scholarly journals COMPARATIVE CHARACTERISTICS OF EROSIVE AND ULCERATIVE LESIONS OF THE GASTROINTESTINAL TRACT AND BLEEDING IN PATIENTS WITH CRITICAL ISCHEMIA OF THE LOWER EXTREMITIES WITH AND WITHOUT DIABETES MELLITUS, WHO UNDERWENT ENDOVASCULAR INTERVENTIONS

2021 ◽  
Vol 79 (3) ◽  
pp. 137-145
Author(s):  
A.A. Poliantsev ◽  
◽  
D.V. Frolov ◽  
A.M. Linchenko ◽  
V.A. Ievlev ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gastrointestinal Tract ◽  
Lower Extremities ◽  
Critical Ischemia ◽  
Endovascular Interventions ◽  
Ulcerative Lesions

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 Indirect revascularization in patients, suffering critical ischemia of the lower extremities on background of diabetes mellitus

2021 ◽  
Vol 88 (3-4) ◽  
pp. 21-27
Author(s):  
Yu. V. Ivanova ◽  
I. A. Kryvoruchko ◽  
V. A. Prasol ◽  
K. V. Miasoiedov ◽  
S. A. Andreieshchev
Keyword(s):  
Diabetes Mellitus ◽  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Ankle Brachial Index ◽  
Lower Extremities ◽  
Critical Ischemia ◽  
Diabetes Mellitus Type Ii ◽  
Indirect Revascularization ◽  
Autologous Mesenchymal Stem Cells

Objective. Determination of clinical efficacy of the mesenchymal stem cells transplantation in patients, suffering critical ischemia of the lower extremities on background of diabetes mellitus. Materials and methods. There were examined 11 patients, suffering critical ischemia of the lower extremities on background of diabetes mellitus Type II with purulent-necrotic processes of the foot, in whom conditions for the direct revascularization of extremity were absent. Microbiological monitoring for the wound discharge, determination of the ankle brachial index and transcutaneous oximetry was performed. The technology elaborated have consisted of two stages. On the first of them a purulent focus sanation (in all the patients the distal amputations of the foot, preserving arterial arch) was done. On the second stage the therapy of the wounds was conducted, using negative pressure, injections of cellular suspension (mesenchymal stem cells) while applying long fine cannula under aponeurosis into the muscles along obliterated vessels in the (10 ± 5) ml quantity with subsequent closure of the wound surface, using fibroblastic matrix. Results. In a year after the treatment critical ischemia in 1 patient was noted, the ischemia Grade III - in 3, and in 7 a IIB Grade have persisted. Conclusion. Performance of indirect revascularization, using autologous mesenchymal stem cells, constitutes an effective and secure procedure.

ENDOVASCULAR AND OPEN SURGICAL OPERATIONS OF CRITICAL ISCHEMIA OF THE LOWER EXTREMITIES

Vestnik ◽  
2021 ◽  
pp. 304-312
Author(s):  
Д.Д. Поцелуев ◽  
С.Е. Турсынбаев ◽  
Р.А. Сапарбаев ◽  
Е.А. Асылбеков ◽  
С.А. Илиев ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Comparative Analysis ◽  
Vascular Surgery ◽  
Lower Extremities ◽  
Clinical Results ◽  
Main Section ◽  
Critical Ischemia ◽  
Surgical Interventions ◽  
Surgical Operations

