Peripheral hemodynamics variables in patients with chronic ischemia of lower limbs

This article deals with the results of studying 110 patients with long-lasting lower limb ischemia, who underwent various reparative operations on a terminal part of the aorta and lower limb arteries. Depending on the degree of damage of lower limb arteries, the patients were classified in three groups. The 1st group included 33 patients (30.0 %) with an isolated damage of the aortoileac segment, the second one – 39 patients (35.5%) with an isolated damage of the femoral-popliteal arterial segment and the 3rd – 38 patients (34.5%) with a combined damage of aortal-ileac and femoral-popliteal arterial segments. A.V. Pokrovsky’s classification was used to divide the patients according to the severity of their lower limb ischemia. 31 patients (28.2%) had II Á stage, 52 patients (47.3%) – III stage and 27 patients (24.5%) – IV stage. The control group consisted of 25 people. To study the lower limb arterial bed, use was made of ultrasound Doppler sonography, duplex scanning and X-ray contract angiography. In the course of studying the maximum bloodstream speed (V max), resistivity index (RI) and pulsation index (PI) on the anterior tibial artery (ATA) and posterior tibial artery (PTA) were calculated. Also estimated was a malleolar systolic pressure index (MSPI). It was found out that augmentation of lower limb ischemia is accompanied by a significant decrease in the maximum systolic speed, a considerable reduction in the pulsation and resistivity indices of the peripheral bloodstream and the index of malleolar systolic pressure. The measures of peripheral bloodstream in patients with II Á stage longlasting ischemia were as follows: V max >10,0 sm/s, RI>0.50, PI>2,0 and MSPI≤0.55, while in those with III– IV stage damage these measures had the following values: V max<10.0 sm/s, RI<0.50, PI<2.0 and MSPI <0.35. The patients with a combined damage of aortalileac and femoral-popliteal arterial segments showed a significant decrease in V max, RI and MSPI as compared to those with an isolated damage of the aorto-ileac segment, with V max≤9. 0 sm/s, RI≤0.5, PI≤1.5 and MSPI≤0.3.