RESUMEN
The study comprised a total of 107 patients (all men) after endured femoropopliteal bypass grafting above the genicular fissure with a synthetic stent graft manufactured by the Gore Company for stage IIB and III chronic arterial insufficiency of the lower extremities according to the Fontain-Pokrovsky classification. Group One I (control group) was composed of fifty-four patients permanently taking in the postoperative period at the out-patient stage pentoxiphylline (trental 400 mg 1 tablet 3 times daily) and xantinol nicotinate at a dose of 150 mg one tablet thrice daily. Group Two (Study Group) consisted of fifty-three patients taking after reconstructive vascular surgery at the out-patient stage in addition to pentoxiphylline and xantinol nicotinate acetylsalicylic acid (cardiomagnil 75 mg 1 tablet once daily). The Control Group patients within 3 to 6 months of follow up were found to have a considerable progressing improvement of the functional abilities of the microcirculatory bed requiring in 44 (81.5%) cases hospitalization to the Surgical Department for intensive vascular therapy. Despite this fact four (7.4%) patients within the time frame from 6 to 9 months after surgery developed thrombosis of the vascular implant requiring a repeat surgical intervention. In the Study Group patients, the degree of functional capabilities of the microcirculatory bed in the postoperative period was less considerable, reaching the maximum after 10-12 months of follow up, with eighteen (34.0%) patients requiring hospitalization for additional vascular therapy to perform. There were no cases of implants' thrombosis in the Study Group patients. Pathological alterations in the functional state of the peripheral vascular bed correlated with viscosimetric indices and activity of blood platelet aggregation. The addition of antithrombocytic agents to conservative postoperative therapy considerably improved the outcomes of surgical treatment.
Asunto(s)
Aspirina , Arteria Femoral , Oclusión de Injerto Vascular/prevención & control , Enfermedad Arterial Periférica/cirugía , Arteria Poplítea , Injerto Vascular/efectos adversos , Aspirina/administración & dosificación , Aspirina/efectos adversos , Coagulación Sanguínea/efectos de los fármacos , Viscosidad Sanguínea/efectos de los fármacos , Arteria Femoral/patología , Arteria Femoral/trasplante , Oclusión de Injerto Vascular/sangre , Oclusión de Injerto Vascular/etiología , Oclusión de Injerto Vascular/patología , Humanos , Extremidad Inferior/irrigación sanguínea , Masculino , Pentoxifilina/administración & dosificación , Pentoxifilina/efectos adversos , Enfermedad Arterial Periférica/sangre , Enfermedad Arterial Periférica/patología , Agregación Plaquetaria/efectos de los fármacos , Inhibidores de Agregación Plaquetaria/administración & dosificación , Inhibidores de Agregación Plaquetaria/efectos adversos , Arteria Poplítea/patología , Arteria Poplítea/trasplante , Periodo Posoperatorio , Reoperación , Resultado del Tratamiento , Injerto Vascular/métodos , Grado de Desobstrucción Vascular/efectos de los fármacos , Vasodilatadores/administración & dosificación , Vasodilatadores/efectos adversos , Niacinato de Xantinol/administración & dosificaciónRESUMEN
The paper analyses diagnosis and treatment outcomes for 20 men aged from 55 to 76 with lower limb arteriosclerosis obliterans. Based on exhaustive laboratory and instrumental diagnostic data the authors conclude that 10-days course of Vazaprostan (20 mkg per day) for patients with IIb stage of chronic lower limb arterial insufficiency yields not only improvement in tissue metabolism, but a reduction of peripheral vascular resistance as well. Thus such therapy can be used for preoperative care before reconstructive vascular interventions in order to reduce the risk of implant thrombosis in early postoperative period.