, radiological and pathohistological diagnostic procedures, such as immunohistochemical analysis. A timely and correct diagnosis and treatment of malignant ameloblastoma require a multidisciplinary approach.Uvod. Ameloblastomi su odontogeni epitelni tumori, lokalno invazivni, sporog rasta, i u većini slučajeva pokazuju benigno ponašanje. Veoma su rijetki. Njihova učestalost je 1% u grupi tumora glave i vrata, kao i 11% kod tumora koji potiču od zubnih tkiva. Maligne varijante ameloblastoma su maligni ameloblastom i ameloblastički karcinom. Oni čine manje od 1% svih ameloblastoma. U radu je prikazan bolesnik sa malignim ameloblastomom donje vilice sa metastazom na vratu. Prikaz bolesnika. Prve subjektivne tegobe bolesnika, starog 72 godine, manifestovale su se kao bolovi u predelu donje vilice, otok u podviličnom predelu sa leve strane i otežano otvaranje usta. Bolesnik je primljen u Odeljenje oralne i maksilofacijalne hirurgije Kliničkog centra Crne Gore dva meseca nakon što je primetio prve tegobe. Ortopantomografski snimak pokazao je suptotalnu bezubost obeju vilica sa terminalnim stadijumom parodontopatije na preostalim zubima. U retromolarnoj regiji i duž prednje ivice ramusa donje vilice, uočen je jasno ograničen polukružni defekt. Biopsija promene na vratu pokazala je metastazu malignog ameloblastoma, sa prisutnim centralnim poljima skvamozne diferencijacije. Imunohistohemijskom analizom određivana je imunoreaktivnost više markera. Nakon ovih dijagnostičkih metoda postavljena je definitivna patohistološka dijagnoza: Ameloblastoma metastaticum in textus fibroadiposus regio colli (typus acanthomatosus). Zaključak. Na osnovu histopatološkog nalaza nije moguće razlikovati konvencionalni, tj. intraosealni, ameloblastom od malignog ameloblastoma. Zbog toga je potrebno obratiti posebnu pažnju, naro čito kod bolesnika starijeg životnog doba, i sprovesti sve dodatne kliničke, radiološke i histopatološke, ali i imunohistohemijske dijagnostičke procedure. Za postavljanje blagovremene i tačne dijagnoze, kao i sprovođenje adekvatnog terapijskog tretmana malignog ameloblastoma, neophodan je multidisciplinarni pristup

Novi oralni antikoagulantni lekovi kod atrijalne fibrilacije i akutnog koronarnog sindroma

After an acute coronary syndrome, patients remain at risk of recurrent ischemic events despite the use of antiplatelet therapy. In order to reduce the risk of recurrent ischemia in the treatment of patients with acute coronary syndromes, standard oral anticoagulants, such as vitamin K antagonists, have been introduced. These drugs have an important role in preventing stroke and systemic embolism in patients with atrial fibrillation. Vitamin K antagonists (e.g., warfarin) reduce the risk of recurrent cardio­vascular events and stroke but increase the risk of bleeding. In addition, the traditional anticoagulants have other significant drawbacks. Therefore, modulation of the coagulation process represents an important target in the development of new oral anticoagulants today. The new oral anticoagulants selectively target thrombin (dabigatran etexilate) or factor Xa (rivaroxaban, apixaban, edoxaban). Unlike traditional anticoagulants, these drugs have rapid onset of action and a relatively wide therapeutic range, do not require routine prothrombin time (PT) monitoring and have low potential for food and drug interaction. Dabigatran etexilate and rivaroxaban have been already approved in many countries for the prevention of stroke and systemic embolism in patients with atrial fibrillation. The third phase of clinical studies in which rivaroxaban was investigated in patients with acute coronary syndrome has been successfully completed. .Nakon akutnog koronarnog sindroma, kod bolesnika postoji povećan rizik od rekurentnih ishemičnih događaja, uprkos primeni antiagregacione terapije. U cilju smanjenja rizika od rekurentne ishemije, u terapiju visokorizičnih bolesnika sa akutnim koronarnim sindromom uvode se standardni oralni antikoagulansi, kao što su antagonisti vitamina K. Ovi lekovi imaju važnu ulogu u prevenciji moždanog udara i sistemskog embolizma kod bolesnika sa atrijalnom fibrilacijom. Antagonisti vitamina K (varfarin) smanjuju rizik od nastanka ponovnih kardiovaskularnih događaja i moždanog udara, ali povećavaju rizik od krvarenja. Pored toga, antagonisti vitamina K poseduju i druge, značajne nedostatke, tako da modulacija procesa koagulacije danas predstavlja značajnu metu za razvoj novih oralnih antikoagulanasa. Novi oralni antikoagulansi deluju selektivno na trombin (dabigatran eteksilat) ili na faktor koagulacije Xa (rivaroksaban, apiksaban, edoksaban). Za razliku od standardnih antikoagulanasa, imaju brz početak dejstva i relativno veliku terapijsku širinu, ne zahtevaju laboratorijsku kontrolu protrombinskog vremena (PT) i retko stupaju u interakcije sa hranom i lekovima. Dabigatran eteksilat i rivaroksaban su već registrovani u mnogim zemljama za prevenciju moždanog udara i sistemskog embolizma kod bolesnika sa atrijalnom fibrilacijom. Treća faza kliničke studije u okviru koje je ispitivan rivaroksaban kod bolesnika sa akutnim koronarnim sindromom uspešno je završena.

