Correction of endothelial dysfunction and impaired microcirculation in patients with critical ischemia of the lower extremities and a high risk of development of reperfusion-reoxygenation complications

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O.B. Kolotylo


Background. Epidemiological studies show that critical ischemia of the lower extremities occurs in 500–1,000 patients per million population per year. About 10,000 reconstructive operations are performed annually in Ukraine for occlusive arterial lesions of the lower extremities. At the same time, about 8–10 thousand amputations of the lower extremities due to atherosclerosis are performed annually. The objective was to study the possibility of correcting endothelial dysfunction and microcirculation disorders in patients with chronic critical lower limb ischemia and a high risk of reperfusion-reoxygenation complications after reconstructive operations. Materials and methods. The work is based on an analysis of a comprehensive examination and surgical treatment of 220 patients with obliterated atherosclerosis of the aorta and main arteries of the lower extremities. Endothelial dysfunction was assessed by determining the level of the following markers: P-selectin, E-selectin, tissue plasminogen activator, endothelin-1, vascular cell adhesion molecule 1, circulating endothelial cells. Results. Comparing the severity of endothelial dysfunction and the state of microcirculation in the early postoperative period in patients with and without special preoperative preparation, it is possible to state the necessity and effectiveness of the preoperative use of nebivolol beta-blocker, angiotensin-converting enzyme inhibitor perindopril arginine and L-arginine. Conclusions. The use of beta-blocker nebivolol, angiotensin-converting enzyme inhibitor perindopril arginine, L-arginine and saline hyperosmotic hypertonic dextran solution in the preoperative period in patients at high risk of reperfusion-reoxygenation complications can prevent significant disturbances in the development of endothelial dysfunction and impaired microcirculation and provide tissue oxygenation at the level of 5.04 ± 0.37 mmHg after revascula­rization of the lower extremities.

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How to Cite
Kolotylo, O. “Correction of Endothelial Dysfunction and Impaired Microcirculation in Patients With Critical Ischemia of the Lower Extremities and a High Risk of Development of Reperfusion-Reoxygenation Complications”. INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine), vol. 15, no. 6, Dec. 2019, pp. 453-8, doi:10.22141/2224-0721.15.6.2019.185407.
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