Діагностика та лікування хворих на хронічну ішемію нижніх кінцівок ІІІ і IV стадій

is it requires a surgical intervention because of risk for ischemic stroke. A use of the algorrhythm proposed for the choice of surgical tactics, which includes the evaluation of a cerebrovascular reserve (CVR) in patients with CILE of III and IV stages, allowed significant reductions to be achieved in the number of remote great ischemic strokes from 4.2 to 0.9% (Р = 0.038) and in mortality – from 3.2 to 0.9% (Р = 0.048).

The new operations proposed, along with the intraoperational evaluation of arterial reserve for distal bed of the ischemic lower extremity, allowed significant reductions to be achieved in per cent of high amputations in patients with CILE of III and IV stages, both in the immediate period from 11.1 to 5.9% (Р = 0.041) and in the remote period from 32.6 to 21.7 (Р = 0.030). The associated mortality rate lowwered from 19 to 8.5% (Р = 0.035).

The combined approach proposed for a solution of the problem of diagnosis and treatment for patients with CILE of III and IV stages ensures a significant growth in the number of good results botn in the immediate period from 59.8 to 75.2% (Р = 0.039) and in the remote period from 50.5 to 63.2% (Р = 0.011).

Key words: chronic ischemia of the lower extremities, brachiocephalic arteries, cerebrovascular reserve.




8-09-2015, 22:01

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