Novi antikoagulantni lekovi

Anticoagulants are effective agents for the prevention and treatment of thrombosis and thromboembolic complications, which represent a common cause of morbidity and mortality. Despite their clinical efficiency, traditional anticoagulants are all associated with significant drawbacks. As a result, modulation of the coagulation process represents an important target in the development of new oral and parenteral anticoagulants today. The new oral anticoagulants selectively target thrombin (ximelagatran, dabigatran etexilate) or factor Xa (rivaroxaban, apixaban, edoxaban). Unlike the traditional anticoagulants, vitamin K antagonists, these drugs have rapid onset of action and a relatively wide therapeutic range, do not require routine prothrombin time (PT) monitoring and have low potential for food and drug interaction. The new parenteral anticoagulants achieve their effects through indirect (semuloparin, idrabiotaparinux) or direct inhibition of factor Xa (otamixaban), as well as through inhibition of coagulation factor IXa (RB006). The main characteristics of these agents are a rapid onset of action and a predictable anticoagulant effect, whereby the most of them can be rapidly neutralized by an adequate antidote.Antikoagulantni lekovi su delotvorni u prevenciji i lečenju tromboze i tromboembolijskih komplikacija, koje su čest uzrok morbiditeta i mortaliteta. Ipak, uprkos kliničkoj delotvornosti, standardni antikoagulansi poseduju značajne nedostatke. Zbog toga, modulacija procesa koagulacije danas predstavlja značajnu metu za razvoj novih, oralnih i parenteralnih, antikoagulanasa. Novi oralni antikoagulansi deluju selektivno na trombin (ksimelagatran, dabigatran eteksilat) ili na faktor koagulacije Xa (rivaroksaban, apiksaban, edoksaban). Za razliku od standardnih antikoagulanasa, antagonista vitamina K, imaju brz početak dejstva i relativno veliku terapijsku širinu, ne zahtevaju laboratorijsku kontrolu protrombinskog vremena (PT), i retko stupaju u interakcije sa hranom i lekovima. Novi parenteralni antikoagulansi svoje antikoagulantno dejstvo ostvaruju indirektnom (semuloparin, idrabiotaparinuks) ili direktnom inhibicijom faktora Xa (otamiksaban), kao i inhibicijom faktora koagulacije IXa (RB006). Glavne karakteristike ovih lekova su brz početak dejstva i predvidljiv antikoagulantni efekat, a kod većine je moguće postići brzu neutralizaciju adekvatnim antidotom

Direktni oralni antikoagulantni lekovi u profilaksi i terapiji tromboembolijskih bolesti

