Kosayev JV¹*, Hasanov IA² and Abushov NS¹

¹Scientific Center of Surgery Named After Akad.M.A.Topchubasheva, Baku, Azerbaijan
²Azerbaijan State Institute for Advanced Training of Doctors Named After A. Aliyev, Baku, Azerbaijan

*Corresponding Author: Kosayev JV, Scientific Center of Surgery Named After Akad.M.A.Topchubasheva, Baku, Azerbaijan.

Received: April 24, 2023; Published: June 12, 2023

Abstract

Objective: To study the dynamics of instrumental and morphological parameters of stimulation of regional blood flow in patients with critical lower limb ischemia against the background of distal steno-occlusions of the arteries.

Materials and Methods: The studies were conducted in 79 patients with CILE. In 48 patients, conventional conservative and surgical treatment was carried out without reconstruction and indirect stimulation (control group) In 31 patients, stimulation of regional blood flow was carried out by revascularizing osteotrepanation with intramedullary laser irradiation, in which intravenous laser irradiation and cytokine therapy with Ronoleukin (main group) were used in the perioperative period. The following parameters of regional arterial and venous blood flow were studied: These parameters were compared with those of 48 healthy individuals (reference group). In the main group, 18 patients studied the dynamics of morphological and immunohistochemical parameters of some parameters of angiogenesis in the soft tissues of the limb(the density of CD34-positive microvessels, the density of VEGF-positive microvessels, the density of microvessels with a free lumen and a diameter of 4.1 mkm ).The "conditionally control" group consisted of soft tissues of 21 practically healthy individuals.

Results: In patients of the control group during inpatient treatment and after 3-4 months. There was only a tendency to improve regional arterial and venous bleeding (except for regional systolic pressure. In patients of the main group during inpatient treatment, a thorough improvement in the arterial and venous links of regional blood flow was observed. 3-4 months after discharge from the clinic, continued stimulation of regional blood circulation was revealed. Morphological and immunochemical studies revealed an increase in the density of CD34+-positive, VEGF-positive microvessels and density of microvessels with an open lumen in the soft tissues of the ischemic limb.

Conclusion: If it is impossible to perform direct revascularization, the proposed method of revascularizing osteotrepanation with intramedullary laser irradiation using intravenous laser irradiation and cytokine therapy with Roncoleukin in the perioperative period significantly improves the instrumental parameters of regional blood flow, stimulates neoangiogenesis and increases the density of microvessels with a free lumen in soft tissues in patients with critical ischemia of the lower extremities.

 Keywords: Dynamics; Blood Flow; Microvessels

References

1. Kosayev JV., et al. “Stimulation of regional circulation by modified revascularizing osteotrepanation in patients with critical ischemia of the lower extremities caused by distal steno-occlusion of the arteries”. Cardiology and Cardiovascular Surgery5 (2020): 421-426.
2. Kosayev JV. “Clinical and hemodynamic aspects of revascularizing osteotrepanation surgery with intracosteal lazer irradiation in patients with critical ischemia of lower limbs on the background of distal steno-occlusion of arteries”. Bulletin of Surgery of Kazakhstan62 (2020): 50-54.
3. Isaev HB., et al. “Features of changes in peripheral circulation in patients with critical ischemia of the lower extremities, who underwent revascularizing osteotrepanation surgery with intraosseous laser irradiation in the postoperative period”. Moscow Surgical Journal76 (2021):46-54.
4. Kosayev JV., et al. “Stimulation of regional circulation by methods of indirect revascularization in patients with critical ischemia of the lower extremities against the background of distal arterial damage”. Cardiology and Cardiovascular Surgery5 (2021): 380-385.
5. Annex BH. “Therapeutic angiogenesis for critical limb ischaemia”. Nature Reviews Cardiology7 (2013): 387-396.
6. Cooke JP and Losordo DW. “Modulating the vascular response to limb ischemia: angiogenic and cell therapies”. Circulation Research 116 (2015): 1561-1578.
7. Botham CM., et al. “Clinical trials of adult stem cell therapy for peripheral artery disease”. Methodist DeBakey Cardiovascular Journal 4 (2013): 201-205.
8. Tasev D., et al. “CD34 expression modulates tube-forming capacity and barrier properties of peripheral blood-derived endothelial colony-forming cells (ECFCs)”. Angiogenesis 3 (2016): 325-338.
9. Poon S., et al. “Improved recovery from limb ischaemia by delivery of an affinity-isolated heparan sulphate”. Angiogenesis4 (2018): 777-791.
10. Hasanov İA and Kosayev JV. “Soft tissues regional blood flow and microvasculature upon different perioperative treatment strategies following indirect revascularization in patients with critical lower limb ischemia, caused by occlusion of distal arteries”. Journal of Life Sciences and Biomedicine. Baku, 2.75 (2020): 159-166.
11. Hasanov İA and Kosayev JV. “Connection of treatment tactics and morphofunctional state of peripheral blood and hemomicrocirculatory bed of soft tissues in patients with critical ischemia of the lower extremities (correlation-statistical analysis)”. Journal of Theoretical, Clinical and Experimental Morphology //Baku 1-2 (2021): 24-33.

Citation

Citation: Kosayev JV., et al. “Dynamics of Instrumental and Morphological Parameters of Stımulatıon of Regional Blood Flow in Patients wıth Critical Ischemia of the Lower Extremities”.Acta Scientific Medical Sciences 7.7 (2023): 45-47.

Copyright

Copyright: © 2023 Kosayev JV., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.