The effect of the state of the microcirculatory bed of the lower extremities in arterial occlusion of the femoral-popliteal-tibial segment on the long-term results of arterial reconstructions

Introduction. The results of vascular reconstructions in atherosclerotic occlusion of the femoral-popliteal-tibial segment depend on the patency of the distal bed, and in particular on the state of the microcirculatory bed.The purpose of the study. To study the possibilities of modern computer capillaroscopy as an additional method for determining indications for reconstructive surgery in patients with obliterating atherosclerosis of the arteries of the lower extremities with lesions of the femoral-popliteal-tibial segment.Materials and methods of research. An attempt was made to study the microcirculatory bed in 156 people with obliterating atherosclerosis of the arteries of the lower extremities of the femoral-popliteal-tibial segment with stage III-IV according to the Fontaine-Pokrovsky classification. With the help of computer capillaroscopy, the indicators of capillary functioning were determined in patients who had effective reconstructive surgery.Results and discussion. If, according to computer capillaroscopy, the number of linear working capillaries is 5,5 ± 2,4 pcs. per 1 mm2, and the number of working capillaries by area is 16,7 ±5,3 pcs. per 1 mm2, then it is possible to predict with a fairly high probability the preservation of the patency of the shunt a year after surgery. If the number of linear working capillaries is 3,3 ± 1,3 pcs. per 1 mm2, and the number of working capillaries by area is 5,7 ± 2,8 pcs. Per 1 mm2, then this indicates an initially unsatisfactory condition of the microcirculatory bed and a high probability that it may not cope with the increased load after surgery.Conclusion. Computer capillaroscopy is a modern method of assessing the state of the microcirculatory bed of the lower limb, which allows you to determine the degree of its compensatory capabilities after reconstructive surgery.