More than 50 years ago, vitamin K antagonists were the only available oral anticoagulants. Since their application involves a number of limitations, it was necessary to develop new oral anticoagulant drugs and introduce them into clinical practice. These drugs have many advantages over vitamin K antagonists, including rapid onset/offset, a small number of interactions with other drugs and food, simplified dosing and predictable pharmacokinetics, eliminating the need for daily laboratory monitoring. In addition, new oral anticoagulant drugs act selectively on a single coagulation factor. Currently, the following drugs are approved for use: direct thrombin inhibitor, dabigatran etexilate, direct factor Xa inhibitor, rivaroxaban, apixaban and edoxaban. Dabigatran etexilate and apixaban are approved for the primary prevention of venous thromboembolism in adult patients undergoing elective surgery of total hip or knee replacement, while in addition to these anticoagulants edoxaban is approved for the prevention of stroke and systemic embolism in adult patients with non-valvular atrial fibrillation. For the treatment and prevention of recurrent deep vein thrombosis dabigatran etexilate, rivaroxaban and edoxaban are approved. In addition, rivaroxaban is approved for the secondary prevention of atherothrombotic events in patients with acute coronary syndrome.Više od 50 godina, antagonisti vitamina K bili su jedini dostupni oralni antikoagulantni lekovi. S obzirom na to da njihova primena podrazumeva brojna ograničenja, bilo je neophodno razviti i uvesti u kliničku praksu nove oralne antikoagulantne lekove. Ovi lekovi imaju brojne prednosti u poređenju s antagonistima vitamina K, koje uključuju brz početak i prestanak dejstva, mali broj interakcija s drugim lekovima i hranom, pojednostavljen način doziranja, kao i predvidivu farmakokinetiku, čime se eliminiše potreba za svakodnevnim laboratorijskim praćenjem. Osim toga, novi oralni antikoagulantni lekovi deluju selektivno samo na jedan faktor koagulacije. Trenutno su odobreni za upotrebu direktni inhibitor trombina, dabigatran eteksilat, kao i direktni inhibitori faktora Xa, rivaroksaban, edoksaban i apiksaban. Dabigatran eteksilat i apiksaban odobreni su za primarnu prevenciju venske tromboembolije kod odraslih pacijenata koji se podvrgavaju elektivnom hirurškom zahvatu totalne zamene kuka ili kolena, dok je za prevenciju moždanog udara i sistemske embolije kod odraslih pacijenata sa nevalvularnom atrijalnom fibrilacijom, pored navedenih antikoagulantnih lekova, odobren i edoksaban. Za terapiju i prevenciju rekurentne duboke venske tromboze odobreni su dabigatran eteksilat, rivaroksaban i edoksaban. Osim toga, rivaroksaban je odobren i za sekundarnu prevenciju aterotrombotičkih događaja nakon akutnog koronarnog sindroma

Mechanisms of endothelium-dependent vasorelaxation induced by procyanidin B2 in venous bypass graft

Cardioprotective abilities of procyanidins, might, at least in part, attribute to their vasodilator properties. The present study was undertaken to assess the vasorelaxant effect of procyanidin B2 on isolated human saphenous vein (HSV) and its underlying mechanisms. Procyanidin B2 relaxed phenylephrine-induced contraction of HSV rings in concentration-dependent manner. The relaxation was dependent on the presence of endothelium and was strongly affected by l-NAME, hydroxocobalamin or ODQ, the inhibitors of NO/cGMP pathway. Indomethacin significantly affected only the relaxation produced by the highest concentrations of procyanidin B2. Apamin and TRAM-34 combination, in the presence of l-NAME and indomethacin, did not additionally decreased procyanidin B2-induced relaxation. In the presence of K+ channel blockers, relaxation induced by procyanidin B2 was partially attenuated by 4-aminopyridine, significantly inhibited by glibenclamide and almost abolished by iberiotoxin. Procyanidin B2 also relaxed the contractions induced by phenylephrine or caffeine in Ca2+-free solution. Finally, nifedipine slightly, while thapsigargin strongly antagonized HSV relaxation. Our results indicate that procyanidin B2 induces endothelium-dependent relaxation of HSV, which results primarily from stimulation of NO production, as well K+ channels opening, especially BKCa, and partially KATP and KV. Regulation of the intracellular Ca2+ release and inhibition of Ca2+ influx probably cont

Tromboliza okludiranog femoropoplitealnog grafta lokalno primenjenim humanim plazminom

