Application of the temporary arterial sound at the footwears of the lower hideship vessels (review and methods of temporary succession)

Abstract

Damage to the vessels remains an urgent and complicated issue of angio-surgery, both in the curative and organizational terms. In the course of the anti-terrorist operation in eastern Ukraine in 2014 — 2018, damage to major vessels requiring reconstructive interventions occurred in 2 % of the victims. In 90 % of the wounded, trauma to the vessels of the lower extremities was noted. In order to prevent the development of irreversible limb ischemia and its amputation in the trauma of major vessels in the conditions of the implementation of the surgical tactic «Damage control», the method of temporary shunting of the trunk vessels of the extremity deserves attention, which allows to restore blood flow through damaged major arteries in the short term, to prevent the development of irreversible ischemia and save the limb. Temporary bypass must be the initial stage of reconstructive surgery on the damaged major artery of the limb.The article describes the main historical stages of the inventions and improvements of temporal vascular shunts. The classification of temporal vascular shunts is given, their characteristics and detailed method of application are given. Temporary vascular shunts are effective; the possibility of their application should be considered when treating wounds of the vessels of the limbs of practically all types, in particular proximal veins. The main advantage of such shunts is to ensure early recovery of blood flow and to reduce the negative effects of arterial ischemia and venous hypertension. Unlike ligation, temporal bypass surgery is an element of multi-stage surgical treatment or damage control surgery. Despite the desire to maximize the implementation of primary reconstructive techniques at the stages of medical evacuation, for various reasons (delayed evacuation, intense combat and medical conditions) the frequency of the use of temporary prosthesis will not decrease. Therefore, in order to improve the results of treatment of injuries with damage to the main vessels, experimental and clinical testing of the use of the temporary prosthesis method in the implementation of the surgical tactic «damage control» is required.