9. Clinical And Hemodynamic Aspects Of Revascularizing Osteotrepanation Surgery With Intracosteal Laser Irradiation In Patients With Critical Ischemia Of Lower Limbs On The Background Of Distal Steno-Occlusion Of Arteries

Authors

  • J.V. Kosayev Scientific center of surgery named after M. A. Topchibashev, Baku, Azerbaijan

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Abstract

Objective: to study the clinical and hemodynamic effectiveness of revascularizing osteotrepanation with intracosteal laser irradiation (ICLI) in patients with critical lower limb ischemia (CILL) on the background of distal steno-occlusion of the arteries. Research material and methods: studies were conducted in 73 patients with CILL on the background of distal steno-occlusiarteria. Standard ROT surgery was performed in 42 patients, and 31 patients had ROT surgery with intracosteal laser irradiation. Clinical results of treatment were evaluated on the Rutherford R. B. et al. (1997). The following indicators of arterial and venous blood flow were determined: rheographic index (RI), linear blood velocity (LBV) in the popliteal artery, regional systolic pressure (RSP) standing and lying down, regional systolic pressure gradient (RSPG), post-occlusive venous pressure (POVP) standing and lying down, post-occlusive venous pressure gradient (GPOVP), venous-arterial index (VAI) standing and lying. Oxygen saturation of the skin (SOS) in the distal part of the foot was also studied. Parameters of regional arterial and venous blood circulation were compared with identical parameters of 48 practically healthy individuals («reference group»).

Results: when patients were admitted to the clinic, a sharp violation of the arterial and venous links of regional microcirculation was revealed. ROT and ROT surgery with ICLI significantly improves regional blood circulation, reduces the degree of chronic ischemia, and increases the number of patients with significant and moderate improvement in the clinical status of patients. These positive results were most pronounced in patients who underwent ROT surgery with ICLI.

Keywords

distal occlusion of the artery, critical ischemia of lower limb, regional blood flow, revascu-larizating osteotrepanation, intracosteal laser irradiation

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Published

2020-04-01

Issue

No. 1 (2020)

Section

Статьи