Asunto(s)
Cateterismo Periférico/efectos adversos , Tromboangitis Obliterante/complicaciones , Aorta Abdominal , Cateterismo Periférico/instrumentación , Cateterismo Periférico/métodos , Catéteres de Permanencia/efectos adversos , Humanos , Infusiones Intraarteriales/métodos , Pierna/irrigación sanguínea , Recurrencia , Tromboangitis Obliterante/tratamiento farmacológico , Factores de TiempoRESUMEN
Standard operative interventions (thromboendarterectomy, (autovenous shunt) in patients with thromboangiitis obliterans of the lower limbs produce a poor effect. This is explained both by a poor initial condition of the draining channels and by advancement of the primary thromboangitic affection of the vascular wall in the zone of the intervention with its development into a stenotic-occlusive process. The use of some technical (operative) innovations, particularly postoperative arterial infusion of suspended forms of immunosuppresive agents (hydrocortisone, Kenalog), increased essentially the efficacy of restorative operations on the vessels with a high level of limb preservation and patency of the vessels which had been operated on.
Asunto(s)
Inmunosupresores/uso terapéutico , Pierna/irrigación sanguínea , Tromboangitis Obliterante/cirugía , Adulto , Femenino , Estudios de Seguimiento , Humanos , Hidrocortisona/uso terapéutico , Masculino , Cuidados Posoperatorios , Reoperación , Tromboangitis Obliterante/tratamiento farmacológico , Factores de Tiempo , Triamcinolona Acetonida/uso terapéuticoRESUMEN
Catheter heparin therapy combined with the intraarterial infusion of microcrystalline suspensions of antiinflammatory and immunosuppressive agents did not provide elimination of the microcirculation block in the affected limbs of the patients with severe ischemia of the limbs. Thrombolytics used in acute and chronic thromboses in most of cases did not help in complete recanalization of the arteries. Regional thrombolysis conducted before the basic course of the arterial infusion (heparin + immunosuppressants) in patients with distal forms of the arterial affections, promoted a significant improvement of conditions of the regional microcirculation. Application of this method has permitted lowering the rate of limb amputations.
Asunto(s)
Anticoagulantes/uso terapéutico , Extremidades/irrigación sanguínea , Fibrinolíticos/administración & dosificación , Isquemia/tratamiento farmacológico , Tromboangitis Obliterante/tratamiento farmacológico , Cateterismo Periférico , Humanos , Infusiones Intraarteriales , Isquemia/etiología , Tromboangitis Obliterante/complicacionesRESUMEN
The authors analysed the immediate and late-term results of treatment of 351 patients with thromboangiitis++ obliterans of the lower limbs by regional intraarterial infusion with the use of microcrystal line suspensions of hydrocortisone, oxytetracycline, and zinc-insulin. The method is shown to be highly effective in patients with affection of the distal arterial bed. A stable remission in the late-term period was attained in 80.4% of the patients.
Asunto(s)
Hidrocortisona/administración & dosificación , Insulina de Acción Prolongada/administración & dosificación , Pierna/irrigación sanguínea , Oxitetraciclina/administración & dosificación , Tromboangitis Obliterante/tratamiento farmacológico , Adolescente , Adulto , Cristalización , Preparaciones de Acción Retardada , Quimioterapia Combinada , Humanos , Infusiones Intraarteriales , Masculino , Persona de Mediana EdadRESUMEN
Lumbar sympathectomy in majority of patients with thromboangiitis was found to be followed by a reduced pathogenetically reliable orthostatic and post-orthostatic++ spasm of the diseased arteries. Patients with persistent and continuous remission had normo- and hypotonic orthostatic reaction of the extremity vessels. Remote clinical results of the intervention on lumbar sympathetic ganglia were dependent on the degree of correction of local angiotonic and angiospastic disorders.
Asunto(s)
Arteria Femoral/inervación , Ganglios Simpáticos/cirugía , Ganglionectomía/efectos adversos , Hipotensión Ortostática/etiología , Pierna/irrigación sanguínea , Arteria Poplítea/inervación , Complicaciones Posoperatorias/etiología , Tromboangitis Obliterante/cirugía , Adolescente , Adulto , Arteria Femoral/fisiopatología , Humanos , Región Lumbosacra/inervación , Persona de Mediana Edad , Arteria Poplítea/fisiopatología , Factores de TiempoRESUMEN
In contrast to atherosclerosis, in thromboangiitis in most patients 4-8 mos after the operation, reocclusion, of the operated vessels and shunts occurred. This was conditioned by the progression of thromboangiitis.