To the jubilee of RAS Academician A.V. Pokrovsky, founder of Russian vascular surgery

 A.V. Pokrovsky It will be 85 years since the birthday of RAS Academician, Professor Anatoly Vladimirovich Pokrovsky, outstanding surgeon, teacher and person who conducted pioneer research, President of the Russian Society of Angiologists and Vascular Surgeons (RCAVS), Head of the Vascular Surgery Department of the Institute of Surgery named after A.V. Vishnevsky, Chief of the Chair of Clinical Angiology, Vascular and Roentgenovascular Surgery of the Russian Medical Academy of Postgraduate Education (RMAPE) under the RF Ministry of Public Health, laureate of the USSR State Prize (1975), Prize named after A.N. Bakulev (2001), State Prize of the Russian Federation (2002), Prize of the RF Government (2004), Honorary Member of the American Society for Vascular Surgery (SVS), President of the European Society for Vascular Surgery (ESVS).

Anatoly Vladimirovich was born on November 21st, 1930 in the city of Minsk in a family of physicians. His father, Pokrovsky Vladimir Aleksandrovich, was Chief of the Chair of Obstetrics and Gynaecology, first of the Khabarovsk and then in the Voronezh Medical Institute, his mother was an obstetrician-gynaecologist. In 1954, prior to graduating from the Second Moscow Medical Institute, Anatoly Vladimirovich trained at the residency in the Clinic of Petrovsky B.V. His first scientific steps were made when he worked at the Chair of Topographical Anatomy of the 2nd Moscow Order of Lenin State Medical Institute. As a result of this work, in 1958 he successfully defended his Candidate Dissertation entitled «To the problem of intrathoracic anaesthesia in operations on the heart». In 1959 Anatoly Vladimirovich passed to the just founded Institute of Thoracic Surgery under the USSR Academy of Medical Sciences and began to operate patients with heart defects. In 1961 the Institute of Thoracic Surgery was transformed to the Institute of Cardiovascular Surgery wherein there was created the first in Russia Department of Vascular Surgery headed by Professor Berezov Yu. E. In 1964 after Berezov Yu. E. had quitted the Institute, Anatoly Vladimirovich, aged 34 years old, was elected Chief of the Vascular Surgery Department of the Institute of Cardiovascular Surgery named after A.N. Bakulev, which he headed during the consequent nearly 20 years. In 1967, Pokrovsky A.V. defended his Doctorate Dissertation dedicated to surgery of aortic coarctation, wherein he proved a series of principal provisions being fundamental to coarctation surgery. In 1968 Pokrovsky A.V. received the rank of professor of surgery.

From 1983, Anatoly Vladimirovich became Head of the Vascular Surgery Department of the Institute of Surgery named after A.V. Vishnevsky wherein he continues to work up to now.

The name of Anatoly Vladimirovich as the founder of vascular surgery in Russia is consonant with the name of legendary teacher of the whole entire world’s elite of vascular surgeons Michel DeBakey.

The main merit of Pokrovsky A.V. consists in creation, formation and development of the Russian school of angiosurgery of the world’s level and formation of a progressive school of vascular surgeons. Anatoly Vladimirovich himself did not have a teacher, since at that time there was no angiosurgery itself. Many theoretical and practical aspects of vascular surgery were worked out by A.V. Pokrovsky by means of studying scientific publications, research at the operating room and sometimes by intuition at the expense of talent and width of general surgical knowledge. With the creation of such a scientific society in Russia Russian angiologists and vascular surgeons became true full-valued participants of the world’s scientific community.

Scientific works of Pokrovsky A.V. have constantly being in the centre of attention of surgical community and concepts and principles developed by him in angiosurgery have been reliable reference points for the majority of vascular surgeons.

Speaking of A.V. Pokrovsky’s amplitude of scientific views, mention should be made that, probably, there are no divisions of vascular surgery wherein Anatoly Vladimirovich would have failed to introduce new ideas, concepts, to have carried the techniques of many surgical interventions to perfection. He has always felt novel tendencies appearing in science, and, being himself a classical vascular surgeon, he never rejected endovascular methods of treatment which began to be actively promulgated in the 1990s. It was as early as then that he envisaged that in some divisions of vascular surgery the endovascular techniques would gain priority and that further strategy of the development of angiosurgery should envisage synthesis of the two directions.

