Journal «Angiology and Vascular Surgery» • 

2016 • VOLUME 22 • №2

Functional reserves of peripheral perfusion in patients with chronic lower limb ischaemia and the risk for restenosis development

Kamenskaya O.V., Klinkova A.S., Karaskov A.M.

Novosibirsk Scientific Research Institute for Circulatory Pathology named after Academician E.N. Meshalkin under the RF Public Health Ministry, Novosibirsk, Russia

The authors studied the functional state of the peripheral microcirculatory blood flow (MCBF) by means of laser Doppler flowmetry and the level of partial pressure of oxygen (TcPO2) in a total of 82 patients presenting with stage IIB–IV chronic lower limb ischaemia (CLLI) prior to percutaneous transluminal balloon angioplasty (PTBA) with stenting of lower limb arteries and in the remote terms following revascularization (after 12 months). The study was aimed at assessing the functional reserves of peripheral perfusion in CLLI patients and the risk for the development of restenoses in the remote period after revascularization. Group One comprised 47 patients with the compensated functional state of the peripheral MCBF by the results of the orthostatic test (changing from the lying to standing position) and Group Two was composed of 35 patients with the decompensated state of MCBF.

Decompensated disorders of functional reserves of the peripheral MCBF in CLLI patients, i.e., 1) no reaction of microcirculation to the orthostatic test and 2) a substantial decrease in the oxygen pressure in peripheral tissues (TcPO2 less than 20 mm Hg) increase the chances of restenoses development in the remote period after revascularization 1.9- and 2.4-fold, respectively. Impairments of carbohydrate and lipid metabolism in CLLI patients promote a more than two-fold increase in the risk for the development of restenoses in the postoperative period. It is necessary to determine the functional reserve of the peripheral microcirculation in patients with CLLI at the preoperative stage in order to assess the prognosis of efficacy of revascularization and determine further goal-directed correction of the MCBF.

KEY WORDS: microcirculation, chronic lower limb ischaemia, restenosis.

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