В отделении сосудистой хирургии на протяжении 40 лет (с 1972 по 2012 гг.) было выполнено 9800 открытых операций у больных с КИНК II-IIIст, клинические результаты которых представлены в соответствующем разделе статьи для сравнительного анализа. В основном разделе работы рассматриваются результаты эндоваскулярных хирургических и открытых операций, выполненных у 1088 больных с критической ишемией нижних конечностей II-IIIст (КИНК) и сахарным диабетом (СД). Проведен сравнительный анализ показателей частоты ампутаций при открытых и эндоваскулярных хирургических вмешательствах (ЭХВ). Установлено преимущество ЭХВ в сравнении с открытыми операциями на основании снижения числа ампутаций после выполненных ЭХВ соотвественно с 52,3% до 3,5%. In the department of vascular surgery, for 40 years (from 1972 to 2012), 9800 open operations were performed in patients with CLI II-IIIst, the clinical results of which are presented in the corresponding section of the article for comparative analysis. The main section of the work examines the results of endovascular surgical and open operations performed in 1088 patients with critical ischemia of the lower extremities II-IIIst (CLI) and diabetes mellitus (DM). A comparative analysis of indicators of the frequency of amputations during open and endovascular surgical interventions (ECS) was carried out. The advantage of ECV in comparison with open operations was established on the basis of a decrease in the number of amputations after ECV performed, from 52.3% to 3.5%, respectively.

scholarly journals Erosive and ulcerative lesions of the gastrointestinal tract and bleeding in patients with critical lower limb ischemia and diabetes mellitus underwent endovascular interventions

2021 ◽  
Vol 180 (1) ◽  
pp. 65-72
Author(s):  
A. A. Poliantsev ◽  
D. V. Frolov ◽  
A. M. Linchenko ◽  
S. N. Karpenko ◽  
A. A. Chernovolenko ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Lower Limb ◽  
Limb Ischemia ◽  
Lower Limb Ischemia ◽  
Endovascular Interventions ◽  
Ulcerative Lesions ◽  
The Relationship

The objective was to study the prevalence of erosive and ulcerative gastroduodenal lesions, bleedings of this localization and the relationship with factors predisposing to them in patients with critical lower limb ischemia and type 2 diabetes mellitus who underwent endovascular intervention for limb revascularization.Methods and materials. The study included 81 patients aged 67.5±6.8 years, hospitalized in the department of vascular surgery with critical lower limb ischemia of atherosclerotic genesis and type 2 diabetes mellitus to perform revascularization by means of transluminal balloon angioplasty with stenting when indicated. In the preoperative period, all patients underwent fibrogastroduodenoscopy, according to the results of which a scoring assessment of the lesion of the gastric mucosa and duodenum was presented.Results. All patients participating in the study were diagnosed with pathology of the gastroduodenal zone: in 95.1 % of the inflammatory nature, in 4.9 % of the ulcer. The relationship between the duration of rest pain, the fact of damage to the mucous membrane of the upper gastrointestinal tract and its severity was not revealed, but the relationship of erosive and ulcerative lesions of the stomach and duodenum with the number of taken pain pills was determined. In patients with repeated endovascular intervention and / or amputation, gastrointestinal bleedings were more often recorded compared with study participants who underwent a single revascularization – 11.1 and 1.6 % of patients, respectively.Conclusion. Erosive and ulcerative lesions of varying severity are present in all patients with critical lower limb ischemia on the background of diabetes mellitus. At the same time, patients with repeated endovascular interventions and / or amputations are more susceptible to bleeding. For the prevention of pathology of the stomach and duodenum, an in-depth diagnosis and a differentiated approach are required.

scholarly journals The angiosome concept in revascularization of the shin and foot arteries in patients with diabetes mellitus

2020 ◽  
Vol 87 (3-4) ◽  
pp. 55-58
Author(s):  
Yu. M. Gupalo ◽  
D. Yu. Shapovalov ◽  
V. V. Shaprynskyi ◽  
O. F. Dzygal ◽  
A. V. Shamray-Sas ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Flow ◽  
Lower Extremity ◽  
Lower Extremities ◽  
Group Iii ◽  
Endovascular Interventions ◽  
Group I ◽  
Patients With Diabetes ◽  
Stenotic Lesions

