TY - JOUR AU - О. E. Kanikovsky AU - S. V. Sander AU - О. I. Bondarchuk AU - О. P. Fedzhaha AU - V. P. Malyarchuk AU - V. V. Mosendz PY - 2021/06/20 Y2 - 2024/03/29 TI - COVID-19-ASSOCIATED ACUTE LOWER LIMBS ISCHAEMIA IN ELDERLY AND SENILE PATIENTS: TREATMENT PROSPECTS (PRELIMINARY ANNOUNCEMENT) JF - Kharkiv Surgical School JA - Khark. Surg. Sch. VL - 0 IS - 2 SE - ORIGINAL RESEARCHES DO - 10.37699/2308-7005.2.2021.02 UR - https://surgical-school.com.ua/index.php/journal/article/view/204 AB - Summery. The aim — analysis of preliminary experience of treatment of COVID-19-associated acute lower limbs ischemia in elderly and senile patients.Materials and methods. We examined 48 patients (age 60- 84 years). First group — 16 patients with COVID-19-associated acute lower limbs ischemia, second group — 32 patients with chronic limb ischemia without coronavirus infection. .Results and discussion. First group’s patients had extended blood clotting time (more than 13-15 min). Other blood clotting indicators changed slightly. An isoline or a low-amplitude curve was recorded during photoplethysmography. After thrombectomy (6 patients) 3 patients had fatal thrombotic complications (PE, myocardial infarction, stroke), 1 had progressive ischemia. Pharmacotherapy was performed in 10 patients (in 2 patients later than 12 hours from the onset of ischemia). The effectiveness of timely started pharmacotherapy reached 67 %. All patients of group II had arteriosclerosis of the tibial arteries. Blood clotting indicators were normal. A high-amplitude curve was recorded during photoplethysmography. Thus, all elderly and senile patients has arteriosclerosis of the tibial arteries. On this basis, there was a fatal coincidence (coagulopathy, a sharp slowdown in blood flow, endothelial dysfunction) in case of coronavirus infection (COVID-19). Prospects for further developments are the improvement of anticoagulant therapy (for example, the simultaneous use of unfractionated and low molecular weight heparin) and improving of collateral circulation (for example, nerve block and forced intraarterial infusion or lavage).Conclusion. Currently, the effectiveness of thrombectomy in elderly and senile patients with COVID-19-associated acute lower limbs ischemiа is 33 %, the effectiveness of timely started pharmacotherapy Is 67 %. ER -