Introduction Acute lower limb ischemia results from thrombosis or embolization of diseased native artery or previously implanted bypass graft. When this occurs, several options are available to restore blood flow: catheter-directed thrombolysis, mechanical thrombectomy or open surgery. Fundamental reasons to apply percutaneous interventions are avoiding open procedures in high risk patients, and avoiding difficult dissection through scar tissue. Case Outline A 67-year-old male was admitted at our Institution for critical limb ischemia. After performed angiography the diagnosis of occluded femoropopliteal graft was established. Occlusion was resolved by catheter-directed thrombolysis with plasmin. Culprit lesions were treated by angioplasty. Conclusion Our patient underwent a successful thrombolysis of occluded femoropopliteal graft with locally-delivered human plasmin.Uvod Ishemija donjih ekstremiteta je posledica tromboze ili embolizacije obolele nativne arterije ili implantiranog grafta. Postoji nekoliko načina lečenja ishemije: tromboliza kateterom, mehanička trombektomija i hirurško lečenje. Osnovni razlozi za primenu perkutanih intervencija jeste izbegavanje klasičnog hirurškog lečenja kod bolesnika s visokim rizikom, kao i izbegavanje preparisanja krvnog suda u ožiljku. Prikaz bolesnika Muškarac star 67 godina primljen je u bolnicu zbog kritične ishemije donjih ekstremiteta. Po učinjenoj angiografiji dijagnostikovana je tromboza femoropoplitealnog grafta. Okluzija je rešena primenom plazmina uz upotrebu intraarterijskog katetera. Stenoze koje su otkrivene posle trombolize lečene su angioplastikom. Zaključak Trombolizom uz primenu plazmina i intraarterijskog katetera uspešno je izlečena okluzija femoropoplitealnog grafta

Novi lekovi u terapiji dislipidemija

Dyslipidemia is the leading risk factor for the development of atherosclerosis and associated consequences, such as coronary heart disease, ischemic cerebrovascular and peripheral vascular disease. These diseases are the major cause of mortality in the world and in Europe as well, where they are responsible for around 45% of all deaths. Treatment of dyslipidemia includes the use of statins, ezetimibe, fibrates, niacin, bile acids sequestrants and omega-3 fatty acids. Although statins play the major role in dyslipidemia treatment by reducing the risk of cardiovascular (CV) events by 30%, there is a need for additional new drugs that reduce the residual risk even more. PCSK9 inhibitors, apolipoprotein B (apoB) synthesis inhibitors, MTP inhibitors and CETP inhibitors are already approved for the specific indications, or are in the advanced stages of clinical investigation. Two PCSK9 inhibitors, alirocumab and evolocumab are approved for use in combination with statins for the treatment of heterozygous familial hypercholesterolemia (FH), but also in patients with clinical atherosclerotic CV diseases who require additional low-density lipoprotein cholesterol (LDL-C) level reduction. In addition, evolocumab is approved for use in patients with homozygous FH. Mipomersen, apoB synthesis inhibitor, lomitapide, and oral MTP inhibitor are currently approved in the treatment of patients with homozygous FH as an adjunct to the maximum tolerated doses of statins and other lipid-lowering drugs. Although the new lipid-lowering agents produce significant LDL-C level reduction, more clinical studies are necessary to confirm their efficacy and safety in dyslipidemia treatment.Dislipidemije su vodeći faktor rizika za razvoj ateroskleroze i njenih posledica, kao što su koronarna bolest srca, ishemična cerebrovaskularna i periferna vaskularna bolest. Ove bolesti su glavni uzrok mortaliteta, kako u svetu tako i u Evropi, gde su odgovorne za 45% ukupne smrtnosti. Terapija dislipidemija uključuje primenu: statina, ezetimiba, fibrata, niacina, smola koje vezuju žučne kiseline i omega-3 masnih kiselina. Od pomenutih lekova, vodeću ulogu u terapiji dislipidemija imaju statini. Treba istaći da uprkos primeni statina, koji redukuju rizik od pojave kardiovaskularnih (KV) događaja za oko 30%, još uvek ostaje tzv. rezidualni rizik za nastanak KV događaja, što ukazuje da su potrebni novi lekovi koji će dalje redukovati rezidualni rizik. Novi lekovi u terapiji dislipidemija uključuju PCSK9 inhibitore, inhibitore sinteze apolipoproteina B (apoB), MTP inhibitore i CETP inhibitore, koji su ili već odobreni za primenu u određenim indikacijama, ili se nalaze u odmaklim fazama kliničkog ispitivanja. Alirokumab i evolokumab, dva PCSK9 inhibitora, odobrena su za primenu, u kombinaciji sa statinima, u terapiji heterozigotne familijarne hiperholesterolemije (FH), kao i kod bolesnika sa kliničkim aterosklerotičnim KV bolestima koji zahtevaju dodatnu redukciju nivoa lipoproteina male gustine (low-density lipoprotein cholesterol, LDL-C). Pored toga, evolokumab je odobren za primenu kod bolesnika sa homozigotnom FH. Mipomersen, inhibitor sinteze apoB, i lomitapid, oralni MTP inhibitor, su, odobreni za primenu samo kod bolesnika sa homozigotnom FH kao dodatak maksimalnoj tolerišućoj dozi statina i drugih hipolipemika. Iako novi hipolipemici značajno redukuju nivo LDL-C, neophodno je sprovesti studije, duže i sa većim brojem ispitanika, koje će potvrditi njihovu efikasnost i bezbednost i time omogućiti njihovu širu primenu u terapiji dislipidemija

