Modified revascularizing osteal trepanation in patients with critical lower limb ischemia and distal arterial lesion

Kosayev J.V.; Abushov N.S.; Namazov I.L.

doi:https://doi.org/10.17116/kardio202013051421

Kosayev J.V.

Topchibashev Research Center of Surgery

Abushov N.S.

Topchibashev Research Center of Surgery

Namazov I.L.

Topchibashev Research Center of Surgery

Modified revascularizing osteal trepanation in patients with critical lower limb ischemia and distal arterial lesion

Authors:

Kosayev J.V., Abushov N.S., Namazov I.L.

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Journal: Russian Journal of Cardiology and Cardiovascular Surgery. 2020;13(5): 421‑426

DOI: 10.17116/kardio202013051421

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To cite this article:

Kosayev JV, Abushov NS, Namazov IL. Modified revascularizing osteal trepanation in patients with critical lower limb ischemia and distal arterial lesion. Russian Journal of Cardiology and Cardiovascular Surgery. 2020;13(5):421‑426. (In Russ.)
https://doi.org/10.17116/kardio202013051421

Подписка 2026 Кардиология и сердечно-сосудистая хирургия (Russian Journal of Cardiology and Cardiovascular Surgery)

Использование инфографики авторами научных работ

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OBJECTIVE

To study the features of regional blood flow stimulation with modified revascularizing osteal trepanation (ROT) in patients with critical lower limb ischemia (CLLI) following distal arterial lesion.

MATERIAL AND METHODS

There were 121 CLLI patients. Standard treatment was performed in 48 patients (control group). Regional blood flow was stimulated by ROT in 42 patients, ROT with intraosseous laser irradiation — in 31 patients. The following in-hospital parameters of arterial and venous blood flow were analyzed: regional systolic pressure in the patient’s standing and lying position, regional systolic pressure gradient, post-occlusive venous pressure in the patient’s standing and lying position, post-occlusive venous pressure gradient, venous-arterial index in the patient’s standing and lying position. The same values were measure in 3-4 months after discharge. Regional arterial and venous circulation was compared with identical parameters in 48 healthy individuals (control group).

RESULTS

Upon admission, severe local arterial and venous circulatory disorders were observed. ROT and ROT with intraosseous laser irradiation reliably mobilize regional circulation and reduce severity of chronic ischemia in comparison with initial data. These results are more obvious after ROT with intraosseous laser irradiation. There was a significant correlation of blood flow stimulation with surgical strategy (p<0.001).

CONCLUSION

Regional blood flow stimulation with a modified ROT (ROT and intraosseous laser irradiation) is justified in patients with CLLI and distal arterial lesion if direct revascularization is impossible. This approach improves treatment outcomes in this severe category of patients.

Keywords:

distal arterial occlusion

critical lower limb ischemia

regional hemodynamic stimulation

revascularizing osteal trepanation with intraosseous laser irradiation

Authors:

Kosayev J.V.

Topchibashev Research Center of Surgery

Abushov N.S.

Topchibashev Research Center of Surgery

Namazov I.L.

Topchibashev Research Center of Surgery

Received:

10.06.2020

Accepted:

08.07.2020

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