METABOLIC AND SURGICAL PREDICTORS OF RESTENOSES AND THROMBOSES OF BIOLOGICAL GRAFTS IN THE INFRAINGUINAL POSITION

Barbarash L.S., Burkov N.N., Kudryavtseva Yu.A., Sizova I.N., Zhuravleva I.Yu.
Scientific Research Institute for Comprehensive Problems of Cardiovascular Diseases -Siberian Branch of the Russian Academy of Medical Sciences,
Kemerovo, Russia

The present study was aimed at revealing metabolic and surgical predictors of restenoses and thromboses of biological grafts «KemAngioprosthesis» in the infrainguinal position in the remote postoperative period. A total of 65 patients (54.2% of the whole group) with primarily functioning bioprostheses underwent dispensary follow-up (consisting of comprehensive analysis of the haemostasis system, blood plasma lipid spectrum, findings of duplex scanning of the prosthesis and anastomosis zones). Based on the laboratory findings (fibrinogen, index of atherogenicity, cholesterol), the patients were subdivided into two groups: Group One (n=27) consisted of patients with normal values, and Group Two (n=38) was composed of those with one or more parameters exceeding the norm. Fifteen Group Two patients were found to have stenoses of the anastomosis zones.

Based on the results of the study we determined a clear relationship between the development of complications and impairments in the system of haemostasis and lipid metabolism. All patients from Group Two whose the remote postoperative period was complicated by stenoses of anastomoses showed hypercholesterolemia, dyslipidemia, and platelet hyperaggregation, regardless of the terms of the development of the complication. Once stenoses developed within 3-to-18 months postoperatively, the levels of fibrinogen and soluble fibrin monomeric complexes were elevated. Analysing surgical predictors of restenoses showed that the technique of establishing either an «end-to-end» or «end-to-side» anastomosis exerted no influence on the incidence rate of restenoses in the remote postoperative period.

KEY WORDS: restenosis of anastomoses zones, biological grafts «KemAngioprosthesis», predictors.

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