Mehanizam vazorelaksacije humane vene safene izazvane procijanidinom B2

Findings from epidemiological studies indicate that polyphenols, widespread in human diet and with numerous biological activities, act cardioprotectively. Procyanidins are subclass of polyphenols with high content in commonly consumed foods and beverages, such as grapes, tea, chocolate, nuts and apples. Cardioprotective abilities of procyanidins, might, at least partly, attribute to their vasodilator properties. Since exact mechanisms of procyanidin B2-induced vasorelaxation are unknown, our study aimed to investigate relaxant effect of procyanidin B2 on isolated human saphenous vein (HSV) and its underlying mechanisms. Discarded segments of HSV were collected from patients undergoing bypass surgery and studied in organ baths. Procyanidin B2 caused concentration-dependent relaxation of HSV precontracted by phenylephrine. The relaxation was strongly affected by inhibitors of NO/cGMP pathway, L-NAME, hydroxocobalamin and ODQ. Indomethacin, a cyclooxygenase inhibitor, significantly reduced only relaxation produced by the highest concentrations of procyanidin B2. Combination of apamin and TRAM-34, selective blockers of small- and intermediate-conductance Ca 2+ -activated K+ (KCa ) channels (SKCa and IK Ca ), in the presence of L-NAME and indomethacin, did not additionally affect procyanidin B2-induced relaxation. Additionally, relaxation induced by procyanidin B2 was partially attenuated by 4- aminopyridine, predominant blocker of voltage-gated K+ (KV) channels, significantly inhibited by glibenclamide, selective ATP-sensitive K+ (KATP) channels inhibitor, and almost abolished by iberiotoxin, highly selective blocker of large-conductance KCa (BKCa ). Our results revealed that procyanidin B2 acts as a potent vasodilator on isolated human venous graft. Mechanism of this relaxation of HSV probably involves stimulation of NO production, as well K+ channels opening, especially BK Ca , and partially KATP and KVNalazi epidemioloških studija ukazuju da polifenoli, široko rasprostranjeni u ljudskoj ishrani i sa brojnim biološkim aktivnostima, deluju kardioprotektivno. Procijanidini su podklasa polifenola sa visokim sadržajem u često konzumiranoj hrani i pićima, kao što su grožđe, čaj, čokolada, orašasti plodovi i jabuke. Kardioprotektivno delovanje procijanidina može se, bar delimično, pripisati njihovim vazodilatatornim svojstvima. S obzirom da tačni mehanizmi pomoću kojih procijanidin B2 izaziva vazorelaksaciju nisu poznati, cilj naše studije bio je da istražimo relaksantni efekat procijanidina B2 na izolovanoj humanoj veni safeni (HSV) i njegove osnovne mehanizme.Neiskorišćeni segmenti HSV su uzimani od pacijenata u toku bajpas operacija i ispitivani u kupatilu za izolovane organe. Procijanidin B2 izazvao je koncentracijski-zavisnu relaksaciju HSV prekontrahovane fenilefrinom. Na relaksaciju su snažno uticali inhibitori NO/cGMP puta, L-NAME, hidroksokobalamin i ODQ. Indometacin, inhibitor ciklooksigenaze, značajno je umanjio samo relaksaciju izazivanu najvećim koncentracijama procijanidina B2. Kombinacija apamina i TRAM-34, selektivnih blokatora Ca 2+ -zavisnih K+ (KCa ) kanala male i srednje provodljivosti (SKCa i IK Ca ), u prisustvu L-NAME i indometacina, nije dodatno uticala na relaksaciju uzrokovanu procijanidinom B2. Osim toga, procijanidinom B2 izazvana relaksacija bila je delimično umanjena 4- aminopiridinom, dominantnim blokatorom voltažno-zavisnih K+ (KV) kanala, značajno inhibirana glibenklamidom, selektivnim inhibitorom ATP-zavisnih K+ (KATP) kanala, i skoro potpuno blokirana iberiotoksinom, selektivnim blokatorom K Ca velike provodljivosti (BK Ca). Naši rezultati pokazuju da procijanidin B2 deluje kao moćni vazodilatator na izolovanom humanom venskom graftu. Mehanizam ove relaksacije HSV verovatno uključuje stimulaciju proizvodnje NO, kao i otvaranje K+ kanala, posebno BK Ca , i delimično KATP i KVVIII Kongres farmaceuta Srbije sa međunarodnim učešćem, 12-15.10.2022. Beogra

