ABSTRACT
The study comprised a total of 107 patients (all men) after endured femoropopliteal bypass grafting above the genicular fissure with a synthetic stent graft manufactured by the Gore Company for stage IIB and III chronic arterial insufficiency of the lower extremities according to the Fontain-Pokrovsky classification. Group One I (control group) was composed of fifty-four patients permanently taking in the postoperative period at the out-patient stage pentoxiphylline (trental 400 mg 1 tablet 3 times daily) and xantinol nicotinate at a dose of 150 mg one tablet thrice daily. Group Two (Study Group) consisted of fifty-three patients taking after reconstructive vascular surgery at the out-patient stage in addition to pentoxiphylline and xantinol nicotinate acetylsalicylic acid (cardiomagnil 75 mg 1 tablet once daily). The Control Group patients within 3 to 6 months of follow up were found to have a considerable progressing improvement of the functional abilities of the microcirculatory bed requiring in 44 (81.5%) cases hospitalization to the Surgical Department for intensive vascular therapy. Despite this fact four (7.4%) patients within the time frame from 6 to 9 months after surgery developed thrombosis of the vascular implant requiring a repeat surgical intervention. In the Study Group patients, the degree of functional capabilities of the microcirculatory bed in the postoperative period was less considerable, reaching the maximum after 10-12 months of follow up, with eighteen (34.0%) patients requiring hospitalization for additional vascular therapy to perform. There were no cases of implants' thrombosis in the Study Group patients. Pathological alterations in the functional state of the peripheral vascular bed correlated with viscosimetric indices and activity of blood platelet aggregation. The addition of antithrombocytic agents to conservative postoperative therapy considerably improved the outcomes of surgical treatment.
Subject(s)
Aspirin , Femoral Artery , Graft Occlusion, Vascular/prevention & control , Peripheral Arterial Disease/surgery , Popliteal Artery , Vascular Grafting/adverse effects , Aspirin/administration & dosage , Aspirin/adverse effects , Blood Coagulation/drug effects , Blood Viscosity/drug effects , Femoral Artery/pathology , Femoral Artery/transplantation , Graft Occlusion, Vascular/blood , Graft Occlusion, Vascular/etiology , Graft Occlusion, Vascular/pathology , Humans , Lower Extremity/blood supply , Male , Pentoxifylline/administration & dosage , Pentoxifylline/adverse effects , Peripheral Arterial Disease/blood , Peripheral Arterial Disease/pathology , Platelet Aggregation/drug effects , Platelet Aggregation Inhibitors/administration & dosage , Platelet Aggregation Inhibitors/adverse effects , Popliteal Artery/pathology , Popliteal Artery/transplantation , Postoperative Period , Reoperation , Treatment Outcome , Vascular Grafting/methods , Vascular Patency/drug effects , Vasodilator Agents/administration & dosage , Vasodilator Agents/adverse effects , Xanthinol Niacinate/administration & dosageABSTRACT
In the experiments on Wistar rats we showed that administration of ulcerogenic drugs (cinchophen, acetylsalicylic acid, butadione, indomethacin etc.) produced the alterations of free activity of lysosomal enzymes in the homogenates of ulcerated stomach, presumably the significant elevation of the activity of cathepsins (more often cathepsin with optimum of activity at pH 5.5) and the significant reduction of free activity of acid nucleases (more often of DNA-ase). The alterations of free activity of lysosomal enzymes were as in cases with gastric ulcerations as in cases with unaffected stomach.
