STUDY OF THE GENETIC ASPECTS OF THE RISK OF SHUNT THROMBOSIS AFTER OPERATIONS IN THE LOWER LIMBS ARTERIES
Introduction. Critical limb ischemia is a serious threat, and even after surgery for revascularization, only 45% of those operated on retain both extremities within 1 year. During this time, unfortunately, in 30% of cases, the affected limbs are amputated, and the remaining 25% of critical ischemia cases result in death.
Purpose. In order to improve the treatment outcomes of patients with peripheral arterial disease (PAD), the relationship between hemocoagulation-related gene polymorphism and the risk of shunt thrombosis after reconstructive arterial disease has been studied.
Materials and Methods. The study included 40 patients who had previously undergone open reconstructive surgery for peripheral arterial disease, who were divided into two groups. The main criterion for inclusion of the patient in the main group was thrombosis of the shunt at any time after reconstructive surgery, and in the comparison group – the absence of thrombosis after peripheral arterial bypass at least 1 year after reconstructive surgery. All patients with polymerase chain reaction were analyzed for the presence of the following hereditary thrombophilia: Leiden factor G1691A, prothrombin G20210A, FGB G (-455) A, ITGA2 C807T, ITGB3 T1565C, PAI-1 5G (-675) 4G and MTHFR.
Discussion. The study found a relationship between FGB G (-455) A, ITGA2 C807T and ITGB3 T1565C gene mutations and thrombosis after peripheral arterial bypass. It has been statistically proven that when there is at least one of the thrombophilia such as FGB G (-455) A, ITGA2 C807T and ITGB3 T1565C present in a patient with peripheral arterial disease, the risk of shunt thrombosis will increase in the future.
A prospective direction for further research is the study of the question of how differentiated additional prevention of thrombosis of arterial shunts in patients with PLEAD depending on the detected hereditary thrombophilia will affect the frequency of thrombosis of these shunts. The study found that in patients with peripheral arterial disease who are planning to undergo surgery on peripheral arteries, it is advisable to study the presence or absence of thrombophilia bypass as FGB G (-455) A, ITGA2 C807T and ITGB3 T1565C. If these patients have at least one of these thrombophilia, the risk of bypass thrombosis in them is statistically significant in the future.
A promising direction for further research may be to investigate how differentiated additional prevention of arterial bypass thrombosis in patients with PAD, depending on the hereditary thrombophilia detected, will affect the frequency of thrombosis of these pass and bypass.
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