Kysileskyi D. Bleeding adjustment in case of occlusive arterial shank wound with regards to endothelium state

81 patient: 75 men and 6 women, aged 42-80 stages, who suffer from ischemia and chronic shank and foot atherosclerotic disease took part in the research and were carefully monitored. Other 10 patients (who were monitored to compare the results of the research) were quite healthy. The research has been conducted in 2 stages. The first one included clinical observation and first group patients' treatment that enabled us to improve diagnostic and treatment algorithm. The second stage implied treatment of 15 patients who had the fourth stage of ischemia and due to the results received at the first stage allowed to cure patients with the third ischemia level. In accordance with the diagnostic program the major group has been subdivided for 3 more subgroups. The first one had 31 patients aged 42-75, average made 59,4+7,8. The second subgroup patients were aged 43-80, the average age was 63,5+9,6, and finally the third group patients' age was 42-85 and average made 64,67 + 12,16. Special diagnostic method (utility model №2866 declaration patent of Ukraine) to determine the type of lower limbs ischemia and to select the proper treatment, to identify endothelin-1 concentration in systematic and regional blood flow was designed. The scheme obtained reduced the likelihood of limbs amputation among the group 1 patients from 40 to 33,3% and also among group 3 patients when endothelia ischemia index made more than 0,50 + 0,11. Finally, we came to realize that endothelia ischemia index and endothelin 1 concentration awareness enables in each individual case to apply optimal and most efficient therapy tactics and to assess whether it is necessary to employ surgical intervention.