WAYS OF IMPROVEMENT OF LOOP ENDARTERECTOMY RESULTS FROM ILIAC-FEMORAL SEGMENT

The article presents an analysis of treatment results of 91 patients with iliac-femoral segment artery occlusion at the period from 2008 to 2014. Patients were divided into 2 groups: main group (n=30) consisted of patients who undergoing a half-closed loop endarterectomy with following implantation of stent-grafts in this area and control group (n=61) had patients whom were performed routine half-closed loop endarterectomy. The II degree of ischemia of lower extremities was in 88 (96,7%) patients and III degree had 3 (3,3%) patients. The areas of abnormalities of intravascular pattern were detected in 100% of cases in intraoperative angiography. They were modified using stent-grafts. A primary vascular patency was 100% in the first group and it numbered 65% in the second group during 5 years. The intraoperative angiography control with stent-graft implantation to the area of endarterectomy allowed reliable improvement of treatment results

ENDOVASCULAR ABDOMINAL AORTIC ANEURISM REPAIR

The authors analyzed the single-center experience of treatment of 72 patients with abdominal aortic aneurisms and severe accompanied pathology. The aneurisms were repaired by stentgrafts. All the patients had abdominal aortic aneurisms with the diameters from 41 to 84 mm against the background of severe somatic pathology. It was a contraindication to planned open surgery. An installation of stent-graft was successful in all 72 follow-ups. It wasn’t necessary to use a conversion to open surgery. The follow-up period consisted of 44,6±2,1 months. Control ultrasound and computer tomography studies hadn’t revealed an increase of aneurism sack sizes or «leakages». A reduction of abdominal aortic aneurism sizes was noted in 37 patients on 4-5% during first year after operation. The stentgraft implantation extends the possibilities of abdominal aortic aneurism treatment for patients from a high surgical risk group

Digital Twins for Precision Healthcare

Precision healthcare is an emerging concept that will see technology-driven digital transformation of the health service. It enables customised patient outcomes via the development of novel, targeted medical approaches with a focus on intelligent, data-centric smart healthcare models. Currently, precision healthcare is seen as a challenging model to apply due to the complexity of the healthcare ecosystem, which is a multi-level and multifaceted environment with high real-time interactions among disciplines, practitioners, patients and discrete computer systems. Digital Twins (DT) pairs individual physical artefacts with digital models reflecting their status in real-time. Creating a live-model for healthcare services introduces new opportunities for patient care including better risk assessment and evaluation without disturbing daily activities. In this article, to address design and management in this complexity, we examine recent work in Digital Twins (DT) to investigate the goals of precision healthcare at a patient and healthcare system levels. We further discuss the role of DT to achieve precision healthcare, proposed frameworks, the value of active participation and continuous monitoring, and the cyber-security challenges and ethical implications for this emerging paradigm