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Khirurgii

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Year 2022 Vol. 30 No 1

GENERAL & SPECIAL SURGERY

R.E. KALININ 1, I.A. SUCHKOV 1, N.D. MZHAVANADZE 1, V.O. POVAROV 1, E.A. KLIMENTOVA 1, O.N. ZHURINA 1, G.A. PUCHKOVA 2

PROGNOSTIC MARKERS OF RESTENOSIS IN PATIENTS WITH PERIPHERAL ARTERY DISEASE AFTER ENDOVASCULAR PROCEDURES

I.P. Pavlov Ryazan State Medical University, Ryazan, Russian Federation 1,
Physician of Ultrasound Diagnostics, Ryazan Regional Clinical Cardiologic Dispensary 2, Ryazan,
Russian Federation

Objective. To study the role of hemostatic parameters as potential markers of restenosis in patients with peripheral artery disease (PAD) after endovascular procedures.
Methods. An open prospective study involved 55 PAD patients aged 63 (57; 69) with the stage IIb-IV Fontaine chronic lower limb ischemia; 48 (87.3%) subjects were male; 18 (32.73%) patients had type 2 diabetes mellitus (T2D). Before angioplasty or stenting of the arteries of the lower extremities, the activity of protein C (PrC), the levels of soluble endothelial receptors for protein C (sEPCR), the activity of coagulation factors FVIII, FIX, FXI were determined in the peripheral blood. Within a year every three months Duplex ultrasound or angiography for follow-up examination have been performed to detect restenosis.
Results. Within one year restenosis was detected in 13 (23.6%) patients. Binary regression analysis revealed T2D, FVIII activity and sEPCR as prognostic markers of restenosis. sEPCR level lower than 46.8 ng/ml was associated with a 4.263 higher risk for restenosis after endovascular procedures (odds ratio 4.263, CI 95% 1.509-12.042); absolute risk 47±11% (CI 95% 25-69 %). The patients with T2D had a 2.6 higher risk for restenosis as compared to subjects without diabetes mellitus (odds ratio 2.6, CI 95% 1.031-6.599); absolute risk 41.18±12% (CI 95% 17.78-64.58%). The probability of developing restenosis was inversely related to the initial indicators of FVIII activity and the level of sEPCR: the lower the absolute values of FVIII and sEPCR, the higher the likelihood of developing restenosis in the postoperative period.
Conclusion. Patients with diabetes mellitus (type 2), reduced activity of coagulation factor FVIII and level of soluble endothelial protein C receptors are at particularly high risk for restenosis

Keywords: hemostatic markers, restenosis, peripheral artery disease, endovascular interventions, diabetes mellitus
p. 12-19 of the original issue
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Address for correspondence:
390026, Russian Federation,
Ryazan, Vysokovoltnaya Str., 9,
I.P. Pavlov Ryazan State Medical University,
the Department of Cardiovascular,
X-ray Endovascular,
Operative Surgery and Radiation Diagnostics,
tel. +7 903 836 24 17,
e-mail: suchkov_med@mail.ru,
Suchkov Igor A.
Information about the authors:
Kalinin Roman E., MD, Professor, Head of the Department of Cardiovascular, X-ray Endovascular, Operative Surgery and Radiation Diagnostics, I.P. Pavlov Ryazan State Medical University, Ryazan, Russian Federation.
http://orcid.org/0000-0002-0817-9573
Suchkov Igor A., MD, Professor of the Department of Cardiovascular, X-ray Endovascular, Operative Surgery and Radiation Diagnostics, I.P. Pavlov Ryazan State Medical University, Ryazan, Russian Federation.
http://orcid.org/0000-0002-1292-5452
Mzhavanadze Nina D., PhD, Associate Professor of the Department of Cardiovascular, X-ray Endovascular, Operative Surgery and Radiation Diagnostics, I.P. Pavlov Ryazan State Medical University, Ryazan, Russian Federation.
http://orcid.org/0000-0001-5437-1112
Povarov Vladislav O., PhD, applicant of the Department of Cardiovascular, X-ray Endovascular, Operative Surgery and Radiation Diagnostics, I.P. Pavlov Ryazan State Medical University, Ryazan, Russian Federation.
https://orcid.org/0000-0001-8810-9518
Klimentova Emma A., PhD, applicant of the Department of Cardiovascular, X-ray Endovascular, Operative Surgery and Radiation Diagnostics, I.P. Pavlov Ryazan State Medical University, Ryazan, Russian Federation.
https://orcid.org/0000-0003-4855-9068
Zhurina Olga N., PhD, Researcher, Scientific and Clinical Center of Hematology, Oncology and Immunology, I.P. Pavlov Ryazan State Medical University, Ryazan, Russian Federation.
https://orcid.org/0000-0002-2159-582X
Puchkova Galina A., Physician of Ultrasound Diagnostics, Ryazan Regional Clinical Cardiologic Dispensary, Ryazan, Russian Federation.
https://orcid.org/0000-0002-6346-2064
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