A.V. MAKSIMOV^1,2, E.A. GAYSINA¹ , R.M. NURETDINOV¹

¹Republican Clinical Hospital of the Ministry of Healthcare of the Republic of Tatarstan, 138 Orenburgskiy trakt, Kazan, Russian Federation, 420064

²KSMA — Branch Campus of the FSBEI FPE RMACPE MOH Russia, 36 Butlerov Str., Kazan, Russian Federation, 420012

Maksimov A.V. — D. Sc. (medicine), Head of the Vascular Surgery Division No.1, Associate Professor of the Department of Cardiology, X-ray Endovascular and Cardiovascular Surgery, e-mail: maks.av@mail.ru

Gaysina E.A. — PhD (medicine), Vascular Surgeon of the Vascular Surgery Division No.1, e-mail: kalbas77@yandex.ru, ORCID ID: 0000-0002-3035-4411

Nuretdinov R.M. — Vascular Surgeon of the Vascular Surgery Division No.1, e-mail: rifkat21@mail.ru, ORCID ID: 0000-0002-0954-0164

The results of thrombolytic therapy in 27 patients with acute limb ischemia are presented. According to I.I. Zatevahin the patients had: the 1^st degree of ischemia — 13 people (48.1 %), the 2a degree of ischemia — 12 patients (44.4 %), the 2b degree of ischemia — 2 patients (7.4 %).

In 62.9 % of cases the clinical success of the procedure was achieved (17 patients), in 18.5 % of cases it was possible to achieve technical success in manipulating with full restoration of the angiographic and clinical picture. 48.1 % of patients (13 people) were required to undergo surgical or X-ray endovascular correction of the cause of thrombosis. Four patients (15.0 %) were amputated limbs due to failure of manipulation. Lethality was 3.7 % (1 patient).

Taking into account the active substance for thrombolytic therapy, all patients were divided into 2 groups. The 1^st group (11 patients) received urokinase, the 2^nd group (16 people) — recombinant tissue plasminogen activator. Clinical success was achieved in 36.4 % in the 1^st group and in 81.3 % in the 2^nd group. In the 1^st group technical success was achieved in 9.1 % of cases, in the 2^nd group — in 68.8 %. The frequency of amputations in the 1^st group was 27.3 %, in the 2^nd group — 6.3 %. Mortality in the 1^st group reached 9.1 % (1 patient), in the 2^nd group there were no lethal outcomes.

Key words: acute limb ischemia, regional thrombolysis.

(For citation: Maksimov A.V., Gaysina E.A., Nuretdinov R.M. Regional thrombolysis in case of acute lower limb ischemia. Practical Medicine. 2018)

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