scholarly journals Pathogenesis of ischemia/reperfusion syndrome

2018 ◽  
Vol 99 (4) ◽  
pp. 640-644 ◽  
Author(s):  
D E Kutepov ◽  
M S Zhigalova ◽  
I N Pasechnik
Keyword(s):  
Blood Flow ◽  
Lower Limb ◽  
Ischemia Reperfusion ◽  
Vascular Complications ◽  
Limb Ischemia ◽  
Biologically Active ◽  
Lower Limbs ◽  
Ion Pump ◽  
Critical Ischemia ◽  
Lower Limb Ischemia

Ischemia/reperfusion syndrome is a collective concept that combines various pathological conditions developing against the background of the restoration of the main blood flow in the organ or limb segment, which has long been subjected to ischemia or traumatic amputation. Intensive care physicians often see ischemia/reperfusion syndrome after restoration of blood supply in patients with critical ischemia of the lower limb. The rate of critical ischemia of the lower limbs ranges from 400 to 1000 cases per 1 million of the population. The number of lower limb amputations due to critical lower limb ischemia in economically developed countries is 13.7-32.3 cases per 100,000 of the population. The main etiological factors of critical lower limb ischemia are atherosclerosis of peripheral vessels and vascular complications of diabetes. The pathogenesis of ischemia/reperfusion syndrome is based on a complex of pathophysiological changes resulting from the restoration of blood flow in previously ischemic lower limb. Restoration of blood circulation leads to massive flow into the systemic bloodstream of anaerobic metabolism products, free myoglobin, biologically active substances and inflammatory mediators. The main sources of reperfusion damage are activated forms of oxygen, in particular, superoxide radical О2-, nitric oxide, lipid peroxidation products. In the conditions of primary ischemia, and then tissue reperfusion, excessive production of activated oxygen forms leads to damage of biological structures (lipids, proteins, deoxyribonucleic acid), which causes disruption of normal cell functioning or its death due to necrosis or apoptosis, ion pump dysfunction, adhesion of leukocytes and increased vascular permeability.

scholarly journals NEXT AND LONG-TERM RESULTS OF X-RAY ENDOVASCULAR INTERVENTIONS IN TREATMENT OF CHRONIC CRITICAL ATHERODIABETIC ISCHEMIA OF LOWER EXTREMITIES

2020 ◽  
Vol 18 (6) ◽  
pp. 710-715
Author(s):  
N. N. Ioskevich ◽  
◽  
L. F. Vasilchuk ◽  
P. E. Vankovich ◽  
S. P. Antonenko ◽  
...  
Keyword(s):  
Lower Limb ◽  
Type I Diabetes ◽  
Lower Extremities ◽  
Limb Ischemia ◽  
Type I ◽  
Critical Ischemia ◽  
Lower Limb Ischemia ◽  
X Ray ◽  
Endovascular Interventions

Background. The treatment of chronic critical ischemia of the lower extremities with their combined atherodiabetic lesion is one of the far from the resolved problems of modern surgery. Aim of the study. Analysis of the results of X-ray endovascular interventions in patients with critical lower limb ischemia due to atherodiabetic lesions of the femoral-popliteal-tibial segment. Material and methods. We analyzed the results of REVS in 60 patients with diabetes mellitus with critical ischemia of the lower extremities due to infra-anginal atherosclerotic occlusions with a follow-up period of up to 5 years from the moment of the manipulation. Results. The total shelf life of the lower limb after REVV was 492.4 ± 10.1 days. Out of 26 amputations performed, balloon angioplasty was performed in 18 cases and stenting in 8 cases. In individuals with type I diabetes, the duration of painless period was 415.4 ± 5.1 days, and the total shelf life of the leg was 465.4 ± 4.3 days. In type II diabetes, these indicators were, respectively, 181.4 ± 4.4 days and 317.8 ± 6.7 days. In the group of patients with type I diabetes, the lower limb was saved in 55.6% of cases (in 20 out of 36 patients), and in type II diabetes - in 58.3% (in 14 out of 24 people). Conclusions. The presence of simultaneously obliterating atherosclerosis and diabetes mellitus in patients leads to a combined atherodiabetic lesion of the arterial bed, including infra-anginal arteries. X-ray endovascular interventions (balloon angioplasty and stenting) on the arterial femoral-popliteal-tibial segment are a rather effective method of eliminating chronic critical lower limb ischemia, which allows preserving the lower limb in 56.7% patients with a follow-up period of up to 5 years from the date of surgery. Improving the results of X-ray endovascular interventions in case of chronic critical atherodiabetic lower limb ischemia requires a comprehensive study of the possible causes of occlusions of reconstructed arterial segments (blood coagulation potential, non-optimal processes in the intervention zone).

scholarly journals Quality of life assessment in patients with acute limb ishemia

2020 ◽  
Vol 23 (2) ◽  
pp. 15-18
Author(s):  
Gennady V. Sinyavin ◽  
Aleksandr N. Kosenkov ◽  
Ivan A. Vinоkurоv ◽  
Gevorg V. Mnatsakanjan ◽  
Sanija N. Odinokova ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Blood Flow ◽  
Lower Limb ◽  
Short Form ◽  
Surgical Care ◽  
Limb Ischemia ◽  
Life Assessment ◽  
Quality Of Life Assessment ◽  
Lower Limb Ischemia

