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The changes of plasma thrombin-antithrombin complex in the patients with peripheral arterial disease undergoing surgical revascularization

100%

Kęsik J. J., Wroński J., Feldo M., Terlecki P., Zubilewicz T.

vol. 85

issue 11

638-643

In patients with severe lower limb ischemia the coagulation and fibrinolytic systems have been found to be activated preoperatively. The aim of the study was to evaluate the changes of TAT level as a selected coagulation factor, before, during and after surgical revascularization and the analysis of the impact of coexisting diseases on the coagulation during the procedure. Material and methods. 50 patients with PAOD, in Fontaine stages IIb to IV (29 men and 21 women; median age 65.8 years, ASA II/III) undergoing elective surgical revascularization were studied. Two groups of patients were compared: 20 undergoing reconstruction on aorto-femoral and 30 on femoropopliteal level. Blood samples were collected 5 times: 24 hours before the operation; intraoperatively after artery exposure; after heparin administration and clamping; after reperfusion and -24 hours postoperatively. Results. Elevated values of TAT (10.5 g/l ±7.1) were found before the operation. The elevated value of TAT increased intraoperatively (25.1 g/l ±44.58; p<0.001) (norm 1-4.1 g/l) and maintaining higher levels after the surgery. The significant correlations between plasma level of TAT and ischemia degree were found. Also the correlation between intraoperative increase of TAT and the duration of surgery was noticed. No significant differences between two analysed groups were observed. Conclusions. The results indicate the activation of coagulation and prothrombotic state in the patients with advanced arteriosclerosis. During the surgical revascularisation permanent increase of activation of blood coagulation was observed. This activation depends on duration of the procedure and maintains increased one-day after the operation. Our findings may explain the unexpected occurrence of early thrombotic complications after technically successful vascular reconstructions.

Endovascular technologies and reconstructive interventions on profound femoral artery at revascularization of multilevel stenotic-occlusive process of infrainguinal arterial channel

100%

Herasymiuk N. I., Husak M. O., Venher I. K., Kovalskyy D. V., Loyko I. I., Selskyy B. P.

Journal of Education, Health and Sport

2021

vol. 11

issue 1

153-162

Introduction. Number of patients with obliterating lesions of the aorta and main arteries of the lower extermities has been steadily increasing every year. When choosing the scope of surgical treatment all the features of the multilevel stenotic-occlusive process of the infrainguinal arterial bed should be taken into account. Purpose. To improve the results of revascularization of the infrainguinal arterial bed by applying surgical intervention on profound femoral artery and endovascular methods to restore permeability of the outflow arteries. Materials and methods. The work is based on the results of examination and surgical treatment of 264 patients with stenotic-occlusive process of the infrainguinal arterial bed. There were four groups of patients. The basis of revascularization interventions on the infranguinal artery was shunt surgery. Bypass surgery was performed using a reverse autovein. The combined shunt was used for localization of the distal anastomosis at the level of the popliteal, shin arteries, tibioperinel trunk. Results. In atherosclerotic stenotic-occlusive lesions of the infrainguinal arterial bed of the lower extremity, the volume of surgical treatment depends on the level of the occlusive process, the functional state of the PFA and the blood flow pathways. And the method of surgical intervention in shunt interventions is determined by the type of distal lesion and the level of imposition of distal and proximal anastomoses. Conclusion. The use of endovascular methods of revascularization and reconstructive interventions on PFA in combination with femoral-distal shunt operations contributes to good and satisfactory results of surgical treatment of stenotic-occlusive processes of the infrainguinal arterial bed.

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1 Journal of Education, Health and Sport

1 Polish Journal of Surgery

1 2020

1 2013

1 Feldo M.

1 Herasymiuk N. I.

1 Husak M. O.

1 Kovalskyy D. V.

1 Kęsik J. J.

1 Loyko I. I.

1 Selskyy B. P.

1 Terlecki P.

1 Venher I. K.

1 Wroński J.

1 Zubilewicz T.

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The changes of plasma thrombin-antithrombin complex in the patients with peripheral arterial disease undergoing surgical revascularization

Endovascular technologies and reconstructive interventions on profound femoral artery at revascularization of multilevel stenotic-occlusive process of infrainguinal arterial channel