Acute Ischemic Neuropathy

Yu.N. Sorokin, S.A. Sagaradze, A.V. Melnikov

Abstract


The atherosclerosis of the main vessels is the most common reason of chronic obliterating diseases of aorta and arteries of the lower extremities with development of acute vascular insufficiency. Along with such severe and common complication, as extremity gangrene, development of ischemic neuropathy of peripheral nerves of extremities with motor deficiency, which is observed rather rarely, can also result in persistent disability.
Material and Methods. Clinical supervision of acute development of ischemic neuropathy, caused by obliterating defeat of abdominal aorta and arteries of the lower extremities, is presented.
Results. Acute impairment of arterial blood flow in the lower extremities has led to the development of ischemic neuropathy with 2-sided affection of fibular and tibial nerves with significant paresis of the feet. Duplex scanning of abdominal aorta and arteries of the lower extremities has revealed dense and soft circular atherosclerotic plaques in the abdominal aorta, signs of 2-sided occlusion of the general and external iliac arteries, 50% stenosis of the lumen of both general femoral arteries and considerable decrease in the speed of blood flow in the right deep and left superficial femoral arteries.
For the purpose of restoration of blood flow, surgical intervention was carried out — left lateral sympathectomy, thrombectomy from distal aorta, endarterectomy from superficial femoral artery of the left hip, bilateral aorto-femoral bypass. Following the surgery the blood flow in the lower extremities and function of fibular and tibial nerves recovered.
Conclusions. Early detection of ischemic neuropathy will promote more effective treatment and will help to prevent development of persistent disability at this pathology.


Keywords


atherosclerosis; ischemic neuropathy; critical ischemia of extremity

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DOI: https://doi.org/10.22141/2224-0713.2.64.2014.80575

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