UA55493C2 - Method for decreasing thrombogenicity of endarterectomized artery - Google Patents

Abstract

The invention relates to the medicine and may be used for the reconstruction surgery of the aorta and the main arteries of the lower limbs. The method for decreasing the thrombogenicity of the endarterectomized artery comprises applying the preparation of the silver onto the reconstruction area. The electrolytic silver solution is sputtered onto the endarterectomized arterial wall at a density of 0.04-0.05 mg/ml.

Description

The invention relates to medicine and can be used in vascular surgery during reconstructive operations on the aorta and main arteries.

There is a known method of reducing the thrombogenicity of an endarterectomized artery, which consists in blocking the activity of the vascular-platelet mechanism by influencing blood coagulation factors with anticoagulants

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The disadvantage of this method is the insufficient effectiveness of the specified methodical approach, which is based on the use of anticoagulants, which in conditions of extensive damage to the intima of the artery causes the activation of the vascular-platelet mechanism and leads to an increase in the thrombogenicity of the endarterectomized artery.

The invention is based on the task of improving the method of reducing the thrombogenicity of an endarterectomized artery in which, by optimizing the electrical potential of the cells of the endarterectomized artery wall, they achieve a decrease in its thrombogenicity.

The task is solved by the fact that in the method of reducing the thrombogenicity of the endarterectomized artery, which includes blocking the activity of the vascular-platelet mechanism, in accordance with the invention, a silver preparation is applied to the endarterectomized wall of the arteries.

When considering the technical solution, it was taken into account that an intact artery has a wall electrical potential of 0.35-0.51 kOhm, and an endarterectomized artery wall during the first 10-20 minutes of restoration of blood flow through the vessel - 1.86-2.20 kOhm ( 2). After spraying the endarterectomized surface of the artery wall with a solution of electrolytic silver in a concentration of 0.04 - 0.05 mg/ml, the wall electrical potential was at the level of 0.50--0.79 kΩ.

The method is carried out as follows.

The lumen of the artery is opened with two longitudinal cuts 5-7 mm long. In the first, the tip of the probe of the device for ultrasonic endarterectomy is introduced, which is brought to the intima damaged by the atherosclerotic process. Behind the tip of the probe is the exit hole of the catheter, through which a solution of electrolytic silver in a concentration of 0.04 - 0.05 mg/ml is given. When performing an endarterectomy using an ultrasound power of 0.6 W/cm? and exposure of 8 - 10 minutes, the tip of the probe is passed between the intima and the muscle layer, and a silver solution at the rate of 0.1 ml/cm2 of the surface of the endarterectomized artery is simultaneously applied to the endarterectomized surface through the catheter. After the manipulation is completed, the removed intima is removed through the second hole.

Example 1. Patient M., 45 years old, with a diagnosis of "obliterating atherosclerosis of the arteries of the lower extremities, chronic arterial insufficiency of the 1st degree", underwent surgical intervention - ultrasound endarterectomy of the right common femoral artery with profundoplasty. The lumen of the artery was opened, an ultrasonic endarterectomy was performed, and at the same time, a solution of electrolytic silver in a concentration of 0.05 mg/ml and in an amount of 5 ml was applied to the endarterectomized surface of the artery. Postoperative period - without complications. The patient was discharged in satisfactory condition.

Example 2. Surgical treatment of 19 patients was carried out in the described manner. The effectiveness of treatment using the proposed method, in addition to the improvement of clinical signs, was judged by the dynamics of changes in the electrical biopotential of the endarterectomized wall according to the method of I.K. Wenger. and co-author (1997) (2).

A positive clinical effect in the early postoperative period was obtained in 10,095 cases (see table).

Table

Dynamics of changes in the electrical biopotential of the endarterectomized arterial wall during reconstructive surgery

The object of research by the method - 29 patients by the proposed method - 8 patients

Thus, the proposed method reduces the frequency of thrombosis in the postoperative period during reconstructive operations, which increases the effectiveness of surgical treatment of atherosclerosis of the main arteries of the lower extremities.

Sources of information that should be taken into account 1. Anaushev A., Noreyka R., Vareikene R. About the possibility of preventing early post-operative thrombosis by heparinization of sndarterctomized arteries // Achievements of medical science in the republic. - Kaunas, 1986. - P. 12 - 13. 2. Wenger I.K. Prevention of alloshunt thrombosis (prosthesis) after reconstruction of atherosclerotic occlusion of the aorto-femoral segment. - Rivne, 1997. - P. 34 - 35. 3. Kobza N.I. Prevention of postoperative thrombosis in patients with critical ischemia of the lower extremities //

Materials of the conference dedicated to the 25th anniversary of the vascular surgery clinic in Lviv. - Lviv, 1996. - P. 37-38.

Claims (2)

1. A method of reducing the thrombogenicity of an endarterectomized artery, which includes blocking the activity of the vascular-platelet mechanism by using anticoagulants, which is distinguished by the fact that in the area of reconstruction, a silver preparation is applied to the endarterectomized wall of the artery. 2. The method according to claim 1, which differs in that the silver preparation is applied by spraying a solution of electrolytic silver on the endarterectomized artery wall at a concentration of 0.04 - 0.05 mg/ml.