Abstract
The aim of the study was to assess the degree of calcification of the vascular wall using the method of luminescence spectroscopy, as one of the factors in choosing the tactics of proximal hybrid reconstruction.
Material and methods. The study involved 20 people operated on in the volume of proximal hybrid reconstruction in the vascular department of GKB No. 29. All patients were divided into 2 groups according to the option of performing the second stage of the intervention. The first group (n=10) consisted of respondents who underwent femoral-popliteal bypass surgery, the second group (n=10) consisted of respondents who underwent balloon angioplasty and stenting of the superficial femoral artery or popliteal artery at this stage of the hybrid operation. The follow-up period was 14 days. The end point of the study was thrombosis of the reconstruction zone. All patients underwent intravascular laser spectroscopy using an excimer laser (HeSl, 308 nm) intraoperatively according to the method proposed by the authors. The calcium level was determined in the plaques obtained as a result of endarterectomy by mass spectrometry with an ion source in the form of inductively coupled plasma. Subsequently, a correlation was carried out between the intensity of calcium luminescence in plaques and its concentration. The SPSS Statistics 17.0 software was used for statistical data processing when comparing study groups.
Results. The characteristic spectrum of the luminescent glow of calcium is estimated, and its characteristic peak at a wavelength of 380 nm is determined. The higher the luminescence intensity at a given frequency, the higher the calcium concentration in the sample. When comparing the luminescence amplitude (S) at the peak of calcium (380 nm) in 3 respondents with postoperative bleeding from the 1st study group (S = 1.76±0.09 105 photons), there was a significant difference with patients with uncomplicated postoperative period (S = 0.57±0.07 105 photons, p<0.05). A similar trend was found in 2 patients from group 1 who had the development of thrombosis of the reconstruction zone. Their luminescence amplitude was (S = 1.01±0.03 105 photons, p<0.05). In 2 cases of arterial thrombosis in group 2 of the study, the amplitude of intraoperative luminescence was 2.05±0.03 105 photons, which is significantly higher than in representatives of group 1 with a similar outcome (p<0.05).
Conclusion. With the amplitude of the glow obtained by intravascular measurement exceeding 1.01±0.03 105 photons, it is rational to perform endovascular angioplasty and stenting as the second stage of proximal hybrid reconstruction.
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About the authors
- Alexey G. Vaganov, Cand. Med. Sci., Surgeon; ORCID
- Dmitry A. Lisitsky, Dr. Med. Sci., Cardiovascular Surgeon; ORCID
- Alexander V. Gavrilenko, Dr. Med. Sci., Professor, Academician of the Russian Academy of Sciences, Head of the Department of Vascular Surgery; ORCID
