Przemyslaw Nowakowski

Polsko Amerykańskie Kliniki Serca · Vascular Surgery Chrzanow

Background: This multicenter retrospective study with a control group was designed to assess the influence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on the outcomes of patients with myocardial infarction (MI). Methods: A total of 129 patients with COVID-19 who were treated for MI were included in this study. The c...

A case of a 64‐year‐old patient who was referred to interventional cardiology unit in order to qualify her to mitral valve repair is presented. Transthoracic echocardiography revealed a giant inferior wall basal aneurysm of the left ventricle (44 mm × 31 mm, 57 ml) and coronary angiography revealed chronic total occlusion of the proximal right coro...

The aim of the BIOPAC trial was to determine long-term safety and efficacy of a novel microcrystalline paclitaxel-coated balloon (mcPCB) with a biocompatible polymer as an excipient in the treatment of occlusive femoropopliteal lesions. In this first-in-human prospective controlled randomized trial, 66 patients with femoropopliteal, symptomatic (Ru...

An Arnold-Chiari malformation is a congenital central nervous system defect. Raised intracranial pressure is commonly observed, and posterior decompression neurosurgery is the treatment of choice. We describe a patient with iatrogenic occlusion of bilateral jugular veins, subclavian vein, and superior vena cava resulting from repeated central venou...

Introduction: The population of patients with lower limb atherosclerosis includes a considerable proportion of individuals with long superficial femoral artery (SFA) lesions. Chronic total occlusions (CTOs) represent the "last frontier" of percutaneous interventions. While open strategies are considered earlier as standard management for these les...

Introduction: Constant technological progress in the field of carotid stenting translates into improved short- and long-term results of endovascular treatment. The introduction of a new generation, self-expanding, open-cell stent has provided a new treatment option in endovascular management of carotid stenosis. Aim: To evaluate 30-day and 1-yea...

Objective: The aim of this study was to investigate the clinical relevance of bilateral peripheral arterial disease (PAD) patterns. Background: No prior study has evaluated the clinical significance of symmetrical lesion patterns, particularly the coexistence of same-level significant plaques in both lower extremities ("mirror lesions"). Method...

Purpose: To evaluate the safety and efficacy of the Serranator Alto PTA Serration Balloon Catheter in subjects with peripheral artery disease in the superficial femoral and popliteal arteries. Materials and methods: A prospective, multicenter, single-arm feasibility study enrolled 25 patients (mean age 66 years; 18 men) to evaluate Serranator in...

Objectives: Low-invasive endovenous thermal ablation techniques have become the preferred modality for the treatment of incompetent perforating veins. Material and methods: We managed 210 varicose-vein patients (268 limbs) presenting with coexisting superficial and perforator incompetence. We utilised bipolar radiofrequency ablation for the treatm...

Background: Stent design may influence the outcomes, suggesting that adverse event rates vary according to free cell area and cell design. Open cell design technology of self-expandable stents, dedicated for carotid revascularisation has better deliverability, although closed cell technology is expected to cause fewer thromboembolic events. Aim:...

Carotid artery stenting (CAS) has become an alternative to carotid endarterectomy. Moreover, percutaneous transluminal angioplasty (PTA) allows other cephalad arteries revascularization. The aim of this study was to evaluate late outcomes of cephalad arteries PTA. This is an international multicenter registry of 434 consecutive patients in which 49...

We present the case of a 55 year-old male admitted to Malopolskie Centrum Sercowo-Naczyniowe PAKS in Chrzanów with diagnosis of anterior wall myocardial infarction (STEMI). We decided to treat the patient invasively because of presence of chest pain, persistent ST elevation and signs of haemodinamical instability. As it revealed later patient neede...

Background: Esophageal cancer is always a great challenge for surgical teams, both in cases of confirmed operable lesion and also when an operation is not possible to be performed. Unfortunately, despite progress in diagnostics and better accessibility to endoscopic examinations, many patients still present themselves at the moment when the lesion...

Background: Vascular prosthesis infection poses one of the most dangerous complications following vascular procedures. Despite the availability of a number of treatment methods, there is still a shortage of a perfect method of treatment concerning these kinds of infections. In this report, our own experience regarding the usage of silver-impregnate...

This paper presents a patient with chronic pancreatatis complicated by a right pancreatico-pleural fistula. Current methods of treatment for such types of complications are also presented.

Ankle-brachial index (ABI) measurements are widely used for evaluating the functional state of circulation in the lower limbs. However, there is some evidence that the value of ABI does not accurately reflect the degree of walking impairment in symptomatic patients with peripheral arterial obstructive disease (PAOD). We investigated the diagnostic...

Les mesures de l'index cheville-bras (ICB) sont largement répandues pour évaluer l'état fonctionnel de circulation dans les membres inférieurs. Cependant, il est établi que l'ICB ne reflète pas exactement le degré de gêne à la marche chez les patients symptomatiques présentant des lésions occlusives périphériques (LOP). Nous avons étudié la valeur...

Esophageus or gaster resection in patients with malignant disease is still a treatment of choice. It is obvious that each surgical procedure in these patients carries some possibility of complications. Esophageo-gastric or esophageo-jejuno anastomosis has a 4-27% frequency of fistula occurrence. All these result in 65% mortality in cases of poorer...

Background: In 1948, Rea and Poppe wrapped the anterolateral surface of an aneurysm with reactive cellophane. They hoped the material would induce fibrosis within the surrounding tissues, causing reinforcement of the aneurysm wall and limiting its expansion. The technique remains in use, although rather sporadically, and mainly in high-risk patient...

The aim of this study was to explain some of the aspects of the epidemiology, risk factors, patho-mechanism and treatment of posthrombotic syndrome. It was prepared in regard to directives from the XIV and XV Congress of the International Union of Phlebology.

