Distal Venous Arterialization and Reperfusion Injury

Focus on Oxidative Status

P Djoric, Jelena Zeleskov Doric, DM Stanisavljevic, ZD Markovic, V Zivkovic, M Vuletic, D Djuric, V Jakovljevic

Research output: Contribution to journalArticleResearchpeer-review

Abstract

In patients with unreconstructable arterial occlusive disease distal venous arterialization (DVA) seems to be a promising option in the treatment. The goals of this prospective study were to assess clinical efficiency and possible impact of DVA on tissue damage by estimating oxidative status of patients with critical limb ischemia treated with this procedure. The subjects were 60 randomized patients: 30 were undergoing DVA and 30 were treated with antiaggregation therapy. During the mean follow-up period (6.13 ± 4.32 months for DVA vs. 6.74 ± 0.5 months for antiaggregation therapy) survival (p < 0.01), limb salvage (p < 0.001), pain relief (p < 0.001) and wound healing (p < 0.001) rates were significantly different between the two groups of patients in favor of the DVA group. Ten minutes after declamping we observed a decreasing trend in the lactate level in the blood of the deep venous system (p < 0.001). Also, on postoperative day 7 digital systolic pressure and digital-brachial index were higher than before the operation (p < 0.001). In blood samples collected immediately before and successively at 1, 3, 5 and 10 min postoperatively, prooxidative status (thiobarbituric acid reactive substances, O2–, H2O2 and nitric oxide) and antioxidative enzymes (superoxide dismutase, catalase and glutathione reductase) were determined spectrophotometrically. Using the nonparametric Friedman test, we noted statistically nonsignificant differences (p > 0.05) in values of both prooxidative parameters and enzymes of the antioxidative defense system, before and successively at 1, 3, 5 and 10 min after operation. These results indicate that there was no statistically significant reperfusion injury after revascularization, which could have been expected after this surgical procedure, thus confirming its validity in these patients.
Original languageEnglish
Pages (from-to)200-207
Number of pages7
JournalEuropean Surgical Research
Volume48
Issue number4
DOIs
Publication statusPublished - Jul 2012
Externally publishedYes

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Reperfusion Injury
Arterial Occlusive Diseases
Therapeutics
Ischemia
Extremities
Prospective Studies
Survival
Enzymes

Cite this

Djoric, P., Zeleskov Doric, J., Stanisavljevic, DM., Markovic, ZD., Zivkovic, V., Vuletic, M., ... Jakovljevic, V. (2012). Distal Venous Arterialization and Reperfusion Injury: Focus on Oxidative Status. European Surgical Research, 48(4), 200-207. https://doi.org/10.1159/000338619
Djoric, P ; Zeleskov Doric, Jelena ; Stanisavljevic, DM ; Markovic, ZD ; Zivkovic, V ; Vuletic, M ; Djuric, D ; Jakovljevic, V. / Distal Venous Arterialization and Reperfusion Injury : Focus on Oxidative Status. In: European Surgical Research. 2012 ; Vol. 48, No. 4. pp. 200-207.
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abstract = "In patients with unreconstructable arterial occlusive disease distal venous arterialization (DVA) seems to be a promising option in the treatment. The goals of this prospective study were to assess clinical efficiency and possible impact of DVA on tissue damage by estimating oxidative status of patients with critical limb ischemia treated with this procedure. The subjects were 60 randomized patients: 30 were undergoing DVA and 30 were treated with antiaggregation therapy. During the mean follow-up period (6.13 ± 4.32 months for DVA vs. 6.74 ± 0.5 months for antiaggregation therapy) survival (p < 0.01), limb salvage (p < 0.001), pain relief (p < 0.001) and wound healing (p < 0.001) rates were significantly different between the two groups of patients in favor of the DVA group. Ten minutes after declamping we observed a decreasing trend in the lactate level in the blood of the deep venous system (p < 0.001). Also, on postoperative day 7 digital systolic pressure and digital-brachial index were higher than before the operation (p < 0.001). In blood samples collected immediately before and successively at 1, 3, 5 and 10 min postoperatively, prooxidative status (thiobarbituric acid reactive substances, O2–, H2O2 and nitric oxide) and antioxidative enzymes (superoxide dismutase, catalase and glutathione reductase) were determined spectrophotometrically. Using the nonparametric Friedman test, we noted statistically nonsignificant differences (p > 0.05) in values of both prooxidative parameters and enzymes of the antioxidative defense system, before and successively at 1, 3, 5 and 10 min after operation. These results indicate that there was no statistically significant reperfusion injury after revascularization, which could have been expected after this surgical procedure, thus confirming its validity in these patients.",
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Djoric, P, Zeleskov Doric, J, Stanisavljevic, DM, Markovic, ZD, Zivkovic, V, Vuletic, M, Djuric, D & Jakovljevic, V 2012, 'Distal Venous Arterialization and Reperfusion Injury: Focus on Oxidative Status', European Surgical Research, vol. 48, no. 4, pp. 200-207. https://doi.org/10.1159/000338619

Distal Venous Arterialization and Reperfusion Injury : Focus on Oxidative Status. / Djoric, P; Zeleskov Doric, Jelena; Stanisavljevic, DM; Markovic, ZD; Zivkovic, V; Vuletic, M; Djuric, D; Jakovljevic, V.

