Novosti
Khirurgii

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Year 2022 Vol. 30 No 2

GENERAL & SPECIAL SURGERY

V.A. LAZARENKO, E.A. BOBROVSKAYA

ANALYSIS OF MICROCIRCULATION PARAMETERS IN PATIENTS WITH THE DEVELOPMENT OF RESTENOSIS IN THE AREA OF ARTERIAL RECONSTRUCTION AFTER FEMORAL-POPLITEAL BYPASS SURGERY

Kursk State Medical University, Kursk,
The Russian Federation

Objective. To identify the features of microcirculation disorders in the development of restenosis of the arterial reconstruction zone in patients with obliterating atherosclerosis after femoral-popliteal stenting.
Methods. The study included patients (n=82) with obliterating atherosclerosis with grade IIB-III chronic arterial insufficiency, who underwent femoral-popliteal stenting. In 21 patients, the postoperative period proceeded without the development of restenosis of the arterial reconstruction zone (group I). Group II included 61 patients who developed restenosis of the arterial reconstruction zone during the year. The parameters of microcirculation were evaluated with the analysis of the amplitude-frequency spectrum (AFS) of blood flow oscillations prior and after revascularization.
Results. The microcirculation index (45.3%, p<0.001) and capillary blood flow reserve (49.2%, p<0.001) were found to be lower in patients of group II both initially prior and after revascularization (30.7%, p<0.001 and 51.4%, p<0.001) with significantly high values of arteriolo-venular bypass prior and post surgery (26.6%, p<0.001 and 41.9%, p<0.001), increasing after occlusion test compared with group I. In the amplitude-frequency spectrum of group II, a violation of the active components was noted due to the initial low value of the myogenic component (47.3%, p<0.001) and high neurogenic (35.5%, p<0.001) component with a significantly high index after the occlusion test (64.3%, p<0.05) compared to group I, not normalized after lower limb revascularization surgery, along with a violation of the function of passive mechanisms of blood flow modulation.
Conclusion. The development of restenosis after femoral-popliteal bypass surgery is accompanied by a pronounced violation of the state of microcirculation and the balance of the mechanisms of blood flow modulation, not normalized after lower limb revascularization surgery. The study of microcirculation indicators with an assessment of the functional activity of microcirculatory blood flow prior and after surgery will allow verifing the existing disorders and personalizing the treatment tactics.

Keywords: microcirculation, atherosclerosis, restenosis, femoral-popliteal bypass surgery, laser Doppler flowmetry
p. 144-151 of the original issue
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Address for correspondence:
305041, Russian Federation,
Kursk, K.Marx Street, 3,
Kursk State Medical University,
the Department of Surgical Diseases
of the Institute of Continuing Education,
tel. +7 4712 58-81-32,
e-mail: azaroks@mail.ru,
Lazarenko Victor A.
Information about the authors:
Lazarenko Victor A., MD, Professor, Head of the Department of Surgical Diseases of the Institute of Continuing Education, Kursk State Medical University, Kursk, Russian Federation.
https://orcid.org/0000-0002-2069-7701
Bobrovskaya Elena A., MD, Associate Professor, the Department of Surgical Diseases of the Institute of Continuing Education, Kursk State Medical University, Kursk, Russian Federation.
https://orcid.org/0000-0003-3898-5522
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