Kosayev JV*, Taghi-zade GT, Guliyev RA, Ibrahimova GR, Aliyev EN, Budaqov İK, Murvaladova NF, Ahmadov SR and Khasayeva N.R

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

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

Received: November 08, 2024; Published: December 18, 2024

Abstract

Objective: To study the clinical and hemodynamic aspects of the use of lumbar sympathectomy in patients with critical ischaemia of the lower extremities.

Material and Methods of Research: The study was carried out in 99 patients with CLI (III-IV degrees of ischemia according to the Fontaine-Pokrovsky classification) The etiological factor for the development of CLI in 67 (67.7%) patients was obliterating atherosclerosis, in 32 (32.3%) patients – thromboangiitis obliterans. In 34 (35.4%) patients, critical ischemia of the III deqree was diagnosed, in 65 (65.6%) patients - in the IV degree. In 48 patients, complex surgical treatment was carried out without the use of any method of indirect revascularization (control group), In 51 patients, lumbar sympathectomy (the main group) was performed. To diagnose and assess the effectiveness of treatment, a clinical study, rheovasography, Doppler ultrasound, multispiral computer-tomographic angiography were carried out, oxygen saturation of the skin, indicators of regional arterial and venous blood flow were studied.

Results of the Study: In the patients of the study group, in comparison with the control group, the short-term results on the Rutherford scale et.al significantly improved, the frequency of major and minor amputations decreased (15.7%), and the frequency of maintaining the supporting function of the limb increased (92.2%) during the hospital stay, The frequency of rehospitalization decreases (69.6% - χ2 = 2.470, p > 0.05, r = 0.2) and major amputations (26.1% - χ2 = 5.920, p < 0.05, r = 0.4) and the number of patients with the preservation of the supporting function of the limb increases (73.9% - χ2 = 5.920, p <0.05, r = 0.4) within 6 months. up to 5 years. In the patients of the study group, in comparison with the baseline ones, after treatment, the indicators of RI, SOS, VAI standing and lying down, POVPG significantly improved (t = 3.75, p > 0.001; t = 2.01, p < 0.05; t = 2.93,p < 0.01; t = 2.01,p < 0.05; t = 2.44, p < 0.05) other than RSPG (t = 1.83, p > 0.05).

Conclusion: Stimulation of peripheral circulation in patients with critical ischaemia of the lower extremities during lumbar sympathectomy is a prognostic criterion for optimizing the immediate and long-term results of surgical treatment.

 Keywords: Obliterating Arterial Disease; Critical Ischaemia of the Lower Extremities; Lumbar Sympathectomy; Stimulation of Regional Blood Flow

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Citation

Citation: Kosayev JV., et al. “Clinical and Hemodynamic Aspects of the Use of Lumbar Sympathectomy in Patients with Critical İschemia of the Lower Extremities”.Acta Scientific Medical Sciences 9.1 (2025): 77-82.

Copyright

Copyright: © 2025 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.