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[Lymphotropic therapy in patients after surgical revascularization of lower-limb vessels]
A L Charyshkin1, M V Iashkov2, I I Gumerov2
1Department of Vascular Surgery, Institute of Medicine, Ecology and Physical Culture, Ulyanovsk State University, Ulyanovsk, Russia.
Insights
Regional lymphotropic therapy effectively reduces reperfusion syndrome after lower limb arterial reconstruction. This treatment decreased postoperative edema and lymphorrhoea in patients undergoing revascularization for chronic limb ischemia.
Area of Science:
- Vascular Surgery
- Cardiovascular System Pathophysiology
- Postoperative Complication Management
Background:
- Lower limb artery occlusive and stenotic lesions cause chronic arterial insufficiency, a common cardiovascular issue.
- Revascularization is key for treating chronic lower limb ischemia, but can lead to reperfusion syndrome.
- Reperfusion syndrome presents as edema and other complications post-arterial reconstruction.
Purpose of the Study:
- To evaluate the efficacy of regional lymphotropic therapy in managing reperfusion syndrome.
- To assess the impact of this therapy on postoperative outcomes in chronic lower limb ischemia patients.
Main Methods:
- A comparative study involving two groups of patients undergoing lower limb arterial reconstruction.
- One group received standard postoperative care; the other received standard care plus regional lymphotropic therapy.
- Outcomes including limb edema, lymphorrhoea, and soft tissue thickness were assessed using ultrasonography.
Main Results:
- Both groups developed reperfusion edema by postoperative day 3.
- By postoperative day 7, the regional lymphotropic therapy group showed significantly reduced limb edema severity compared to the control group.
- Lymphorrhoea occurred less frequently, and ultrasonography confirmed decreased subcutaneous fat edema in the study group.
Conclusions:
- Regional lymphotropic therapy is effective in mitigating reperfusion syndrome after lower limb arterial reconstructive surgery.
- This therapy reduces postoperative edema and associated complications, improving patient outcomes.
Abstract:
Occlusive and stenotic lesions of lower-limb arteries appear to be amongst the most common manifestations of the pathology of the cardiovascular system and are characterized by various degree of chronic arterial insufficiency. Revascularization is the main stage of treatment for chronic arterial insufficiency of the lower extremities. Performing a reconstructive operation aimed at restoring the arterial blood flow in the ischaemized extremity is accompanied and followed by the development of reperfusion syndrome. The purpose of this study was to assess efficacy of using regional lymphotropic therapy for treatment of reperfusion syndrome in patients with chronic ischaemia of lower limbs in the postoperative period. The study included two groups of patients: the comparison group with standard postoperative treatment and the study group where the standard therapy was supplemented with regional lymphotropic therapy. In the postoperative period, the patients in both groups developed reperfusion oedema of the operated lower limb on day 3 after arterial reconstruction, however, on POD 7 after revascularization, the severity of oedema was apparently less in the study group. Lymphorrhoea after operative treatment in the study group was encountered significantly less often as compared with the control group. According to the findings of ultrasonographic examination of soft tissues in the postoperative period, patients of both groups on POD 3 were found to have pronounced oedema of soft tissues. However, on POD 7 the study group patients demonstrated a dramatic decrease in the thickness of oedema of the subcutaneous fat versus the comparison group patients. Regional lymphotropic therapy after reconstructive operations on arteries of lower limbs promoted a decrease in the severity of reperfusion syndrome on the operated lower limb.
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