Novosti
Khirurgii

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Year 2014 Vol. 22 No 1

GENERAL AND SPECIAL SURGERY

I.I. KATELNITSKIY, IG.I. KATELNITSKIY

THE IMPACT OF TYPE AND VOLUME OF BLOOD FLOW RESTORATION ON LONG-TERM SURGICAL TREATMENT RESULTS IN PATIENTS WITH OBLITERATING ATHEROSCLEROSIS IN STAGE OF CHRONIC CRITICAL ISCHEMIA OF THE LOWER EXTREMITIES

SBEE HPE "Rostov State Medical University"
The Russian Federation

Objectives. To assess the long-term revascularization results depending on the volume, type of reconstructive interventions as well as the achieved degree of the blood flow compensation as a result.
Methods. Operative treatment results of 157 patients with atherosclerotic occlusions of the lower extremities arteries have been analyzed. Patients were subdivided into 2 groups. Open interventions on the iliac-femoral-popliteal region without blood flow correction along the shin vessels were done in the 1st group (66 patients). Shin revascularization using the combined or hybrid techniques was carried out in the 2nd group (91 patients). The long-term results were followed in terms up to 5 years.
Morphological and functional changes of the blood cells flowing from the ischemic extremities as well as their regress depending on the volume of the blood flow restoration were studied in 57 patients.
Results. A positive result immediately after the operation was obtained in 56,1% of patients of the 1st group and in 62,9% of patients of the 2nd group. The same percentage of positive outcomes was registered immediately after the surgery in the 1st group in (63,1%) and in (63,1%) in the 2nd group, thus a significant prevalence of positive results (29,5%) in the 2nd group of patients compared with the 1st group (16,7%) has been detected. Negative results in the patients of the 2nd group made up 13,1%, it was lower than in the patients of the 1st group (20,2%). Within the whole period 73,23% cases of thrombosis were registered in the 1st group and in the 2nd group they occurred reliably seldom – 58,76%.
At electronic microscopy the rough changes of the structure and function of blood cells were revealed that testify to thrombus formation tendency correcting by the blood flow disturbance degree.
Conclusions. While using the combination of open and X-ray-endovascular methods of revascularization the better results were obtained in short- and long-term terms. Severe disturbances of the blood cell composition were registered in patients with obliterating atherosclerosis. Disturbance regress was more evident in the blood flow restoration on all affected portion of the extremity arterial system.

Keywords: obliterating atherosclerosis, critical ischemia, operative treatment, revascularization, hybrid intervention, morphology of blood cells
p. 68 - 74 of the original issue
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Address for correspondence:
344000, Rossiiskaia Federatsiia, g. Rostov-na-Donu, per. Nakhichevanskii, d. 29, GBOU VPO «Rostovskii gosudarstvennyi meditsinskii universitet», kafedra khirurgicheskikh boleznei ¹1,
e-mail: katelnizkji@mail.ru,
Katelnitskiy Igor Ivanovich
Information about the authors:
Katelnitskiy I.I. MD, professor, a head of the chair of surgical diseases N1 SBEE HPE
"Rostov State Medical University" Public Health Ministry of Russian Federation
Katelnitskiy Ig.I. PhD, an accosiate profesor of the chair of surgical diseases N1 SBEE HPE
"Rostov State Medical University" Public Health Ministry of Russian Federation
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