Objective. To analyze the results of revascularization of the shin and foot arteries in patients with diabetes mellitus in accordance to the angiosome concept. Materials and methods. Results of roentgen-endovascular interventions on 71 lower extremities, performed in 48 patients, suffering diabetes mellitus and ischemia, menaced for the extremity loss, were analyzed. All the patients had purulent-necrotic affections of the foot Degree III-IV in accordance to classification of WIFI (Wound, Ishemia and Foot Infection). In accordance to anatomic zones of revascularization all roentgen-endovascular interventions were divided into three groups: Group I - 24 (33.8%) direct angiosomic revascularizations, Group II - 38 (53.5%) indirect angiosomic revascularizations, Group III - 9 (12.7%) nonangiosomic revascularizations. Results. There was established, that following the angiosome concept raises possibility of preservation of the lower extremity (92.9%) comparing with nonangiosomic revascularization (77.8%). Conclusion. Efficacy of revascularization of the shin arteries with occlusion-stenotic lesions is significantly higher while restoration of the blood flow in accordance to the angiosome concept.

STUDY ON THE CHARACTERISTICS OF DOPPLER ULTRASOUND OF LOWER EXTREMITY ARTERIES IN PATIENTS WITH DIABETES MELLITUS TYPE 2

2011 ◽  
pp. 25-30
Author(s):  
Keyword(s):  
Diabetes Mellitus ◽  
Doppler Ultrasound ◽  
Lower Extremities ◽  
Arterial Stenosis ◽  
Invasive Technique ◽  
Atherosclerotic Plaques ◽  
Type 2 Dm ◽  
Arterial Lesions ◽  
Patients With Diabetes

Objectives: Vascular Doppler ultrasound is a non-invasive technique to rapidly detect lesions of the vessels in the lower extremities with high accuracy. The use of this technique for detecting early vascular damages in patients with diabetes mellitus (DM) type 2 could help preventing major vascular complications caused by this disease. Materials and Method: This descriptive, cross-sectional study included 31 patients with type 2 DM who were treated in Endocrinology - Neurology - Respiratory Department, Hue Central Hospital between March and August 2011. All patients were undergone clinical and biochemical examinations, and Doppler ultrasound for detection of arterial lesions in their lower extremities. Results: Most patients had high intima media thickness (IMT) (77.42%), and all of them suffered from hypertension concomitant, with the rate of atherosclerotic plaque accounted for 35.48%. No one experienced arterial stenosis >50% and arterial occlusions, but the peak systolic velocities were significantly higher in patients with atherosclerotic plaques than those without atherosclerotic plaques. Conclusion: Vascular Doppler ultrasound should be used as routine test for early detection of arterial lesions in patients with type 2 DM.

scholarly journals Efficacy of Prokinetic Itopride in Type 2 Diabetes Mellitus

2020 ◽  
pp. 35-39
Author(s):  
A. E. Shklyaev ◽  
D. D. Kazarin ◽  
Y. V. Gorbunov
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Gastrointestinal Tract ◽  
Chronic Gastritis ◽  
Motor Dysfunction ◽  
Upper Gastrointestinal Tract ◽  
Itopride Hydrochloride ◽  
Upper Gastrointestinal

The constant increase in the incidence of diabetes in the world and the high frequency of lesions of the upper gastrointestinal tract with impaired motor function in this category of patients, on the one hand, worsen the clinical picture, and on the other, reduce the effectiveness of sugar-lowering therapy. Currently, specialists have at their disposal a number of prokinetics that contribute to the restoration of the motor-evacuation function of the stomach, but many of them have many undesirable effects. The aim of our study was to evaluate the effectiveness of itopride hydrochloride in the treatment of patients with chronic gastritis associated with Helicobacter pylori and type 2 diabetes. During the study, both general clinical and more specific research methods were used, in particular, esophagogastroduodenoscopy. According to the results of the study, the use of prokinetics in the treatment of patients with type 2 diabetes mellitus reduces the manifestations of impaired motor-evacuation function of the upper gastrointestinal tract. The results obtained indicate to verify the manifestations of chronic gastritis in patients with type 2 diabetes mellitus and the identification of motor dysfunction and the need for prokinetic therapy.

Sign in / Sign up

Export Citation Format

Share Document