Predictors of reperfusion-reoxygenation syndrome in patients with atherosclerotic occlusion of the aorto-femoral segment
DOI:
https://doi.org/10.11603/2414-4533.2022.4.13617Keywords:
atherosclerosis, reperfusion-reoxygenation syndrome, predictorsAbstract
The aim of the work: to determine the main risk factors for the development of reperfusion-reoxygenation syndrome in order to improve the results of treatment of patients with atherosclerotic occlusion of the aorto-femoral segment.
Materials and Methods. An analysis of the disease histories of patients with atherosclerotic lesions of the main arteries of the lower extremities, who were undergoing in patient treatment in the vascular department of the Ternopil University Hospital during 2013–2019 years, was carried out.
172 medical histories of patients were analyzed, of which 58 were diagnosed with atherosclerosis of the aorta and main arteries of the lower extremities with chronic limb ischemia of the IIb stage (according to Fontaine's classification).
The obtained results, in order to optimize the prediction of the risk of developing complications in the postoperative period, were subjected to neural network clustering using the NeuroXL Classifier add-on for the Microsoft Excel program. The elaborated components of each block are included in the table of the aggregate point system for assessing the risk of developing complications.
Results and Discussion. In 172 patients, the risk of developing postoperative complications was determined. Based on the obtained calculations, the average age of patients at 57.4 years can be attributed to the risk predictors of the development of reperfusion-reoxygenation syndrome.
The development of chronic critical ischemia in patients of the selected group occurred between 5 and 3 weeks before hospitalization.
A short history of an average of 8.8 years can be attributed to predictors of the risk of developing reperfusion-reoxygenation syndrome in patients with atherosclerotic occlusion of the aorto-femoral segment.
Among 172 patients with atherosclerotic occlusion of the aorto-femoral segment, stenotic atherosclerotic lesions of extracranial arteries were found in 92. Stenotic atherosclerotic process of extracranial arteries was diagnosed in 52 patients with atherosclerotic occlusion of the aorto-femoral segment and in 40 patients with a risk of developing reperfusion-reoxygenation syndrome. Among the laboratory indicators, it should be noted that in 31 (77.50 %) patients with a risk of developing reperfusion-reoxygenation syndrome, an increased level of leukocytosis in the blood, an increased indicator of the content of monocytes and immature neutrophils, an increased level of CRP, a progressive uncorrected atherosclerotic process, which is caused by a high the level of atherogenic lipoproteins, as well as the content of indicators in the blood indicating the activation of the inflammatory response syndrome. The set of presented indicators can be combined into predictors of the risk of developing reperfusion-reoxygenation syndrome.
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