DOI: https://doi.org/10.22141/2224-0721.15.4.2019.174820

State of antioxidant, pro-oxidant and endothelial systems in patients with chronic critical lower limb ischemia and high risk of reperfusion-reoxygenation complications

O.B. Kolotylo

Abstract


Background. Obliterating atherosclerosis of the peripheral arterial vessels accounts for more than 20 % of cases of cardiovascular pathology, that is more than in 3 % of the total population. Despite the large experience of performing operative arterial interventions, the 3­year ability of the femoral subcutaneous shunts does not exceed 80 %. The frequency of re­occlusion of iliac arteries is from 6 to 42 %. The purpose of the research was to study the features of the oxidant, pro­oxidant and endothelial systems in patients with chronic critical lower limb ischemia. Materials and methods. The work is based on the analysis of complex examination and surgical treatment of 220 patients with obliterating athe­rosclerosis of aorta and main arteries of the lower extremities. The patients were divided into two groups in terms of volume of surgical revascularization of femoropopliteal arteries. In the first group of patients, operative intervention included one­stage reconstruction of the aorta­femoral and femoropopliteal segments, in patients of the second group, the reconstruction of the indicated segments was performed in two stages. The activity of the components of the pro­oxidant­antioxidant system was determined using spectrophotometric methods. Results. Investigations of the activity of free­radical oxidation demonstrated that the processes involving the tissues of the lower limbs, due to the influence of oxygen free radicals on them, not only activate free radical processes, but can also enhance the processes of damaging effects on the tissue cells and, moreover, on the endothelial system. Conclusions. The risk of reperfusion complications in the postoperative period in patients is confirmed by the high level of the inflammatory response. When revascularization occurs, the destruction, detachment of endothelial cells, the spread of endothelial cell­cell contacts contributes to increase of penetration of the endothelial layer.


Keywords


reperfusion and reoxygenation syndrome; antioxidant system; pro-oxidant system; endothelial system; critical ischemia; revascularization

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