Virtuelni brahijalni indeks gležnja – može li se predvideti neposredni ishod femorodistalne bajpas hirurgije?

  • Dragan B. Sekulić Military Medical Academy, Clinic for Vascular and Endovascular Surgery, Belgrade, Serbia
  • Aleksandar B. Tomić Military Medical Academy, Clinic for Vascular and Endovascular Surgery, Belgrade, Serbia; University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia
  • Andreja Dimić University Clinical Center of Serbia, Clinic for Vascular and Endovascular Surgery, Belgrade, Serbia; University of Belgrade, Faculty of Medicine, Belgrade, Serbia
  • Aleksandar C. Mitrović University Clinical Center of Serbia, Clinic for Vascular and Endovascular Surgery, Belgrade, Serbia
  • Lazar B. Davidović University Clinical Center of Serbia, Clinic for Vascular and Endovascular Surgery, Belgrade, Serbia; University of Belgrade, Faculty of Medicine, Belgrade, Serbia
  • Dragana S. Paunović Military Medical Academy, Clinic for Vascular and Endovascular Surgery
  • Dalibor D. Nikolić University of Kragujevac, Faculty of Engineering Sciences, Kragujevac, Serbia
  • Uroš M. Miladinović Military Medical Academy, Institute for Radiology, Belgrade, Serbia
  • Igor M. Sekulić University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia; Military Medical Academy Institute for Radiology Belgrade, Serbia
  • Nemanja K. Rančić University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia; Military Medical Academy Institute for Radiology Belgrade, Serbia; Military Medical Academy Center for Clinical Pharmacology Belgrade, Serbia
  • Momir M. Šarac Military Medical Academy, Clinic for Vascular and Endovascular Surgery Belgrade, Serbia; University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia
  • Ivan R. Marjanović Military Medical Academy, Clinic for Vascular and Endovascular Surgery Belgrade, Serbia; University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia
  • Ivan R. Leković Military Medical Academy, Clinic for Vascular and Endovascular Surgery Belgrade, Serbia; University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia
  • Boško I. Milev University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia; Military Medical Academy Clinic for General Surgery, Belgrade, Serbia
DOI: https://doi.org/10.2298/VSP230516033S
Ključne reči: arterije, okluzione bolesti, brahijalni indeks gležnja, angiografija, tomografska, kompjuterizovana, analiza konačnih elemenata, kompjuterski asistirano tumačenje slika, noga, prognoza, ultrasonografija

Sažetak


Uvod/Cilj. Najbolji način lečenja okluzije površne femoralne arterije je femorodistalni (FD) bajpas. Brahijalni indeks gležnja (BIG) i angiografija primenom metode multidetektorske kompjuterizovane tomografije (MDKT) predstavljaju „zlatni standard” u dijagnostici periferne okluzivne bolesti arterija. Analiza konačnih elemenata (AKE) može pomoći u merenju količine protoka krvi i arterijskog pritiska u arterijama donjih ekstremiteta. Cilj rada bio je da se ispita mogućnost korišćenja AKE u predviđanju ishoda FD bajpas hirurgije. Metode. Istraživanjem je obuhvaćeno 45 bolesnika kojima je indikovana FD arterijska rekonstrukcija u periodu od 01. decembra 2021. do 31. marta 2023. godine. Svakom bolesniku je preoperativno i postoperativno urađena angiografija arterija donjih ekstremiteta primenom MDKT, na osnovu koje su, uz korišćenje AKE, napravljeni modeli na kojima su mereni BIG. Svim bolesnicima su mereni BIG preoperativno i postoperativno, korišćenjem Doppler ultrazvuka i sfigmomanometra. Na osnovu preoperativne MDKT angiografije, korišćenjem metode AKE, napravljeni su postoperativni virtuelni hirurški modeli, na kojima su takođe mereni BIG. Vrednosti BIG raspoređene su u pet grupa: BIG meren preoperativno (BIG pre-op), BIG meren postoperativno (BIG post-op), BIG meren na modelima konačnih elemenata dobijenim primenom MDKT [BIG (sim) pre-op], BIG sim post-op, i BIG dobijen merenjem na virtuelnom hirurškom modelu [BIG sim post-op (virtual)]. Statistički su upoređivane vrednosti BIG dobijene na modelima sa vrednostima dobijenim merenjem na bolesnicima. Rezultati. Vrednosti dobijene na osnovu virtuelnih BIG modela nisu pokazale značajnu razliku u poređenju sa vrednostima dobijenim merenjem na bolesnicima i vrednostima dobijenim primenom AKE uz MDKT angiografiju (p < 0,001). Značajna statistička korelacija pokazana je između vrednosti virtuelnih BIG i vrednosti dobijenih primenom druge dve metode, merenim na postoperativnom modelu MDKT angiografije i na virtuelnom postoperativnom modelu (p < 0,001). Zaključak. Virtuelna simulacija parametara dobijenih primenom MDKT angiografije perifernih krvnih sudova može se uspešno koristiti za predviđanje neposrednog ishoda FD bajpas hirurgije

Biografija autora

Igor M. Sekulić, University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia; Military Medical Academy Institute for Radiology Belgrade, Serbia

 

 

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Objavljeno
2023/11/02
Broj časopisa
Vol. 80 Br. 10 (2023): Vojnosanitetski pregled
Rubrika
Originalni članak