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EN
The study presented an approach to the morphometric image of atherosclerotic lesions of the final segment of the abdominal aorta, femoral and iliac arteries, considering possible endovascular intervention. The evaluation of these arteries is very important, because they are often used as a point of access for endovascular procedures performed on the peripheral arteries, or within the thoracic and abdominal aorta and its branches, as well as coronary arteries. The aim of the study was to determine morphometric measurements describing the atherosclerotic lesions, including the methodology of their surgical interpretation. Material and methods. The study group comprised 128 tomograms of patients qualified for surgery. An algorithm based on the mathematical morphology was designed to track the vessels, starting from the division of the common femoral artery, and ending at the bifurcation of the abdominal aorta. We proposed a set of numerical measurements of the observed arterial changes. Results and conclusions. We analysed 128 tomograms with a 94.5% efficiency, and with the assessment accuracy of the degree of lumen reduction (MAE- 1.5%). We observed much higher measurement values of local tortuosity of the atherosclerotic arteries (0.3 - 1 radians), as compared to their anatomical course in a healthy subject (0 - 0.2 radians). The presented method can be a very accurate and useful tool in the numerical analysis of the lumen distribution of the arteries and atherosclerosis, dedicated to surgeons elaborating management strategies.
EN
Introduction: Sarcomatoid renal-cell carcinoma is a very rare cancer characterised with aggressive course of disease and poor prognosis. At present there are no standards of care for this histologic subtype of renal cell carcinoma resistant to various forms of systemic treatment. Methods: The study describes a case of 58 year old woman after left nephrectomy for clear cell carcinoma with sarcomatoid component and after resection of right-kidney tumour for synchronous clear cell carcinoma who received first-line bevacizumab and temsirolimus under the clinical trial, and then second-line chemotherapy based on gemcitabine and doxorubicin and ifosfamide-based third-line chemotherapy. The patient underwent pulmonary metastasectomy twice, and once a metastasectomy for liver metastases. Conclusions: Surgery (including metastases treatment) followed by the systemic chemotherapy seems to be correct option of treatment in patients with renal cell carcinoma with sarcomatoid features. The development of optimum method of systemic treatment requires further prospective randomised trials.
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