Effect of immunocorrection on surgical outcomes in patients with autoimmune-aetiology vasculitis and vasculopathies.
The present study was undertaken to investigate and compare the outcomes of three options of preoperative preparation and postoperative management of patients presenting with autoimmune-aetiology vasculitis and vasculopathies, who had been subjected to angiosurgical interventions over a 7-year period. According to the aetiopathogenetic sign, the majority of the patients appeared to have thromboangiitis obliterans, non-specific aortoarteritis, primary and secondary vasculopathies. All the patients were age- and sex-matched and well comparable by the underlying disease, the level of lesions of the vascular bed, and the ischaemia burden. The study was performed retrospectively. A total of three options of preoperative preparation and management of the postoperative period were used: option one - treatment comprising plasmapheresis, immunoglobulins and biological immunomodulators; option two - using cytostatic agents and hormone therapy; and option three - consisting of conventional basic vascular therapy alone. The comparative analysis performed demonstrated a clear advantage of immunocorrection and efferent techniques of treating patients presenting with the pathology concerned. The use of the therapeutic-and-diagnostic algorithm we are suggesting herein would make it possible to avoid complications in the immediate postoperative period, to reduce the duration of the patients' hospital stay averagely by 10 days, and to prolong persistence of the obtained positive results by 11.5%.
Andrievskikh
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Chair of Hospital Surgery State Medical Academy, Chelyabinsk, Russia. hospsurg@mail.ru
Fokin
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Grafov
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D000465:Algorithms; D001327:Autoimmune Diseases; D020144:Basal Ganglia Cerebrovascular Disease / Q000601:surgery* / Q000628:therapy; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010956:Plasmapheresis; D016896:Treatment Outcome; D014657:Vasculitis / Q000276:immunology* / Q000601:surgery* / Q000628:therapy