FUNCTIONAL FLOWMETRY IN DETERMINING THE INDICATIONS FOR RECONSTRUCTIVE SURGICAL INTERVENTIONS ON THE MAJOR ARTERIES OF THE PELVIS AND LOWER LIMBS

M.R. Kuznetsov, V.M. Koshkin, S.V. Rodionov, A.O. Virgansky, E.P. Moskalenko, P.Yu. Golosnitsky, M.V. Dobryansky
Chair of Faculty Surgery of the State Educational Facility of Postgraduate Medical Training Russian State Medical University,
Moscow, Russia

The work was based on the findings of the examination and surgical management of 69 patients with obliterating atherosclerosis of the lower limbs with various degree of chronic arterial insufficiency. The authors analyzed the main causes promoting development of early reocclusion of the bypasses and prostheses following reconstructive surgical operations. They also proved the role of high peripheral vascular resistance and, in particular, diminished functional possibilities of the microcirculatory-bed vessels in the genesis of early reocclusions in patients with chronic arterial insufficiency of the lower limbs. They also suggested a new technique of determining the carrying capacity of the microcirculatory channel, the use of which in the preoperative period makes it possible to predict development of early thrombotic complications, and in some cases to wisely abstain from carrying out a reconstructive vascular intervention due to high risk of its poor outcomes. It is preferable for such patients to undergo conservative pathogenetic preoperative therapy aimed at improving the functional possibilities of the microcirculatory vessels.

KEY WORDS: chronic arterial insufficiency, surgical management, early reocclusions, peripheral vascular resistance, flowmetry, microcirculatory channel.

P. 132

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