Background. In conditions of permanent progress in the quality of surgical care in various areas of surgery, it is very important to allow patients themselves to evaluate provided treatment. Aims: this paper analyzes the quality of life in individuals with acute lower limb ischemia who have undergone lower limb revascularization surgery. Materials and methods. An assessment of the quality of life of 122 patients with acute lower limb ischemia (ALI) of II degree who were treated at the Moscow Сity Сlinical Hospital оf S.S. Yudin from 2016 to 2018 (average age 72.1 14.7 years) was performed. The quality of life was assessed using the medical Outcomes Study-Short Form (MOS SF-36) quality of life assessment methodology. Results. When assessing the quality of life of patients, it was found that the psychological and physical components of patients health are significantly affected by the angiotropic effect of the affecting factor associated with the presence of diabetes mellitus. 1 month after surgical restoration of blood flow against the background of the initial embolism, 83.6% of the respondents who did not suffer from diabetes noted a persistent improvement in their General condition and quality of life. Conclusion. This method of assessing the quality of life after surgical restoration of blood flow in patients with acute lower limb ischemia can be used in angiosurgical practice and clearly reflects of patient satisfaction with the treatment.

scholarly journals Analysis of associated diseases in patients with acute critical lower limb ischemia

2013 ◽  
Vol 66 (1-2) ◽  
pp. 41-45 ◽  
Author(s):  
Vladimir Manojlovic ◽  
Vladan Popovic ◽  
Dragan Nikolic ◽  
Djordje Milosevic ◽  
Janko Pasternak ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Lower Limb ◽  
Balloon Catheter ◽  
Limb Ischemia ◽  
Lower Limbs ◽  
Metabolic Decompensation ◽  
Arterial Embolism ◽  
Lower Limb Ischemia ◽  
Associated Diseases ◽  
Arterial Blood

Introduction. Acute critical lower limb ischemia refers to the state of severely impaired vitality of lower limbs due to acute occlusion of arterial blood vessel by a thrombus or emboli. Surgical revascularization in the first 6-12 hours after the onset of symptoms gives the best results. However, a high mortality rate and probability of limb loss make this problem more debatable, and can be related with associated diseases. Material and Methods. This research included 95 patients who had been operated within the first 12 hours after the onset of symptoms of critical limb ischemia. We collected the following data: age and sex of patients, etiology of limb ischemia, type of operation, associated diseases and outcome of treatment. Results and Discussion. Most of the patients were 70 to 80 years old, both sexes being equally represented. There was significantly more arterial embolism (70%) than thrombosis on the prior arterial lesion. Most of the embolizations were treated with Fogarty balloon catheter embolectomy (98%); however, a great number of arterial thrombosis demanded more complex ?inflow? and ?outflow? ensuring procedures such as thromboendarterectomy and bypass (33%). The performed surgical procedures showed no statistical differences when final outcome was analyzed. Amputation had to be performed in about 3% of the patients and all of them were diabetics. Mortality rate in this research was 10.5% and 7/10 with this outcome had severe form of chronic myocardiopathy and metabolic decompensation. Conclusion. Acute critical lower limb ischemia should be treated surgically as soon as possible. Negative outcomes are associated with comorbidity and general condition of the patient.

Lower Limb Ischemia-Reperfusion Injury Triggers a Systemic Inflammatory Response and Multiple Organ Dysfunction

2001 ◽  
Vol 26 (1) ◽  
pp. 115-121 ◽  
Author(s):  
Magdi M.I. Yassin, M.D. ◽  
Denis W. Harkin, M.D. ◽  
Aires A.B. Barros D’Sa, M.D. ◽  
M. Isla Halliday, Ph.D. ◽  
Brian J. Rowlands, M.D.
Keyword(s):  
Inflammatory Response ◽  
Reperfusion Injury ◽  
Organ Dysfunction ◽  
Lower Limb ◽  
Ischemia Reperfusion Injury ◽  
Ischemia Reperfusion ◽  
Limb Ischemia ◽  
Multiple Organ ◽  
Multiple Organ Dysfunction ◽  
Lower Limb Ischemia

Organ dysfunction after blood flow restoration in patients with acute lower limb ischemia

2019 ◽  
Vol 12 (5) ◽  
pp. 477
Author(s):  
Yu. V. Belov ◽  
G. V. Sinyavin ◽  
I. A. Vinokurov ◽  
G. V. Mnatsakanyan
Keyword(s):  
Blood Flow ◽  
Organ Dysfunction ◽  
Lower Limb ◽  
Limb Ischemia ◽  
Lower Limb Ischemia ◽  
Flow Restoration

Protective Effect of Antithrombin III Against Lung and Myocardial Injury in Lower-Limb Ischemia–Reperfusion Syndrome

2012 ◽  
Vol 26 (4) ◽  
pp. 566-570 ◽  
Author(s):  
Neophytos A. Zambas ◽  
Christos D. Karkos ◽  
Apostolos G. Kambaroudis ◽  
Dimitrios G. Karamanos ◽  
Charalampos T. Spyridis ◽  
...  
Keyword(s):  
Protective Effect ◽  
Lower Limb ◽  
Myocardial Injury ◽  
Antithrombin Iii ◽  
Ischemia Reperfusion ◽  
Limb Ischemia ◽  
Lower Limb Ischemia

scholarly journals Does Esmolol Havean Effect on Erythrocyte Deformability in Rat Lower Limb İschemia Reperfusion İnjury?

2019 ◽  
Vol 6 (4) ◽  
Author(s):  
Dursun Ali Doğan ◽  
Çomu Faruk Metin ◽  
Küçük Ayşegül ◽  
Sabuncu Ülkü ◽  
Salman Nevriye ◽  
...  
Keyword(s):  
Reperfusion Injury ◽  
Lower Limb ◽  
Ischemia Reperfusion Injury ◽  
Ischemia Reperfusion ◽  
Limb Ischemia ◽  
Erythrocyte Deformability ◽  
Lower Limb Ischemia
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