[PROCURING OF ІNTRAOPERATIVE HEMOSTASIS IN REVASCULARIZATION INTERVENTIONS]

Area of Science:

• Vascular Surgery
• Hemostasis
• Thrombosis

Background:

• Atherosclerotic disease affects aorta and lower extremity arteries, requiring revascularization.
• Surgical intervention can lead to hypercoagulation in the early postoperative period.
• This hypercoagulation is linked to thrombinemia and reduced fibrinolytic activity.

Purpose of the Study:

• To analyze hemostasis management in patients undergoing revascularization for atherosclerotic disease.
• To investigate the causes of postoperative hypercoagulation.
• To establish optimal thromboprophylaxis strategies.

Main Methods:

• Studied 106 patients operated on for atherosclerotic affection of the aorta and lower extremity arteries.
• Monitored hemostasis parameters in the early postoperative period.
• Evaluated the efficacy of different heparin protocols.

Main Results:

• Hypercoagulation syndrome was observed post-surgery, characterized by thrombinemia and fibrinolytic depression.
• Non-fractionated heparins administered immediately post-operation effectively impacted the thrombin-fibrinogen factor (factor IIa).
• Prolonged thromboprophylaxis with low-molecular heparins (targeting factor Xa) aligned with established standards.

Conclusions:

• Immediate postoperative administration of non-fractionated heparin is necessary to manage the thrombin-fibrinogen factor.
• Continued thromboprophylaxis with low-molecular heparin is essential for preventing postoperative complications.
• This approach addresses hypercoagulation by targeting key factors in the hemocoagulant cascade.