[Revascularizing osteotrepanation in combined surgical treatment of chronic lower limb ischemia]. / Revaskuliariziruiushchaia osteotrepanatsiia v kompleksnom khirurgicheskom lechenii khronicheskoi kriticheskoi ishemii nizhnikh konechnostei.

Short and long-term results of revascularizing osteotrepanations by Zusmanovich's method performed in 80 patients with lower limb critical ischemia were analyzed. The operation is effective in distal and diffuse forms of atherosclerosis and inflammatory diseases if it is impossible to perform reconstruction. Isolated revascularizing osteotrepanation is indicated for patients with recurrence of critical ischemia who earlier have undergone conventional surgical procedures. Duplex sonography is the main method for diagnosis and determination of indications for surgery which provides an objective criterion of the treatment failure - the index of tibial arteries resistance.

Treatment strategies for patients with chronic ischemia of the lower limbs in erosive-ulcerous gastroduodenitis.

Endoscopic examination of the stomach and duodenum with microscopic examination of biopsy material was performed in 66 patients with lower limbs chronic ischemia before reconstructive surgeries on aorto-ilio-femoral segment. High incidence (30.3%) of erosive-ulcerous diseases of the stomach and duodenum was revealed, 12% of the patients had undergone surgeries on the stomach and duodenum due to peptic ulcer. Hemodynamic studies of mesenteric vessels showed some increase of their diameter, slight increase of blood velocity, decrease of pulsation indices and circulatory resistance which may be regarded as the phenomenon of blood shunting and reduced blood flow in terminal branches of visceral vessels. Erosive-ulcerous diseases of the stomach and duodenum are more severe in patients with lower limbs critical ischemia.