Effectiveness of step-by-step treatment of neurovascular syndrome

Introduction. The progression of neurovascular syndrome leads not only to temporary disability, but also often to disability of the patient. The purpose of the study: to evaluate the effectiveness of various options for stage-by-stage treatment of neurovascular syndrome. Materials and methods. The present study is based on the analysis of the examination results of 155 patients with neurovascular syndrome. At the first stage, all patients underwent conservative therapy, and later, if necessary, surgical treatment was performed. 136 (87.7 %) patients received inpatient treatment and 108 (69.7 %) were operated on. All of them were observed in the vascular surgery department of the Republican Clinical Hospital of the Ministry of Health of the CBD in the period 2000-2018. Against the background of conservative treatment for 5 years, an aggravation of clinical manifestations occurred in 67.7 % of patients. We performed surgical intervention on these patients. Distal periarterial sympathectomy allowed to obtain a 10-year positive result (without relapse) in 34.2 % of patients. Subsequently, 59.4 % of patients underwent proximal periarterial sympathectomy. Results. During 68.3 ± 8.2 months after distal sympathectomy, 40.6% of patients had no manifestations of chronic upper limb ischemia. Discussion. Most authors tend to believe that secondary neurovascular syndrome prevails in FR. However, according to some epidemiological studies of a healthy population, up to 89% of people with FR have primary FR, while in the study of clinic patients secondary FR is more often detected (50-70 %). Conclusion. Thus, our study demonstrated that staged minimally invasive surgical treatment can delay the onset of severe upper limb ischemia.