Influence of the activity of vascular wall inflammation on the results of reconstructive surgery in patients with atherosclerosis obliterance of the aorta and lower extremity arteries
A.A. Poliantsev, P.V. Mozgovoy*, D.V. Frolov, G. L. Snigur**
Volgograd State Medical University, Department of General Surgery.
*- Clinic № 1 Volgograd State Medical University, Department of Cardiovascular Surgery
**- Volgograd State Medical University, Department of Pathology
Abstract: This study included 42 patients (basic group) who were operated on aortoiliac arterial segments in the department of vascular surgery of The Clinic of General Surgery after A.A. Polyantsev, Volgograd State Medical University in 2007. Observation period for patients after operation was 3 years. The average age of patients: 58.48 years ± 6,4. All patients in the study group - male. Late thrombotic reocclusion occurred in 6 patients (14,3%) in the period from 1 to 3 years old and required to perform the amputation of limbs at the thigh in 2 patients (4.8%). To carry out histological studies the material obtained during surgical operations on patients with atherosclerosis obliterans of the aorta and lower extremity arteries was used. During the operation tissues of wall of the aorta in the proximal anastomosis were carried out. If surgery was performed only in the distal anastomosis, then the wall of the common femoral artery was carried out. Monoclonal antibodies to caspase 3 and endothelial NO-synthase (Novocastra, UK), as well as to the proliferating cell nuclear antigen (PCNA) and Ki-67 protein (Lab Vision, USA) were used. To visualize the indirect immunoperoxidase method with high temperature demasking of antigens with positive and negative controls was used.
Conclusion: Patients with atherosclerosis of aorta and lower extremity arteries have a high level of proliferative activity of the endothelium, compared with patients without atherosclerosis. Proliferative activity of endothelial and smooth muscle cells of aortic wall, aggressiveness and activity of atherosclerosis in patients with thrombotic reocclusion in the late postoperative period exceeds that of patients without thrombosis, and contributes to the offensive of the complications after surgery.
atherosclerosis, the arteries of the lower limbs, surgical treatment, long-term results, immunohistochemistry, morphometry.
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