[Hemorheologic applications in vascular surgery].

Abstract

Possible vascular surgery interventions are reviewed in respect of the supraaortic segment (carotis obstruction), in aortic aneurysm, and in the lower extremities region (aorto-iliac/femoro-popliteal segment). The conservative therapeutic measures in terms of pre-, per-, and postoperative reocclusion prevention are discussed--also with a view to "surgically exhausted" cases--with special focus on platelet antiaggregants (acetylsalicylic acid [ASA]), hemorheological principles (hemodilution, pentoxifylline) and anticoagulation. In an one year comparative reocclusion prevention study of ASA and pentoxifylline (Trental 400) in patients with prosthetic bypass surgery in the femoro-popliteal segment no difference was found in respect of the patency rate between the two treatments, the hemorheological medication, however, proved significantly better tolerable. It can be concluded that such conservative treatments can clearly support the outcome of vascular surgery on the long run, with, indeed, control of risk factors and activation of patients to physical therapy (walking exercise).