Estimation of regional blood flow in reimplanted segments of upper extremity

Svetlov, Kirill; Svirshchevskij, E. B.; Trofimov, E. I.; Филиппов, В. В.; Adrianov, S. O.; Rodionova, T. V.

doi:10.17116/hirurgia2015749-56

Cited by 2 publications

(1 citation statement)

References 8 publications

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“…Danas, kada je u pitanju ova hirurgija, periferni nervni blokovi gornjeg i donjeg ekstremiteta imaju prioritet u odnosu na opštu anesteziju. Oni obezbeđuju blok simpatikusa i time sprečavaju vazospazam, ali i adekvatnu postoperativnu analgeziju za razliku od opšte anestezije [74][75][76][77] .…”

Section: Mikrovaskularna Hirurgijaunclassified

Anesthesia and perioperative medicine in orthopedic surgery

Srećković¹,

Milovanovic²,

Stojimanovska³

et al. 2019

Serb J Anest Inten Therapy

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Ortopedska hirurgija danas predstavlja veliki izazov za anesteziologe sa aspekta stanja pacijenta, tipa operacije, kao i položaja koji pacijent zauzima u toku operacije. U skladu sa trendom porasta gerijatrijske populacije, ortopedski pacijenti su najčešće stari sa brojnim komorbiditetima, ali i mladi, zdravi, najčešće traumatizovani, kod kojih postojanje udruženih povreda ima značajan uticaj na izbor tipa anestezije. Prilikom izbora tipa anestezije kod ortopedskih pacijenata neophodno je da se napravi adekvatna preoperativna procena i priprema i da se sagleda celokupno stanje pacijenta, a ne samo deo od značaja za hirurgiju. U okviru preoperativne pripreme kod ortopedskih pacijenata je najčešće neophodna kardiološka, pulmološka, ali i neurološka evaluacija, zatim nazalni skrining i dekolonizacija, preoperativna priprema kože, kontrola glikemije, kao i primena antibiotske profilakse. Ortopedska hirurgija ima najveći rizik za nastanak venskog tromboembolizma. Pravovremeno započinjanje tromboprofilakse, kao i njen nastavak posle operacije, kod ortopedskih pacijenata je od izuzetnog značaja. Za optimalnu upotrebu adekvatne tromboprofilakse postoji nekoliko objavljenih vodiča sa jasnim preporukama za dnevnu kliničku praksu. Poznavanje specifičnosti operacije, toka hirurgije, kao i položaja koji pacijent zauzima omogućava obezbeđivanje adekvatnih uslova rada uz minimalne gubitke krvi i komplikacije. Smanjenje krvarenja, kako intraoperativno tako i postoperativno, postiže se normovolemijskom hipotenzijom, bledom stazom uz pomoć poveske (touriquet), ali i primenom traneksamične kiseline, bilo sistemski ili lokalno. Kao hirurgija sa velikim postoperativnim zahtevima u analgeziji, u okviru multimodalnog pristupa se sve češće, pored perifernih nervnih blokova, u svakodnevnom radu primenjuje i periartikularno ubrizgavanje lokalnog anestetika. Poznavanje specifičnosti, ali i zahteva ortopedske operacije sa adekvatnom preoperativnom pripremom, iz-Revijalni članak

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Section: Mikrovaskularna Hirurgijaunclassified

Anesthesia and perioperative medicine in orthopedic surgery

Srećković¹,

Milovanovic²,

Stojimanovska³

et al. 2019

Serb J Anest Inten Therapy

View full text Add to dashboard Cite

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Possibilities of the Hybrid Method (Three-Phase Scintigraphy-SPECT/CTAngiography) in the Diagnosis and Staging of Acute Lower Limb Ischemia

Ляшчынская¹,

Kudryashova²,

Mikhailov³

et al. 2023

Neotložnaâ med. pomoŝʹ

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Acute lower limb ischemia (ALLI) is a limb threatening condition with high risk of adverse outcomes. The timely and proper diagnosis of the severity of limb ischemia is crucial in selecting the optimal treatment method.AIM OF STUDY To evaluate the advantages of hybrid imaging in diagnosis of ALLI, patient selection and its severity in order to choose an optimal revascularization method.MATERIAL AND METHODS we examined 163 patients with grade 1–3A ALLI based on I.I. Zatevakhin et al. classification (2002) on a Discovery 670 NM/CT hybrid device, using X-ray (computed tomographic angiography) and radionuclide method (three-phase scintigraphy/single photon emission computed tomography with osteotropic or perfused radiopharmaceutical).RESULTS CT angiography accurately showed level of acute occlusion as well as distal arterial blood flow in all ALLI cases, thus allowing optimal choice of possible revascularization. CT angiography findings alone did not allow optimal staging of ALLI, which is essential for choosing an optimal revascularization method and were considered as supplementary. Three-phase scintigraphy allowed to differentiate the degrees of ALLI based on the visual picture and calculated data, while studies with osteotropic radiopharmaceutical 99mТс-PYP provided information on viability of affected tissues showing the areas of muscle necrosis, compared to perfused radiopharmaceutical.CONCLUSION 1. CT angiography makes it possible to assess in detail the level and severity of occlusive lesions of the arterial system and study the vascular anatomy of the lower limb to resolve the issue of the possibility of revascularization, and also indirectly characterizes the presence of ischemic changes in soft tissues. 2. The radionuclide method (three-phase scintigraphy with an osteotropic radiopharmaceutical/single photon emission computed tomography), performed in addition to computed tomographic angiography, allows not only to detect the presence of ischemic changes in soft tissues, but also to differentiate the degree of acute ischemia of the lower. 3. The hybrid method (three-phase scintigraphy in combination with computed tomographic angiography) contributes to an objective assessment of the state of blood flow in the lower extremities in acute ischemia, both at the main and at the microcirculatory

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Estimation of regional blood flow in reimplanted segments of upper extremity

Cited by 2 publications

References 8 publications

Anesthesia and perioperative medicine in orthopedic surgery

Anesthesia and perioperative medicine in orthopedic surgery

Possibilities of the Hybrid Method (Three-Phase Scintigraphy-SPECT/CTAngiography) in the Diagnosis and Staging of Acute Lower Limb Ischemia

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