Nicorandil directly and cyclic GMP-dependently opens K+ channels in human bypass grafts

As we previously demonstrated the role of different K+ channels in the action of nicorandil on human saphenous vein (HSV) and human internal mammary artery (HIMA), this study aimed to analyse the contribution of the cGMP pathway in nicorandil-induced vasorelaxation and to determine the involvement of cGMP in the K+ channel-activating effect of nicorandil. An inhibitor of soluble guanylate cyclase (GC), ODQ, significantly inhibited nicorandil-induced relaxation, while ODQ plus glibenclamide, a selective ATP-sensitive K+ (KATP) channel inhibitor, produced a further inhibition of both vessels. In HSV, ODQ in combination with 4-aminopyridine, a blocker of voltage-gated K+ (K-V) channels, did not modify the concentration-response to nicorandil compared with ODQ, whereas in HIMA, ODQ plus iberiotoxin, a selective blocker of large-conductance Ca2+-activated K+ (BKCa) channels, produced greater inhibition than ODQ alone. We showed that the cGMP pathway plays a significant role in the vasorelaxant effect of nicorandil on HSV and HIMA. It seems that nicorandil directly opens KATP channels in both vessels and BKCa channels in HIMA, although it is possible that stimulation of GC contributes to KATP channels activation in HIMA. Contrary, the activation of K-V channels in HSV is probably due to GC activation and increased levels of cGMP

Significance and specificity of vascular anastomosis in liver transplantation: Our experience

Introduction Transplantation is the method of choice in the treatment of terminal liver diseases with acute and structural damage of liver tissue and congenital liver diseases. Objective The aim of our study was to determine specificity and significance of vascular anastomosis in liver transplantation by postoperative evaluation of vascular anastomosis function. Method The study included 16 patients with 16 liver transplantations and one re-do liver transplantation. In all patients, preoperative angiography and postoperative duplex sonographic and angiographic evaluation of vascular anastomosis were performed. Results Preoperative angiographic evaluation did not reveal anomalies in liver blood vessels of transplant candidates. In one patient, we identified and angiographically confirmed stenosis on anastomosis of the hepatic artery on the 7th postoperative day. In another patient, we had artificial thrombosis of the hepatic artery branch due to the liver biopsy. Conclusion The successful performance of vascular anastomosis in liver transplantation is significant for adequate liver graft perfusion, good postoperative graft function and overall outcome of the liver transplantation