In: European Surgical Research, Vol. 48, No. 4, 07.2012, p. 200-207.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Distal Venous Arterialization and Reperfusion Injury

T2 - Focus on Oxidative Status

AU - Djoric, P

AU - Zeleskov Doric, Jelena

AU - Stanisavljevic, DM

AU - Markovic, ZD

AU - Zivkovic, V

AU - Vuletic, M

AU - Djuric, D

AU - Jakovljevic, V

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Y1 - 2012/7

N2 - In patients with unreconstructable arterial occlusive disease distal venous arterialization (DVA) seems to be a promising option in the treatment. The goals of this prospective study were to assess clinical efficiency and possible impact of DVA on tissue damage by estimating oxidative status of patients with critical limb ischemia treated with this procedure. The subjects were 60 randomized patients: 30 were undergoing DVA and 30 were treated with antiaggregation therapy. During the mean follow-up period (6.13 ± 4.32 months for DVA vs. 6.74 ± 0.5 months for antiaggregation therapy) survival (p < 0.01), limb salvage (p < 0.001), pain relief (p < 0.001) and wound healing (p < 0.001) rates were significantly different between the two groups of patients in favor of the DVA group. Ten minutes after declamping we observed a decreasing trend in the lactate level in the blood of the deep venous system (p < 0.001). Also, on postoperative day 7 digital systolic pressure and digital-brachial index were higher than before the operation (p < 0.001). In blood samples collected immediately before and successively at 1, 3, 5 and 10 min postoperatively, prooxidative status (thiobarbituric acid reactive substances, O2–, H2O2 and nitric oxide) and antioxidative enzymes (superoxide dismutase, catalase and glutathione reductase) were determined spectrophotometrically. Using the nonparametric Friedman test, we noted statistically nonsignificant differences (p > 0.05) in values of both prooxidative parameters and enzymes of the antioxidative defense system, before and successively at 1, 3, 5 and 10 min after operation. These results indicate that there was no statistically significant reperfusion injury after revascularization, which could have been expected after this surgical procedure, thus confirming its validity in these patients.

AB - In patients with unreconstructable arterial occlusive disease distal venous arterialization (DVA) seems to be a promising option in the treatment. The goals of this prospective study were to assess clinical efficiency and possible impact of DVA on tissue damage by estimating oxidative status of patients with critical limb ischemia treated with this procedure. The subjects were 60 randomized patients: 30 were undergoing DVA and 30 were treated with antiaggregation therapy. During the mean follow-up period (6.13 ± 4.32 months for DVA vs. 6.74 ± 0.5 months for antiaggregation therapy) survival (p < 0.01), limb salvage (p < 0.001), pain relief (p < 0.001) and wound healing (p < 0.001) rates were significantly different between the two groups of patients in favor of the DVA group. Ten minutes after declamping we observed a decreasing trend in the lactate level in the blood of the deep venous system (p < 0.001). Also, on postoperative day 7 digital systolic pressure and digital-brachial index were higher than before the operation (p < 0.001). In blood samples collected immediately before and successively at 1, 3, 5 and 10 min postoperatively, prooxidative status (thiobarbituric acid reactive substances, O2–, H2O2 and nitric oxide) and antioxidative enzymes (superoxide dismutase, catalase and glutathione reductase) were determined spectrophotometrically. Using the nonparametric Friedman test, we noted statistically nonsignificant differences (p > 0.05) in values of both prooxidative parameters and enzymes of the antioxidative defense system, before and successively at 1, 3, 5 and 10 min after operation. These results indicate that there was no statistically significant reperfusion injury after revascularization, which could have been expected after this surgical procedure, thus confirming its validity in these patients.

U2 - 10.1159/000338619

DO - 10.1159/000338619

M3 - Article

VL - 48

SP - 200

EP - 207

JO - European Surgical Research

JF - European Surgical Research

SN - 0014-312X

IS - 4

ER -

Djoric P, Zeleskov Doric J, Stanisavljevic DM, Markovic ZD, Zivkovic V, Vuletic M et al. Distal Venous Arterialization and Reperfusion Injury: Focus on Oxidative Status. European Surgical Research. 2012 Jul;48(4):200-207. https://doi.org/10.1159/000338619