Voloshyn O. Lower limb indirect types of revascularization with femoral-popliteal-tibial occlusions

The research has been devoted to improving the results of surgical treatment of patients with femoral-popliteal- occlusion of the tibia via the deep femoral artery revascularization and PRP-therapy depending on the type of lesion and topographic-anatomical features femoral artery. A prospective analysis of surgical treatment of 80 male patients with atherosclerotic lesions of the femoral-popliteal-tibial segment had been implemented. The topographic-anatomical peculiarities of arterial channel thigh had been established using the intraoperative assessment and angiograms analysis. The efficiency of intraoperative ultrasound duplex scanning elaboration techniques had been determined which allowed to estimate the length of the wall-occlusive lesions and to select the optimal reconstruction type leading to the diameter of the deep femoral artery increasing up to 87,5% (p <0,05), and tripled the blood flow velocity in the area of the mouth. The high efficiency of the PRP-therapy for patients with inoperable types of occlusion of the femoral-popliteal-tibial segment had been shown for the first time which could normalized the concentration of serum VEGF 121,64±26,4 pg/ml, raised the number of capillaries per muscle fiber up to 58,6% (p<0,05) and significantly increases the ABI on 28,9% (p<0,05). The optimized techniques of deep femoral artery revascularization application, PRP-therapy and regular exercises had been led to sustainable growth life index, rapid healing of trophic disorders, painless distance walk increasing and promoted more rapid social rehabilitation as well as increased the number of desirable treatment results up to 31% and halve the number of lower limb amputations.