[The potentials of polarography in predicting the effect of a reconstructive operation in patients with severe ischemia of the lower extremities]. / Vozmozhnosti poliarografii v prognozirovanii éffekta rekonstruktivnoi operatsii u bol'nykh s tiazheloi ishemiei nizhnikh konechnostei.

Possibilities to prognose the effect of reconstructive operation on the lower extremity vessels are shown on the basis of transcutaneous of oxygen on the dorsal surface of the foot in complex with ultrasonic Dopplerometry in patients with severe ischemia of lower extremities. Effectiveness of the test with the orthostatic growth of Po is proved. An examination of 60 patients with severe ischemia of lower extremities and 10 patients without pathology of main vessels (control group) was performed. Operations were performed on 48 patients, in 35 of them reconstructive operations were made. No correlation was found between preoperative value of Po and a result of the reconstruction. A correlation was found between the value of the orthostatic growth of Po and outcome of the reconstructive operation. The average growth of Po in the group of patients with a negative outcome of the reconstruction made up 9.93 + 2.78 mm Hg, with a positive outcome it was 14.137 + 2.30 mm Hg (p < 0.05). In patients with malleolus index of the regional systolic pressure > 0.3 with the orthostatic growth of Po > 20 mm Hg the probability of positive prognosis of the reconstruction made up 88.8%.

[The potentials for noninvasive diagnosis in predicting the effect of a reconstructive operation in patients with severe ischemia of the lower extremities]. / Vozmozhnosti neinvazivnoi diagnostiki v prognozirovanii éffekta rekonstruktivnoi operatsii u bol'nykh s tiazheloi ishemiei nizhnikh konechnostei.

The paper discusses whether the outcome of reconstructive surgery can be predicted by using the orthostatic test in Doppler sonography and transcutaneous polarography. A total of 97 patients with severe lower extremity ischemia were studied, of them 87 were operated on. Reconstructive operations on the vessels were performed in 72 patients. There was no relationship between the value of the humero-mallear index of regional systolic pressure as well as TcpO2 and the outcome of an operation. At the same time there was a correlation between the orthostatic rise in regional systolic pressure on the tibial arteries at the ankle-bone and the orthostatic increase in pO2 in the feet and the outcome of a reconstructive operation. The orthostatic rise in pO2 and regional systolic pressure was 8.06 +/- 4.0 and 58.2 +/- 5.43 mm Hg in patients with poor outcomes and inoperable patients, respectively. In good outcomes, these figures were 17.8 +/- 2.14 and 91.3 +/- 3.64 mm Hg (p < 0.05), respectively. The positive outcome of a reconstructive operations was observed in 88.8 = 92.0% patients with an orthostatic rise of pO2 in the feet by more than 20 mm Hg and that at the ankle-bone by more than 90 mm Hg.

[Use of transesophageal electrostimulation of the atrium and nitroglycerin test in the evaluation of the degree of risk of the development of cardiac complications after reconstructive surgery in patients with Leriche's syndrome]. / Primenenie chrespishchevodnoi élektrostimuliatsii predserdii iprobys nitroglitserinom dlia otsenki stepeni riska razvitiia kardial'nykh oslozhnenii posle rekonstruktivnykh operatsii u bol'nykh s sindromom Lerisha.

By the method of transesophageal electrostimulation of the left auricle, 98 patients with Leriche's syndrome were examined. Of them in 51, the coronary disease was revealed. The degree of ischemic changes in the terminal part of the ventricular complex were defined by the rate of stimulation, depth of the ST segment shift, and duration of ischemic depression. The nitroglycerin test permitted to evaluate the anti-ischemic effect of the drug, quality and effectiveness of the preoperative preparation. In patients with negative or doubtful anti-ischemic effect, the risk of the development of cardiac complications increases.