Pathogenesis of acute ischaemia Sudden stop of the blood flow in great vessel. Periferal vasospasm. Blood stasis. Prolonged thrombosis – ascendal and descendal. Developping of acute inflammation in intima. Venouse tgrombosis. Hypoxia, metabolic acidosis. Hyperkaliemia, «Myoglobinuric nephrosis».
Treatment before hospitalisation Spasmolytics – no-spa, papaverin (liquidation of periferal vasospasm). Analgetics – non-narcotic or narcotic. Anticoagulation – heparin ED, for prevention of continued thrombosis Hospitalisation into angiosurgery dept.
Indications to angiography: Not clear clinics of the disease. In inconsistency between the level of occlusion and the level of ischaemic tissue. For the purpose of differentiation between different forms of acute ischaemia. In case of plural or many-storied Ljng lasting disease In case of ischaemia saving after the oparation
The baseground of the tactics The term The localisation The degree of the ischaemia The stay of a patient Reconstruction is contrindicated in: Agony III degree of ischaemia Ia, Ib degree of ischaemia in hard condition of a patient
Surgery Initial surgical treatment Vascular repare Side or circular stitch Plastics In case of defect 1-3 cm - anastomosis In case of defect more than 3 cm – prostethics with autovein of artificial graft