Journal «Angiology and Vascular Surgery» • 

2004 • VOLUME 10 • №3

LUMBAR SYMPATHECTOMY IN TREATMENT OF OBLITERATING DISEASES OF LOWER LIMBS: STATE OF THE ART

A.V. Gavrilenko, E.P. Kokhan, A.V. Abramyan, S.I. Skrylev, S.P. Kozlov, O.A. Omarzhanov
Vascular Surgery Department RAMS Russian Research Surgical Centre, Centre for Vascular Surgery, A.A. Vishnevsky 3rd Central Military Clinical Hospital,
Moscow, Russia

The article deals with analysing examination and surgical treatment of 80 patients with predominant lesions to the distal arterial bed of the lower extremities, who were operated on at the RRSC from 1996 to 2003 with various degree on the background of chronic obliterating diseases of lower limbs arteries.

All the patients were subdivided into two groups according to the outcomes of the epidural block: Group I – wth positive outcomes consisted of 36 (45%) patients, and Group II – with a negative outcome – included 44 (55%) patients.

The patients from the both groups underwent the following operations: lumbar sympathectomy combined with direct and indirect methods of revascularisation, as well as lumbar sympathectomy as an independent therapeutic method.

To solve the problem concerning feasibility of either done, or concomitant lumbar sympathectomy, we devised assessment of microcirculation state (alterations in volumetric blood flow indices in epidural block in relation to the indices at rest, as well as in the immediate or remote postoperative period) and peripheral haemocirculation (dynamics of the onkle brachial index values on the background of epidural block test, nitroglycerine test in relation to the ARI at rest both in the short-, and long-term postoperative period) by data of scintigraphy and dopplerography of the lower limbs.

KEY WORDS: chronic ischemia of lower limbs, lumbar sympathectomy, epidural sympathetic block.

P. 95

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