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About the clinic: I.M. Sechenov First Moscow State Medical University (Sechenov University) is the top medical university in Russia. Its history begins in 1758 as the medical faculty at Imperial Moscow University. For over two centuries Sechenov University has been a pioneer in the Russian healthcare system. A lot of outstanding physicians and scientists, who contributed significantly to the progress in medicine, worked at the University. In 2018, Sechenov University celebrates its 260th Anniversary.
About the clinic: Federal research and clinical center for specialized types of medical care and medical technologies of the FMBA of Russia (FSCC of the FMBA of Russia) is one of the largest multi — specialty medical institutions in Russia for providing specialized medical care, combining a consulting and diagnostic center and more than 40 departments.
About the clinic: Yusupovskaya hospital is a continuity of traditions in the treatment of patients in combination with the latest achievements of modern scientific and evidence-based medicine and advanced expert experience. The Yusupov hospital carries out scientific activities — on the basis of the clinic there are scientific and practical centers aimed at solving patients' problems in a comprehensive manner.
About the clinic: Clinical hospital No. 1 (Volynskaya) of The Presidential administration of the Russian Federation is one of the oldest institutions of Kremlin medicine, which itself has more than 400 years of history. In may 1600, by Decree of Tsar Boris Godunov, a pharmacy order was created to "protect the health of the sovereign". The hospital began with a small reception House adapted for a medical institution Near the dacha of I. V. Stalin.
Atherosclerosis of the lower extremities is a chronic vascular disease, which is based on violations of lipid metabolism, leading to the formation of atherosclerotic plaques, thickening of the walls of the arteries and reducing the vascular lumen. As a result, ischemia develops – insufficient oxygen supply to the cells and tissues of the lower extremities.
Most often, the popliteal, femoral and tibial arteries are involved in the pathological process.
Atherosclerosis of the arteries of the lower extremities is in the first place among the diseases of the peripheral arteries of atherosclerotic origin.
With atherosclerosis, the patient can feel and observe the following:
– muscle pain in the legs
– tingling, numbness in the affected area;
– sores on the skin;
– livid color of the fingers;
– cooling of the skin of the leg;
There is a standard diagnostic program for this disease:
– Ultrasound of lower extremity vessels ( duplex and Doppler scanning);
– Coagulogram (determination of the blood clotting system);
– Determination of cholesterol and LDL levels in the blood;
– Arteriography of the legs;
– Establishment of pulsation in the peripheral arteries;
– Mr -, MSCT-angiography.
– MRI and CT scans with contrast and reovasography can be performed as prescribed by a doctor.
Percutaneous transluminal angioplasty of the lower extremity vessels is a minimally invasive procedure that expands the arteries of the lower extremities. The procedure consists of inserting a hollow catheter equipped with a balloon into the vascular bed and an artery affected by atherosclerosis. The catheter advances under x-ray control. When the catheter reaches the place of narrowing of the artery, the balloon inflates. Due to the pressure of the balloon, partial destruction of atherosclerotic plaques occurs, increasing the lumen of the vessel and restoring blood flow through it. After the test images are taken, stenting is performed for indications – a stent is inserted (a compressed spring, which is made using a special alloy). The stent is straightened in the artery, resulting in the expansion of the vessel diameter and normalization of blood supply to the lower extremities.
Thrombendarterectomy is an open surgical intervention to remove thrombotic masses from the arteries affected by atherosclerosis, which provides normalization of blood supply to the lower extremities.
Surgical intervention to restore blood supply to the lower extremities by shunting is to install a shunt bypassing the clogged segment of the artery. The blocked area or lumen of the vessel remains closed even after surgery. Bypass surgery can be performed from your own tissues (often, a large saphenous vein) or with a vascular prosthesis.
If trophic ulcers are poorly treated conservatively, they are operated on, removal of necrosis (affected tissues) is performed and the patient’s own skin is covered – transplantation of their own skin.
Amputation – is prescribed in severe cases when gangrene occurs, after which prosthesis installation technique is performed.