Year 2017 Vol. 25 No 6

REVIEWS

V.N. ZASIMOVICH, N.N. IOSKEVICH

REPERFUSION (REOXYGENATION) INJURY AS A PROBLEM OF THE ARTERY RECONSTRUCTIVE SURGERY IN ATHEROSCLEROTIC GENESIS CHRONIC ISCHEMIA OF THE LOWER LIMBS

ME Brest Regional Hospital1, Brest
EE Grodno State Medical University2, Grodno
The Republic of Belarus

Objective. To perform the analysis of literature sources dedicated to the problem of reperfusion (reoxygenation) injury after revascularization of the lower limbs.
Methods. The native and foreign literature data have been analyzed concerning the investigation stages of the problem, pathogenesis, clinical manifestations of reperfusion (reoxygenation) injury and methods of its prediction, prevention and correction for recent 20 years.
Results. The steady increase in atherosclerosis incidence, quantitative rise of lower limbs revascularization determines an increase in the frequency of reperfusion injury, significantly reducing the effectiveness of surgical interventions, impeding the restoration of function and, often, and preservation of the limb. Post-reperfusion injuries of the organs and systems remote from the lower limbs result in an evident life quality decline and lethality increase. The generalization of data on the studies of various links in the pathogenesis of ischemia-reperfusion and the methods of its correction indicate their fragmentation. The relationship between the severity of reperfusion injuries and the initial degree of the limb ischemia has not been adequately investigated.
Conclusions. Necessity in improvement of the surgical treatment results of chronic lower limb ischemia requires systemic researches on the correlation of disturbances of prooxidant-antioxidant balance, oxygen transport function, electrolyte and energy balance, depending on the degree of ischemia. This will allow developing the criteria for the severity of reperfusion (reoxygenation) injury, algorithms of its prediction, diagnosis, and correction. There is an urgent need to create a practically meaningful classification of ischemia-reperfusion, to determine the laboratory criteria for the degree of its severity, and to develop schemes for its medicinal prevention and treatment.

Keywords: reperfusion injury, revascularization, peripheral artery disease, atherosclerosis, prooxidant-antioxidant balance, oxygen transport function
p. 632-642 of the original issue
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Address for correspondence:
224027, Republic of Belarus,
Brest, Meditsinskaya str., 7,
ME "Brest Regional Hospital",
Vascular Surgery Unit,
Tel.office: +375 162 27-23-64,
E-mail: zasimovich.v@gmail.com,
Vladimir N. Zasimovich
Information about the authors:
Zasimovich V.N., Head of the Vascular Surgery Unit of ME Brest Regional Hospital.
Ioskevich N.N., MD, Professor of the Department of Surgical Diseases 1 of EE Grodno State Medical University.
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