Journal «Angiology and Vascular Surgery» • 

2008 • VOLUME 14 • №4

PRACTICAL MEDICINE NON-INVASIVE DIAGNOSIS AND TREATMENT TACTICS IN MANAGEMENT OF DISORDERED REGIONAL HAEMODYNAMICS IN PATIENTS WITH CHRONIC OBLITERATING DISEASES OF LOWER-LIMB ARTERIES

Sukovatykh B.S., Knyazev V.V.
Chair of General Surgery Kursk State Medical University,
Kursk, Russia

By means of ultrasonographic angioscanning, Doppler ultrasonography, photoplethysmography, and determination of oxygen partial tension, the authors have analysed the relationship between the arterial inflow, venous return, and the state of microcirculation in a total of 120 patients presenting with various-degree chronic ischaemia of the lower extremities, having developed on the background of obliterating arterial diseases. The authors worked out a complex of methods of non-invasive diagnosis, making it possible to determine the beginning of and to take control over the course of chronic ischaemia of the extremity involved. Also determined herein were the threshold levels of critical disorders of macro-and micro-haemodynamics (the regional systolic pressure gradient of more than 2, the postocclusion venous pressure gradient of more than 3, and the venous-arterial index of more than 40%), which makes it possible to consider that the patient concerned is running a high risk of the development of critical ischaemia in the near future. Such being the case, it is necessary to perform a reconstructive vascular operation, and if impossible – to carry out intensive therapy of both systemic and local risk factors.

KEY WORDS: noninvasive diagnosis, macrohaemodynamics, microcirculation, critical ischaemia, lower limbs.

P. 145

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