A.V. Pokrovsky was one of the first in Russia to promote and perform operations of carotid endarterectomy in patients presenting with cerebral insufficiency. Touching upon technical aspects of this operation, one cannot but mention eversion endarterectomy which A.V. Pokrovsky started to use at the Department he headed. These operations having become convenient during recent years made it possible to save lives and prevent the development of stroke in many thousands of patients. Pokrovsky A.V. irrefutably proved that early detection and active surgical policy in pathology of brachiocephalic arteries are capable of precluding the development of acute ischaemic impairments of cerebral circulation in this cohort of patients. This direction has become one of the most significant divisions of modern angiosurgery owing to joint efforts of vascular surgeons and leading Russian and foreign neurologists. Specialists under his leadership have worked out and implemented ultrasound methods of monitoring and control of cerebral haemodynamics during reconstructive operations on brachiocephalic arteries, as well as developed various techniques of carrying out operations in stenosis of carotid arteries.

Pokrovsky A.V. paid special attention to the problem regarding diagnosis and management of nonspecific aortoarteritis. He has accumulated the world’s largest clinical material on operative treatment of patients presenting with the pathology concerned, having suggested original methods of complicated reconstructive interventions, as well as implemented methods of assessing the immunological status into clinical practice. Anatoly Vladimirovich was the first in the world to suggest performing transaortic endarterectomy from the aorta and visceral arteries in patients presenting with nonspecific aortoarteritis. In 1985 at the Department of Anatoly Vladimirovich it was proposed to use the method of pulse therapy for arresting inflammation, thus making it possible to obtain permanent laboratory and morphological remission in the overwhelming majority of patients. These works were accorded deserved recognition not only in Russia but abroad and became the so-called a «visiting card» of A.V. Pokrovsky. He was the author of the chapter regarding these problems in one the most important American guidelines on vascular surgery.

Surgical activity of Academician A.V. Pokrovsky embraces the whole spectrum of interventions in vascular pathology. Specialists under the leadership of A.V. Pokrovsky also elaborated unique operations on arterialization of venous blood flow of the foot in patients with critical limb ischaemia in occlusion of all arteries of the crus, which made it possible to save the limb in hundreds of «inoperable patients». Achievements of Russian surgeons in this direction were also pointed out in the foreign press.

The development of vascular surgery in the USSR was not at all simple, i.e. the operations currently considered conventional were during the 60s born by means of long contemplations sitting at the working table, effluent flashes of intuition and insights, disputes and debates with his colleagues and unceasing thoughts on saving patients.

In Russia Pokrovsky A.V. was a pioneer in the development of the most difficult division of vascular surgery, i.e. surgery of the thoracic and thoracoabdominal aorta. In 1962 he was the first in the USSR to perform resection of an ascending aortic aneurysm with prosthetic repair, in 1965, he was also the first in the USSR who carried out resection of a dissecting aneurysm of the descending aortic portion of the aorta, and in 1972 he carried out a unique operation – resection of an aneurysm of the aortic arch with prosthetic repair of its branches.

The development of problems concerning surgery of visceral arteries allowed A.V. Pokrovsky in 1971 for the first time in the world to carry out simultaneous transaortic endarterectomy from the aorta, coeliac, superior mesenteric and renal arteries.

Pokrovsky A.V. was one of the first in the USSR starting to work out surgical management in coronary artery disease. In 1966, Anatoly Vladimirovich carried out a series of resections of cardiac aneurysms in conditions of artificial circulation. And on September 3rd, 1970, A.V. Pokrovsky was the first in the USSR to perform resection of a postinfarction aneurysm of the left ventricle in combination with aortocoronary bypass grafting in conditions of assisted circulation.

A then very young surgeon (A.V. Pokrovsky became Head of the Department when he was just 34 years old), he formed around himself a very strong team of like-minded fellows, thinking, seeking, gifted young, sometimes almost nearly his equals in age, scientists-surgeons becoming later on the first generation of his school – the school of A.V. Pokrovsky: Rabotnikov V.S., Klioner L.I., Moskalenko Yu.D., Spiridonov A.A. The tradition of the presence of groups of assistants-like-minded fellows around Anatoly Vladimirovich has been preserving during his whole creative path. Continuing the subject on priority of A.V. Pokrovsky in creation of the Russian school of vascular surgery, mention should be made that under the leadership of Anatoly Vladimirovich there were defended a total of 57 Doctorate dissertations and 114 Candidate dissertations. His followers work in various regions of Russia, in both neighbouring and far foreign countries. More than 30 his followers work as professors and heads of chairs of medical institutes.

