DOI: https://doi.org/10.22141/2224-0586.8.103.2019.192374

Use of a test with double local hypoxia of the upper extremity in patients with obliterating atherosclerosis of the lower extremities vessels

I.V. Tverdovsky

Abstract


Background. The atherosclerosis of the lower extremities affects more than 35 million people in the European Union and about 10 % of the world population. The cardiovascular community is embarrassed about medication in patients with peripheral arterial disease of the lower extremities. It is widely acknowledged that anticoagulant medication therapy is an integral part of the prevention of cardiovascular mortality and morbidity in this category of patients. The purpose of this study is to compare and evaluate the state of hemostasis in healthy volunteers and in patients with obliterating lower extremity atherosclerosis by using a double-localized hypoxia test of the upper limb. Materials and methods. A study was based on the reaction of the hemostatic system in healthy volunteers (n = 30) and patients with obliterating atherosclerosis (OA) of the lower limb arteries (n = 90) obtained while conducting a functional test in the form of double local hypoxia of the upper limb using low-frequency piezoelectric thromboelastography. Results. A sample with double local hypoxia of the upper limb can be used as a test stimulus for patients with obliterating atherosclerosis of the lower limb arteries to assess the reserve capacity of the hemostasis system. Depending on the nature of the reaction of platelet-vascular, coagulation components of hemostasis and fibrinolysis on the effect of the test stimulus, two types of reaction of the hemostatic system in healthy individuals are possible: compensated and sub-compensated. In impaired hemostatic system, such types of the reaction as decompensated and exhausted can be determined. When carrying out an ischemic test in patients with OA, the decompensated type of reaction to the test with local hypoxia of the upper limb was determined.


Keywords


obliterating atherosclerosis; thrombosis; hemostasis

References


Aboyans V., Ricco J.B., Bartelink M.-L. et al. 2017 ESC guidelines on the diagnosis and treatment of periphery arterial di­seases. Eur. Heart J. 2018. 39. 763-816.

Gerhard-Herman M.D., Gornik H.L. et al. 2016 AHA/ACC Guideline on the management of patients with lower extremi­ty peripheral artery disease: executive ummary. J. Am. Coll. Cardiol. 2017. 69. 1465-1508.

Sundboll J., Veres K., Horvath-Puho E. et al. Risk and prognosis of cancer after lower limb arterial thrombosis. Circulation. 2018. 138. 669-677.

Tarabrin O., Shcherbakov S., Gavrychenko D., Saleh O., Lyoshenko I., Kushnir O. Can we use the low-frequency piezoelectric tromboelastography for diagnosis coagulation disorders? European Journal of Anaesthesiology. 2013. 30(51). 92.




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