Journal «Angiology and Vascular Surgery» • 

2018 • VOLUME 24 • №4

Objective assessment of the degree of ischaemia and efficacy of treatment in chronic arterial insufficiency of lower limbs

Shabunin A.V.1, Matveev D.V.1, Kuznetsov M.R.2, Fedorov E.E.3, Matveev A.D.1

1) First Department of Surgery, Russian Medical Academy of Continuing Professional Education under the RF Ministry of Public Health,
2) Department of Faculty Surgery No 1, Pirogov Russian National Research Medical University (RNRMU),
3) Municipal Clinical Hospital No 29 named after N.E. Bauman, Moscow, Russia

Presented in the review is the data concerning contemporary criteria for assessing the degree of chronic lower limb ischaemia and quality of the treatment performed. Problems regarding objectivization of the degree of an ischaemic lesion of an extremity and assessment of quality of conservative treatment still remain unresolved. Currently, in the world practice along with instrumental methods (assessment of the ankle-brachial index) subjective criteria are mainly employed: assessment of pain-free walking distance or maximum distance walked. In order to work out appropriate regiments of conservative treatment and compare efficacy of various drugs for treatment of chronic lower limb ischaemia and, in particular, intermittent claudication, it is necessary to use objective criteria. Detailed consideration is hence given to the possibilities of using morphological, biochemical and histological criteria such as determination of vascular endothelial growth factor A (VEGF-A) in peripheral blood and determination of apoptosis markers (BNIP3) and hypoxia-inducible factor (HIF-1) in a biopsy sample of the gastrocnemius muscle of the ischaemized extremity.

KEY WORDS: chronic lower limb ischaemia, ankle-brachial index, transcutaneous oxygen tension, limb viability, critical ischaemia, WIFI scale, morphology, apoptosis, VEGF-A.

P. 183

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