UA95706C2 - METHOD FOR LASER revascularizing osteotrepanation (LAROT) IN THE TREATMENT OF LOWER EXTREMINTYTISSUE ISCHEMIA - Google Patents

Abstract

A method for laser revascularizing osteotrepanation (LAROT) in the treatment of tissue ischemia of the lower extremities comprises the access to a. epigastrica inferior, its catheterization and day and night administration of vascular and antibacterial preparations through the catheter. In parallel, within 20-25 days regional medical therapy is carried out, which comprises the infusion of nitric oxide donor (tivortin - 100 ml/day), angioprotectors - Actovegin (160 mg), antiplatelet agents - dipyridamol 0.5% (2 ml), nicotinic acid 1% (5 ml), lidocaine 2% (4 ml), magnesium sulfate 25% (10 ml), heparin (5000 IU), alprostan 100 µg directly through a catheter a.epigastrica inferior and further a. iliaca ext. into a. femoralis using infusion pumps day and night at the rate of 10-15 ml/hour. The irradiation course of arterial blood through catheterized a.epigastrica inferior with low-energy lasers of red (wavelength 632.8 nm, power 5 mW, the exposure 20-25 min.), infrared (wavelength 850 nm, 5 mW, the exposure 20-25 min.) and UV spectrum with the wavelength 360 nm, power 8.5 mW, the exposure 20-25 min.) using quartz-polymer monofilaments with fiber diameter of 0.4- and length of 30-. Also on 3-4 day of said therapeutic manipulations the tibial percutaneous laser revascularizing osteotrepanation (LAROT) is carried out for what the skin puncture is performed under spinal anesthesia as well as puncture of deep tissues up to the periosteum along the lateral surfaces of the tibia from 4-5 positions on each side at a distance of 2-, the monofilament LED is introduced into puncture needle having diameter and destruction of bone tissue is carried out as a tunnel with high-intensity diode laser with wavelength of 940 nm, in the modulated mode, 50:10, power of 28-32 Wt. The level of osteotrepanation openings on both sides is alternated for prevention of fractures in the postoperative period, and after removal of the monofilament LED the same punction needle in introduced in formed tunnel, which is introduced into the bone with the helical coil to 1.0-, mechanically removing carbonized tissue and expanding osteotrepanation opening, which stimulates the formation of collateral circulation of the soft tissues at the expense of the bone vessels.