COMBINED METHOD OF TREATMENT OF PATIENTS WITH CRITICAL ISCHEMIA OF LOWER EXTREMITIES Russian patent published in 2023 - IPC A61B17/11 A61B17/3209 A61M5/00 A61K31/713 A61P9/14 

FIELD: medicine; cardiovascular surgery.

SUBSTANCE: after conservative treatment, femoral-foot bypass surgery is performed with a reversed autovein or a combined conduit — a reversed autovein in combination with a reinforced conical synthetic prosthesis. A distal anastomosis is applied and an arteriovenous anastomosis is formed with one of the arteries of the leg, and previously, according to the results of arteriography and ultrasound Dopplerography. The artery of the leg with the best outflow pathway — the posterior tibial artery or the anterior tibial artery is determined. A fasciotomy is performed along the anterior and posterior surfaces of the leg, and on the seventh and twenty-first days after surgical treatment, the patency of the femoral-foot shunt is monitored. “Neovasculgen” is administered paravasally, in fractions, 1 ml of the medicinal product into the muscles of the lower leg in the projection of the anterior and posterior tibial arteries, through five injections along the course of each artery, at a distance of 4–5 cm from each other, 3 cm in depth 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.

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