Abstract:
Structure of the thesis. The thesis includes 167 pages of the main text: introduction, five chapters,
general conclusions and practical recommendations, 25 figures and 21 tables. The bibliography
includes 218 references. The principal results of the study were published in 22 scientific papers.
Key words: acute limb ischemia, clinical diagnosis, imaging, surgical treatment.
The aim of study. Determination of the possibilities for improving the diagnosis and treatment of
patients with acute limb ischemia, based on the identification of perioperative factors that have a
negative impact on the results of urgent revascularization interventions.
Objectives of the study. Study of the demographic, clinical and paraclinical characteristics of the
contemporary cohort of patients with acute limb ischemia undergoing revascularization interventions.
Evaluation of preoperative management and assessment of the value of different diagnostic methods
of acute limb ischemia. Development of the method for predicting the early outcome of
revascularization interventions, based on available criteria for analysis at the preoperative stage.
Analysis of early and long-term results after urgent revascularization interventions and identification
of factors associated with amputation risk and/or patient death. Determining the particularities of
clinical evolution and surgical treatment results in acute upper limb ischemia and in cases associated
with SARS-CoV-2 infection.
Scientific originality and novelty. For the first time in the Republic of Moldova, a prospective
scientific cohort study was carried out in patients with acute limb ischemia and allowed the complex
evaluation of the clinical and demographic characteristics, the peculiarities of the diagnostic-curative
approach and the results of the treatment. For the first time, the use of non-contact infrared
thermometry was proposed for the pre- and postoperative examination of patients with acute limb
ischemia. It has been shown that the degree of patient frailty and the severity of ischemia, evaluated
with the help of the "MoST-Do" score developed in the study, represent the true risk factors associated
with the unfavorable outcome of revascularization interventions. Prospective external validation of
the value of the Baligh ultrasound sign was performed and demonstrated its acceptable diagnostic
performance in determining the cause of arterial occlusion.
Theoretical significance and applicative value. The identification of preoperative risk factors,
associated with the failure of the revascularization intervention in patients with acute limb ischemia,
allowed the prediction of the outcome of the operation and the scientifically reasoned selection of the
curative tactics. Based on the research results, was demonstrated the necessity and usefulness of
including non-contact infrared thermometry examination in the diagnostic procedure, applied to
patients with acute limb ischemia. The study data identified a number of possibilities for improving
the outcomes of treatment of acute limb ischemia: education of patients in risk group; rational use
and monitoring the effectiveness of antithrombotic treatment; prognosis, early diagnosis and
appropriate treatment of compartment syndrome and ischemia-reperfusion syndrome.
Implementation of scientific results. The results of study were implemented in the clinical activity
of the departments of surgery at Institute of Emergency Medicine from Republic of Moldova. Seven
acts of implementation of the results were registered.
