Keywords
critical ischemia
hydraulic disobliteration
How to Cite
Abstract
The optimal type of arterial disobliteration in patients with critical ischemia, taking into account the prognosis of the progression of restenosis of the disobliterated zone have been determine. 80 patients with critical ischemia of the lower extremities were examined. All patients were operated and divided into two equal groups, depending on the application of the proposed technique. TGF-β1 levels tended to slightly increase, or remained at the same level in both groups. The levels of endoglin decreased in the first postoperative day in both groups by an average of 23 %. Nevertheless, low levels of TGF-β1 (< 150 ng/ml) and CD105 (< 8 ng/l) in the long-term period correlated with higher degrees of restenosis. In the comparison group, rates and degree of restenosis were higher than in the main group at the 1-st and 3-rd years of follow-up. In the main group in a year after discharge, the degree of stenosis in the CFA was (6.2±4.3) % in 52 patients, in the comparison group (7.5±3.2) % (in 50) and 59 % (in 1). The permeability of reconstructions performed on the infrainguinal segment was significantly worse than the given index after correction of the aorto-iliac segment in both groups, but on average for the year the levels of patency in the main group were 5 % higher than in the comparison group. In patients with critical ischemia, initially low levels of CD105 and TGF-β1 indicate a significant disturbance of endothelial function and «cytokine balance» in atherogenesis processes. It is making the prognosis of treatment unfavorable on these data because of the high risk of restenosis of the disobliterated zone, which in our study is suppressed by the proposed method of hydraulic disobliteration.
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