Clinical and pathogenetic aspects of the revascularizing osteotrepanation in patients with critical lower limb ischemia
The study was conducted in 101 patients with critical limb ischemia (CLI; chronic ischemia III-IY degree by Fontaine-Pokrovsky) underinability to perform direct revascularization surgeries. Mobilization of collateral blood flow in 38 patients was performed revascularizating osteotrepanation (ROT) of tibia. Simultaneously with ROT performed lumbar sympathectomy (LS) in 63 patients. In all patients, both with collateral revascularization performed medication, prolonged epidural blockade, laser irradiation. The control group consisted of 48 patients who underwent conventional surgical and conservative treatment. The obtained results confirms that operation ROT separately and in combination with LS allows to preserve the limb'ssupporting functionin 94,06% of patients. This kind of collateral revascularization surgery does not influenceon main bloodstream and significantly and reliably stimulate collateral circulation and microcirculation.