Effect of Buerger's thromboangiitis activity on the outcomes of vascular reconstructions

Altogether 39 patients suffering from thromboangiitis obliterans were under observation. The vasculitis activity score (VAS) developed by R.A. Luqmain et al. (1994) was used as a criterion for thromboangitis activity. The patients were distributed into 2 groups: the first group included patients in the period of remission and the second, group comprised patients in the period of exacerbation. The patients underwent different types of vascular reconstructions. On examination of hemostasis and hemorheology the second group patients demonstrated potentiation of platelet function, inhibition of antiaggregation activity of the arterial wall, the rise of aggregation activity of red blood cells, and inhibition of blood fibrinolytic activity. The tendency toward hypercoagulation and hyperaggregation revealed in the second group patients led to deterioration of the immediate outcomes of reconstructive operations. Thrombosis of the reconstructed area was recorded in 5 (26.31%) first group patients and in 7 (35%) second group patients. In the first group, the high limb amputation was accomplished in one (5.26%) patient whereas in the second group, amputation was performed in 6 (30%) cases. So, the VAS according to R. A. Luqmain et al. (1994) is a reliable predictor which allows to carry out the screening of patients with Buerger's thromboangiitis for vascular reconstructions. The presence of the clinical signs of vasculitis activity in Buerger's thromboangitis requires preliminary preliminary preparation aimed at the removal of inflammation and correction of hemorheologic and hemostatic disorders.