LASER DOPPLER FLOWMETRY FOR EVALUATION OF IRREVERSIBLE ISCHEMIC CHANGES IN LOWER LIMB TISSUES IN PATIENTS WITH ARTERIOSCLEROSIS OBLITERANS

Yu.A. Burov, E.G. Mikulskaya, A.N. Moskalenko
Department of Vascular Surgery, 1st Clinical Hospital,
Saratov, Russia

The aim of the study was to define and evaluate factors indicating irreversible tissue ischemia in lower limb by functional assessment of microcirculation for critical ischemia treatment planning. Analysis of laser Doppler flowmetry (LDF) in lower extremities of 92 patients with III-IV grade atherosclerotic critical ischemia is presented. Postischemic test results appeared to be the most valuable for LDF assessment of lower limb microcirculation. Evaluation of basal skin blood flow (BF) in foot and toes was useful for diagnostic screening of irreversible tissue changes. LDF curves for BF in the latter case were monophasic, without peaks. Comparison of LDF data with clinical treatment outcome of lower limb critical ischemia revealed that combination of BK low values and postischemic blood flow increase lower then 40% was a significant predictor of irreversible changes. Intraoperative LDF measurements during extremity amputation enabled to detect critical fall of blood flow in different muscular segments. When BK values were lower then 2.5 units, muscular mass was dissected and not used for myoplasty.

KEY WORDS: ischemia in lower limb, laser Doppler flowmetry.

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