Specific complications of semi-closed endarterectomy from the iliac arteries.

Altogether 104 patients were examined. Semi-closed endarterectomy from the iliac arteries was attempted in 110 limbs of these patients. In 13.6% of cases, operation was unsuccessful. In 3.6% of cases, the failure was caused by arterial perforation when applying a loop-shaped tool. Ninety-five patients underwent deobliteration of the iliac arteries. In the short-term postoperative period, 2 (2.1%) patients developed reocclusion of the operated segment and 5 (5.3%) had acute ischemia of the contralateral limb. The causes and the clinical importance of errors and complications from semi-closed endarterectomy are discussed.

[Choice of level and establishment of limb stump in patients with obliterative arteries diseases]. / Vybor urovnia i sposoba formirovaniia kul'ti konechnosti u bol'nykh obliteriruiushchimi zabolevaniiami arterii.

335 patients with obliterative diseases of arteries of the low extremities were examined. Results of motor rehabilitation depend on the severity of post-amputation defect of the extremity and functional condition of the stump. The lower is the level of the amputation the higher is the effectiveness of the rehabilitational measures. Ischemia of femoral stump springs up rarely but its course is mare severe than ischemia of the stump of the shin, which is confirmed by the data of clinical examination, investigation of biochemical parameters of the blood and mortality rate. For prophylaxis of ischemia of the stump it is suggested simultaneously with the amputation of the extremity to perform reconstructive procedures on the arteries, aimed at restoration of blood flow through the profound femoral artery. This policy provides the possibility to form a long functional stump of the extremity and to improve results of motor rehabilitation.

[Surgical treatment of ischemia of the stump of the lower extremity]. / Khirurgicheskoe lechenie ishemii kul'ti nizhnei konechnosti.

The authors observed 22 patients who had obliteration of leg arteries and stage III-IV leg stump ischemia. The reconstruction of the stump circulation by using a deep artery of the thigh allowed to stop the ischemia and make the stump more functional or gave an opportunity to make Gritty operation.

[Regional blood lactate level in arterial occlusive diseases]. / Issledovanie kontsentratsii laktata v regionarnoi krovi pri obliteriruiushchikh zabolevaniiakh arterii.

Fifty-seven patients with obliterating diseases of the lower limb arteries were examined. The concentration of lactate in the venous blood and the venous-arterial difference in the blood lactate level in the affected limb were found to be increased. A relationship between the marked character of these shifts and the severity of the ischemic syndrome was noted. The authors discuss the possibility of using the values of the lactate content in the regional blood as criteria for evaluating the efficacy of treatment and the prognosis of obliterating diseases of the lower limb arteries.

[Pathophysiological and clinical evaluation of the effectiveness of dalargin in the treatment of arterial occlusive diseases of the lower extremities]. / Patofiziologicheskaia i klinicheskaia otsenka éffektivnosti dalargina pri lechenii obliteriruiushchikh zabolevanii arterii nizhnikh konechnostei.

Eighty seven patients with Stages II-III vascular occlusions in the lower extremities were examined. The clinical and biochemical parameters of the course of the disease were found to improve in the patients who received in earlier periods dalargin supplemented to the combined therapy than in those from a matched group. There was a decrease in femoral venous blood lactate concentrations in the diseased extremity, blood cholesterol and parathyroid hormone levels. The mechanisms responsible for effects of dalargin on metabolic parameters and clinical indices of the patients' condition were also discussed. Whether it is possible to use dalargin in the combined therapy for extremity vascular occlusive diseases is considered.