Introduction: A prevalence of imaging examinations facilitating diagnosis and differentiations of hepatic tumors contributes to the introduction of surgery in very early moment what improves the final results of treatment. It has a great impact on the number of surgical operations on the liver enhancement in the recent years. Authors analyz ed the...

Background: The objective of the study was to estimate, on the basis of the authors' experience, the importance of cardiological diagnostics for the efficacious risk stratification of perioperative cardiac complications in vascular surgery. Material and methods: Since 2002 we evaluated the usefulness of a coronary angiography before elective surgic...

Background: The constant development of operative techniques as well as progress in anaesthesiology has allowed one to treat patients with abdominal aortic aneurysm (AAA) with increasing success. The aim of performing a scheduled AAA resection is the prophylaxis of an aneurysm rupture. Perioperative mortality as a result of a ruptured aneurysm is s...

Background: The treatment of inoperable changes and tumors of the oesophagus and cardia is a great changes for a surgeon. How to help the patients, the medicine does not have much to offer? After the change is found to be inoperable, a nutritional fistula is usually applied in the stomach or small intestine, which significantly reduces the comfort...

Background: The frequency of the occurrence venous ulcers of the leg is assessed at 1.1-1.8% in highly-industrialized regions. Despite the proper treatment - conservative as well as surgical - and despite following prophylaxis, the frequency of recurrences is estimated at 16-25% in the first year after treatment and on 28-69% two years afterwards....

Background: The aim of the study was to assess the six minute corridor walking test as a non-invasive method in the preoperative evaluation of the PAOD vascular patients. Material and methods: 51 patients were examined (mean age 60.5 ± 9.8). Claudication distance, maximum claudication distance and pre- as well as post-excercise heart rate, blood pr...

Background: Aim of the study was to compare the perioperative and late results of endovascular therapy of internal carotid artery (ICA) stenosis with open surgery in patients with critical stenosis. Material and method: An endarterectomy was performed in 54 patients (36 males and 18 females) of the age of 58-76 (mean 65). The procedure duration was...

Background: Our paper is a pilot study of the usefulness of enoxaparin in the treatment of patients with 50-200 m claudication (2-nd degree of Fontaine classification). This is a multicenter, randomized and open investigation. Material and methods: An initial observation was performed on a group of 21 patients consisting of 17 males and 4 females,...

In the paper 2 cases of recurrent abdominal aortic aneurysm after subrenal aortic aneurysmectomy 4 and 6 years after subrenal aneurysmectomy were described. Due to an increasing diameter and pain complaints the patients were qualified for surgery. The postoperative course was uncmplicated. The authores emphasized the role of control examinations (U...

The authors present a case of oesopahogastroanastomosis treatment by means of a covered stent implantation. The report describes advantages and disadvantages of this method of treatment.

A 26-year old female was admitted to the Department of General and Vascular Surgery with left common iliac vein occlusion. Three years earlier she underwent iliac vein thrombosis, which occurred during the 9th month of pregnancy. An ultrasound Doppler examination showed complete occlusion of the left iliac common vein. She was therefore qualified t...

In the paper, early results of endovascular treatment of critical stenoses of the internal carotid artery (ICA) are presented. Twenty-nine patients from the group with elevated risk of surgery with concomitant cardiac diseases suffering from critical (> 70%) and symptomatic ICA stenoses were qualified to the procedure. There were 9 women and 20 men...

Introduction: The condition of the microcirculation is one of the decisive factors regulating proper tissue blood supply. Due to the very difficult treatment of the disease concerning this level of the vascular bed, the damage of microvessels occurring in patients with inflammatory arterial diseases still remains an unsuccessfully resolved problem...

Background: The aim of this double-blind study was to evaluate the efficacy of intravenous injection of Solcoseryl (HD) in patients who underwent vascular reconstruction due to pre-gangrene of the lower extremities. Other surgical approaches were ineffective in these patients. In this study, the authors can establish that Solcoseryl would alleviate...

Peripheral arteries disorders cause not only leg ischaemia, but also peripheral polyneuropathy. Polyneuropathy increases ischaemic pain. The aim of this study was to estimate how many patients suffering from critical leg ischaemia have symptoms of peripheral polyneuropathy. 40 patients were investigated: 37 men and 3 women; mean age was 57 years. A...

A case of 69-year-old male patient with recurrent abdominal aortic aneurysm is described. The patient had been successfully operated on for infrarenal abdominal aortic aneurysm 4 years before, and 2 months postoperatively dilatation of juxtarenal part of abdominal aorta was diagnosed in ultrasonic examination. Due to progressive enlargement of juxt...

The occurrence of the postcholecystectomy syndrome is very often connected with inappropriate preoperative diagnostics. One of the reasons might be the presence of gastric or duodenal ulcer, what can be connected with peri- and late postoperative complications. The prospective analysis of 250 patients admitted to the Department because of cholelith...

Graft enteric fistula is observed in 0.2-4% of patients after abdominal aortic surgery. From 1991 to 1996, 11 patients were operated on because of graft-enteric fistula. In seven cases endoscopic diagnosis was made preoperatively. In five patients undergoing endoscopic examinations in other hospitals obtained outcomes were incorrect. All patients a...

Streszczenie Wstęp: Powszechna dostępność badań obrazowych ułatwiających wykrywanie i różnicowanie guzów wątroby przyczyniła się do wcześniejszego wdrażania leczenia chirugicznego i poprawy osiąganych wyni-ków operacji. Dzięki temu w ostatnich latach wzrosła ilość wykonywanych na narządzie operacji. Autorzy pracy dokonują oceny wyników leczenia ope...