Acknowledgment of A.V. Pokrovsky’s scientific authority was appreciated by his being elected in 1982 as a Corresponding Member of the Academy of Medical Sciences of the Soviet Union, and in 1997 he became its Full Member.

The development and existence of vascular surgery and angiology as a speciality in Russia belong to one of the most important merits of Pokrovsky A.V.

In 1986 he became Head of the Department of Angiology and Vascular Surgery (currently also of roentgen-endovascular surgery) of the Russian Medical Academy of Postgraduate Education. During these years more than 5,000 students – vascular surgeons from more than 52 cities managed, undergoing occupational specialization or retraining, to attend him in operating rooms and to listen to a lecture course. Today, the majority of «yesterday’s» students work as chiefs of departments and leading surgeons in medical centres of virtually all regions of Russia. Annually, Anatoly Vladimirovich together with his staff members carry out visiting cycles on vascular surgery.

In the same 1986, Pokrovsky A.V. managed to create initially the section of vascular surgeons under the All-Union Society of Surgeons later on reformed to the Russian Society of Angiologists and Vascular Surgeons headed by him up to now. Annually the Society holds All-Russian conferences with participation of leading foreign specialists. Regular conduction of such congresses has united vascular surgeons of various regions of Russia into one family. This made it possible to form annual reports on the state of vascular surgery in Russia and to create the register of the performed various interventions. Under the auspices of the Association, annual general national conferences with international participation during the last decade became to be accompanied and followed by holding regional conferences for vascular surgeons of the Far East, Siberia, and Urals (supported by the Tersamed Company). All in all, since the day of foundation of the Association a total of 31 conferences were held in 18 cities of Russia. With the participation of Anatoly Vladimirovich and under the auspices of the Society in 2004 was created the school of atherothrombosis whose listeners became several thousand physicians in various regions of Russia. Owing to efforts of Pokrovsky A.V. worked out and published were national guidelines on treatment of lower-limb critical ischaemia, aneurysms of the abdominal portion of the aorta, lesions of brachiocephalic arteries. The activity of Anatoly Vladimirovich on the arena of the development of national vascular surgery was highly appreciated by international colleagues – he, the only one of Russian surgeons, was in 2000 elected President of the European Society for Vascular Surgery.

The most important milestone in the life of the medical community of Russia became creation by A.V. Pokrovsky in 1994 of the first in Russian history quarterly bilingual journal «Angiology and Vascular Surgery» accepted by the world’s medical community.

The journal has become an official printed organ of the Russian Society of Angiologists and Vascular Surgeons and Anatoly Vladimirovich became its irremovable Editor-in-Chief. The Editorial Board of the Journal beside Russian leading specialists include leaders of vascular surgery from European countries, USA and the Commonwealth of Independent States thus making it possible to publish in the considerable amounts foreign articles. Currently, «Angiology and Vascular Surgery» is the only of all subject editions representing Russian cardiovascular surgery at the international level. More than 80 issues of this journal have been published during these years.

A.V. Pokrovsky is an author of 720 scientific works and 16 monographs. An important constituent part of his pedagogical activity are monographs «Clinical Angiology», «Diseases of the Aorta and its Branches» published in 1979, two-volume manual «Clinical Angiology» (2004), the books on which generations of vascular surgeons studied and continue to study. A.V. Pokrovsky is an author of a chapter in the American manual «Vascular Surgery». He was elected Honourable Member of the American Society for Vascular Surgery (SVS) and a series of European learned societies.

Professional achievements of Anatoly Vladimirovich have been marked by the State Prize of the USSR (1975), Prize named after A.N. Bakulev (2001), RF State Prize (2002), Prize of the RF Government (2004), Orders «For Merits to the Motherland» degree II and IV.

Anatoly Vladimirovich Pokrovsky still loves his main lifework, i.e. surgery and continues to actively work, helping a great number of people with various vascular diseases.

TV reports

Present from Ryazan State Medical University

Present from Ryazan State Medical University