Research is devoted to topical issue of vascular surgery – to treatment of patients with multilevel arterial occlusions of the lower extremities in a stage of critical ischemia. 80 patients with a combination of critical ischemia and coronary heart disease were randomized in 2 groups. The concept of the combined treatment of patients with multilevel defeat of the arterial course in combination with the coronary heart disease combining complex conservative therapy with perioperation application of a vazaprostan and sulodexide and multicomponent reconstructive (including endovascular) operations, is applied at 40 patients with critical ische-mia. Improvement of diastolic function of the left ventricle against reduction of heart rate is noted. In the first three months after the beginning of reception of a vazaprostan and a sulodexide improvement of a coronary blood-groove in the first for 23% was observed. Total number of attacks of ischemia per day in the main group decreased by the end of 3 months by 68% in the main group. Recovery of normal geometry of heart in group of the patients receiving vazaprostan and sulodexide is revealed at 56% of patients. In 3 years after operation the frequency of preservation of an extremity at them was 30% higher, than at patients to whom therapy wasn´t carried out by these drugs. Use in strategy of complex conservative therapy of a vazaprostan and sulodeksid allows to reduce at them the frequency of amputations and to improve quality of life due to stabilization of a course of coronary heart disease.
critical ischemia, coronary heart disease, vazaprostan, sulodexide, complex therapy, heart haemodynamics.
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