Pavliuk N. The choice of amputation level in patients with occlusive diseases of arteries of lower extremities. - Qualifying scientific work on the rights of the manuscript

The dissertation on acquisition of a scientific degree of the candidate of medical sciences (doctor of philosophy) on a specialty 14.01.03 - surgery. - Ivano-Frankivsk National Medical University of the Ministry of Health of Ukraine, Ivano-Frankivsk, 2020. This paper analyzes the examination and treatment of 189 patients with occlusive arterial disease of the lower extremities of various origins, which led to an amputation. The main reasons that caused the need for amputation were atherosclerosis obliterans (30.7 ± 3.4 %) and occlusive lesions of the arteries due to type 2 diabetes (69.3 ± 3.35 %). Performing light optical and electron microscopic research, arteries revealed that atherosclerosis obliterans dominant pathological changes in the intima, such as atheromatous mass and some parts of endothelial desquamation, fragmentation, and multiplication of internal elastic membrane. In diabetes mellitus, there are dystrophic-desquamative changes of the intima, lipid- fibrous plaques, islets of petrification in the media, lymphocyte-macrophage infiltration are found in the wall of all studied arteries, and edema are detected in the adventitia. The principle of preoperative preparation was the same in different terms of analysis, but there were some differences, involving the duration of conservative preoperative treatment and choice of drugs. An important indicator that determined the duration of preoperative preparation was the presence of signs of systemic inflammatory response syndrome (SIRS).