1. [Role of low-dose acetylsalicylic acid in comprehensive postoperative treatment of patients with lower-limb chronic arterial insufficiency].
- Author
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Kuznetsov MR, Rodionov SV, Koshkin VM, Virganskiĭ AO, Golosnitskiĭ PIu, Tepliakov SA, Kosykh IV, Ostapchuk NA, Lisenkov OP, and Chernikov VP
- Subjects
- Blood Coagulation drug effects, Blood Viscosity drug effects, Graft Occlusion, Vascular blood, Graft Occlusion, Vascular etiology, Graft Occlusion, Vascular pathology, Humans, Lower Extremity blood supply, Male, Pentoxifylline administration & dosage, Pentoxifylline adverse effects, Peripheral Arterial Disease blood, Peripheral Arterial Disease pathology, Platelet Aggregation drug effects, Platelet Aggregation Inhibitors administration & dosage, Platelet Aggregation Inhibitors adverse effects, Postoperative Period, Reoperation, Treatment Outcome, Vascular Grafting methods, Vascular Patency drug effects, Vasodilator Agents administration & dosage, Vasodilator Agents adverse effects, Xanthinol Niacinate administration & dosage, Aspirin administration & dosage, Aspirin adverse effects, Femoral Artery pathology, Femoral Artery transplantation, Graft Occlusion, Vascular prevention & control, Peripheral Arterial Disease surgery, Popliteal Artery pathology, Popliteal Artery transplantation, Vascular Grafting adverse effects
- Abstract
The study comprised a total of 107 patients (all men) after endured femoropopliteal bypass grafting above the genicular fissure with a synthetic stent graft manufactured by the Gore Company for stage IIB and III chronic arterial insufficiency of the lower extremities according to the Fontain-Pokrovsky classification. Group One I (control group) was composed of fifty-four patients permanently taking in the postoperative period at the out-patient stage pentoxiphylline (trental 400 mg 1 tablet 3 times daily) and xantinol nicotinate at a dose of 150 mg one tablet thrice daily. Group Two (Study Group) consisted of fifty-three patients taking after reconstructive vascular surgery at the out-patient stage in addition to pentoxiphylline and xantinol nicotinate acetylsalicylic acid (cardiomagnil 75 mg 1 tablet once daily). The Control Group patients within 3 to 6 months of follow up were found to have a considerable progressing improvement of the functional abilities of the microcirculatory bed requiring in 44 (81.5%) cases hospitalization to the Surgical Department for intensive vascular therapy. Despite this fact four (7.4%) patients within the time frame from 6 to 9 months after surgery developed thrombosis of the vascular implant requiring a repeat surgical intervention. In the Study Group patients, the degree of functional capabilities of the microcirculatory bed in the postoperative period was less considerable, reaching the maximum after 10-12 months of follow up, with eighteen (34.0%) patients requiring hospitalization for additional vascular therapy to perform. There were no cases of implants' thrombosis in the Study Group patients. Pathological alterations in the functional state of the peripheral vascular bed correlated with viscosimetric indices and activity of blood platelet aggregation. The addition of antithrombocytic agents to conservative postoperative therapy considerably improved the outcomes of surgical treatment.
- Published
- 2011