METHOD FOR COMBINED TREATMENT OF PATIENTS WITH CRITICAL ISCHEMIA OF LOWER EXTREMITIES Russian patent published in 2025 - IPC A61K31/192 A61K31/708 A61K31/727 A61K31/4545 A61K31/5377 A61K31/616 A61K31/407 A61K35/44 A61P9/10 A61F2/01 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to cardiovascular surgery. Conservative treatment is followed by a femoral foot bypass surgery with a reversed autovein or a combined conduit – a reversed autovein in a combination with a reinforced conical synthetic prosthesis. Distal anastomosis is applied and an arteriovenous junction is formed with one of the shin arteries, and preliminary, according to the results of arteriography and ultrasonic Doppler sonography, shin artery with outflow pathways is determined – posterior tibial artery or anterior tibial artery. Fasciotomy is performed along anterior and posterior surface of shin. In the postoperative period, the patient is prescribed a conservative therapy from the first day: dissolving contents of two ampoules of lyophilisate of Vazaprostan®, which corresponds to 40 mcg of alprostadil, in 50-250 ml of physiological solution and the obtained solution is administered intravenously for two hours twice a day or three ampoules for three hours once a day, which corresponds to 60 mcg of alprostadil, or Pentoxifylline 5.0 ml per 250 ml of normal saline is administered intravenously for 10 days, patient takes Vasonit 600 mg, one tablet twice day for 4-6 months. Vessel Due F 600 LU per 250 ml of normal saline is administered intravenously drop-by-drop for 10 days, then Vessel Due F 250 LU in tablet form is prescribed, one tablet twice a day for up to 60 days. For the whole period of postoperative inpatient and outpatient treatment, the patient undergoes anticoagulant therapy, Eliquis 2.5 mg 2 times a day and Thrombo ASS 100 mg are administered one tablet once a day, and Ketorolac 2.0 ml is also administered to the patient. Then, on 4th postoperative day, the patency of the femoral-foot shunt is monitored and the preparation Slavinorm is administered intramuscularly in dose of 5 mg once a day twice a week; the therapeutic course is 10 injections; the contents of the vial are dissolved in 1-2 ml 0.9% sodium chloride solution.

EFFECT: method allows to normalize vascular wall endothelial functions, to stimulate angiogenesis on working shunt in case of shin artery occlusion.

1 cl, 2 ex