Roentgeno-surgical treatment of vascular occlusive diseases of the lower extremities

The methods of direct revascularization of the lower extremities in occlusive-stenotic lesion at the stage of severe ischemia were used in 144 patients. Of them in 35, simultaneously or with a several day interval, the ++roentgeno-endovascular dilatation (RED) in the several segments of the arterial bed was carried out, in 36--RED was performed in combination with 2-3 procedures of plasmapheresis, in 16 patients in occlusion to a large extent, the isolated balloon profundoplasty was performed, in 46 patients with total lesion of the vessels--isolated RED of the aorto-iliac segment. This contributed to increase in the effectiveness of the collateral blood flow in the vessels of the lower extremities. A high effectiveness of the methods employed was noted in follow-up of from 1 to 5 years. The indications for the use of RED and causes of failures are presented.     

Use of UV-irradiated autologous blood in the treatment of patients with occlusive vascular diseases of the lower extremities]

Based upon the investigation of the hemogram, biochemical indices of blood and certain instrumental methods of research in patients with a critical form of obliterating diseases of lower extremity vessels, whose treatment included UVI of auto-blood, the authors have shown pronounced clinical efficiency of the method of treatment resulting in the improvement of theological properties of blood, microcirculation in tissues, less pain syndrome and rapid healing of trophic ulcers against the background of better condition of the patient. The method allowed the time of staying at the hospital to be substantially shortened.     

Use of regional perfusion in the treatment of arterial occlusive diseases of the lower extremities

The work presents an analysis of 120 isolated perfusions performed in 103 patients with obliterating injuries of the peripheral vessels of lower extremities. In 17 patients the perfusion was performed twice. For prophylactics of the commissural process the area of connection of main vessels of the artificial circulation apparatus (ACA) in 56 patients was wrapped up by teflon in order to ease reoperation. Good and satisfactory results were obtained in 79 (76.7%) of the patients which allowed them to return to their working activity. The application of the teflon sleeve at the level of connection of the ACA vessels was found to prevent the commissural process and to facilitate the access to the vessel in a repeated isolated perfusion.     

Clinical aspects of using extremely high frequency electromagnetic radiation in the complex treatment of occlusive vascular diseases of the lower extremities

A method of local influencing with the extremely high frequency electromagnetic irradiation on the points of acupuncture was used in the complex treatment of 44 patients with obliterative diseases of the vessels of the lower extremities at the age of 34-75 years. Obliterative atherosclerosis was diagnosed in 15 of them, obliterative endarteritis --in 29. A high effectiveness of the method even in late stages of vascular pathology was noted. No complications were observed.     

Autologous transfusion of UV-irradiated blood in the treatment of occlusive arterial diseases of the lower extremities

Complex examination of 72 patients with obliterating atherosclerosis and 10 patients with obliterating endarteritis was performed. All the patients were given autotransfusion of UV-irradiated blood as conservative treatment, preoperative preparation and postoperative management. The course of AUVIB was followed by a decrease of the lactic acid level, increase of functional properties of hemoglobin, activation of humoral immunity, change of the blood hemostatic potential to the side of hypocoagulation. The AUVIB treatment was most effective in patients at initial stages and those with peripheral forms of the disease.     

Partial denervation in complex treatment of occlusive diseases of the lower extremity arteries

The interventions efficacy, conducted on a nervous structures in 198 patients for occlusive diseases of the lower extremities arteries, in 68 of whom a femoral and sciatic nerves blockade were performed together with epidural anesthesia and open alcoholizing of sciatic nerve, was estimated. Efficacy of partial denervation in complex treatment of patients, suffering chronic ischemia of the lower extremities stages II - IlIA, was established, when performance of a direct revascularization is impossible because of a secured functional reserve present.     

Venous hemodynamics in chronic occlusive diseases of arteries of the lower extremities

The authors have revealed a gradual development of venous hypertension and deceleration of the rate of venous blood flow in the damaged extremities in chronic obliterative arterial diseases. Decompensation of arterial hemodynamics is accompanied by the development of pronounced venous congestion with reduced venous pressure and tension. This may cause the incompetence of the deep venous valves.     

长段股腘动脉硬化闭塞的腔内治疗初步经验分析

目的 评价血管腔内治疗长段股咽动脉硬化闭塞的临床效果.方法 2006年4月～2009年1月采用血管腔内治疗长段股咽动脉硬化闭塞10例(共14条肢体),术中同时行股咽动脉血管腔内球囊扩张成形术及支架植入术.结果 手术技术成功率为90%,放置12个支架,术后12个月通畅率为70%,术后血管再狭窄率30%.结论 血管腔内成形治疗长段股咽动脉硬化闭塞是一种安全有效的治疗方法.     

Functional cineangiography in the diagnosis of arterial occlusive diseases of the lower extremities

An analysis of cineangiograms of lower extremity arteries of 225 patients with occlusive lesions of the abdominal aorta and lower extremity arteries has been made. Symptoms detected by cineangiography are described which allow to judge on stenotic lesions of the arteries with greater reliability than by the data of serial angiography. Quantitative analysis of cineangiograms has been performed with the determination of time of blood flow along arterial segments.