FIELD: medicine; cardiovascular surgery.
SUBSTANCE: invention is intended for the combined treatment of critical ischemia of the lower extremities with occlusion of the arteries of the lower leg. After conservative treatment, a femoral foot bypass operation is performed with a reversed autovein, while a distal anastomosis is applied and an arteriovenous anastomosis is formed with one of the lower leg arteries. Preliminarily, according to the results of arteriography and ultrasound dopplerography (USDG), the leg artery with the best outflow paths is determined — the posterior tibial artery (PTA) or the anterior tibial artery (APTA). The operation is supplemented with fasciotomy along the anterior and posterior surface of the lower leg. Intraoperatively, bone marrow sampling is performed by puncture of the anterior and posterior iliac spines. After treatment of the bone marrow, a preparation of progenitor cells of the bone marrow is obtained, which is injected twice — on the third and thirtieth days after the operation, while the drug is administered paravasally, fractionally, 1 ml into the leg muscles in the projection of PBBA and ZBBA, after five injections along the course of each of the arteries, at a distance of 4–5 cm from each other, 3 cm deep at an angle of 90° to the skin.
EFFECT: method makes it possible to increase the efficiency of reconstructive surgery to restore arterial blood flow in patients with critical ischemia of the lower extremities by stimulating angiogenesis while the shunt is in operation.
1 cl, 2 ex
