REPROFUSION-REOXYGENATIVE SYN-DROME AT REVASCULARIZATION IN CONDI-TIONS OF CHRONIC CRITICAL ISCHEMIA OF LOWER EXTRAMITIES

The aim of the study is to improve the results of revascularization surgical interventions at chronic critical ischemia of the lower extremities. Materials and methods. The work included 54 pa-tients with atherosclerotic lesions of the abdominal aorta and major arteries of the lower extremities. In all patients, the lower limb was with a high risk of reperfusion-reoxygenative compli-cations and characterized by stage III and IV chronic arterial insufficiency. To obtain information on changes in capillary blood flow and arteriovenular blood flow, the method of laparoscopic Doppler fluorometry was used. For the prevention and treatment of the phenomena of no-reflow and reflow-paradox in the pre-operative period, a complex of proposed measures was implemented. Results. Ultrasound monitoring of hemodynamics of the thigh -popliteal segment in the postoperative period revealed a reduction peak systolic velocity and an index of resistance, which was an indication for additional reconstruction of the thigh-popliteal segment. In analysing the results of the study of the state of the microcirculation bed in 48 hours after revascularization significant improvement of functional capacity was established. Along with this, the difference in the level of functional state of the microcirculatory bed after the application of different types and volume of revascularization surgical interventions was noted. Conclusions. Pathogenetically grounded preoperative preparation and application of methods in the form of revascu-larization of the lower extremity, which prevent the sudden massive flow of blood in the arterial bed of the lower limb, make it possible to prevent the development of a series of terrible reperfusion reo-syndication complications.