Ahmadov MB*, Kosayev JV, Abushov NS, Taghi-zade GT, Babayev NI, Quliyev RA, Ibrahimova GR, Murvaladova NF and Ahmadov SR

Scientific Center of Surgery Named After Acad. M.A. Topchubashov, Baku, Azerbaijan

*Corresponding Author: Ahmadov MB, Scientific Center of Surgery Named After Acad. M.A. Topchubashov, Baku, Azerbaijan.

Received: October 04, 2024; Published: November 07, 2024

Abstract

The Aim of the Study: To improve the results of conservative and surgical treatment of Buerger's disease (BD) using plasmapheresis (PF) and ultraviolet irradiation of blood (UVİB).

Materials and Methods: the studies were carried out in 170 patients (study group-89, control group-81) with grade III-IV critical limb ischaemia and in patients with stage II-III chronic ischaemia (216 pain in total). Contrast angiography and duplex scanning of peripheral arteries, computed rheography and plethysmography were performed, oxygen partial pressure (tcpO2) was measured, and general clinical, biochemical and immunological studies were performed. In addition to surgical operations, complex drug therapy was carried out in both groups. PF procedures were carried out - in case of unbearable pain and intoxication, 3-6 operations every 1-2 days, in other cases 2-3 with a break of 3-5 days with an exfusion of 700-1500 ml of plasma, and 4 (8) mg of dexamethasone was administered (in 3 patients-pulse therapy: 1000 mg of metipred for 3 days). The number of UVIB determined the severity of BB and was performed every 1-2 days, from 5 to 10 sessions. Patients from both groups underwent catheterization epidural analgesia (CEA) at the LII-LIII level and administered 10 ml of 2% lidocaine solution every 3-6 hours for 7-14 days to prevent acute pain. In the study group, all patients underwent PF in parallel.

Outcomes: In comparison with the parameters in the patients of the control group in the study group, there was a significant improvement in many instrumental and laboratory studies (RI, ABI, TcpO2, CIC, DE, F, IgG, LA ( respectively t = 2.12, p < 0.05; t = 2.00, p < 0.05; t = 21.20, p < 0.001; t = 3.64, p < 0.001; t = 5.57, p < 0.001; t = 3.77, p < 0.001; t = 4.89, p < 0.001; t = 14.14, p < 0.001) except for PA, CRP, İgM and ESR. Immediate satisfactory results significantly depend on the tactics of complex treatment (χ2 = 8.907; p = 0.003). The reduction in the frequency of "large + small" amputation in patients of the study group also significantly depends on the tactics of complex treatment (χ2 = 6.815; p = 0.010).

Conclusion: The use of ET methods in the presented treatment regimen (CEA + PF + UV + glucocorticosteroid + drug therapy) made it possible to correct the multilateral disorders caused by Buerger's disease and improve the results of complex treatment.

 Keywords: Buerger's Disease; Critical Ischemia; Plasmapheresis; Ultraviolet Irradiation of Blood; Epidural Analgesia

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Citation

Citation: Ahmadov MB., et al. “Effect of Efferent Therapy on Clinical and Laboratory Parameters in Complex Treatment of Patients with Thromboangiitis Obliterans at the Critical Ischemic Stage”.Acta Scientific Medical Sciences 8.12 (2024): 03-08.

Copyright

Copyright: © 2024 Ahmadov MB., 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.