[New possibilities of extremity revascularization in chronic ischemia: neoangiogenesis induced by exposure to high-intensive laser (an experimental study)].

The present work analyzes the results of an experimental study concerned with the treatment of chronic extremity ischemia. The experiments were carried out on 29 mongrel dogs. Chronic ischemia of the right hind extremity was simulated in 24 dogs (the superficial femoral artery was ligated just beneath the iliac artery and over its whole length as were all its collaterals). The significance of extremity ischemia was confirmed clinically, angiographically and morphologically. In the first group (19 dogs), the ischemized extremity underwent one month later concurrent tunneling of the femoral muscles and bone perforation in the diaphysis and metaphysis by exposure to high-intensive laser (Nd: YAG laser). The second group (5 dogs) served as control to study the response to ischemia. There were examined the area of laser-induced injury, the internal diameter of the capillaries and the diameter of muscle fibers, the specific area of the surface of blood vessels in the muscle and connective tissue. By the 60th day after exposure to laser an appreciable difference was recorded in the control and experimental groups: in the experimental group, angiography revealed a much greater number of vessels in the zone of the ligated femoral artery. Microscopy showed vascularized scars with muscle type arteries, active proliferation of endotheliocytes, formation of a new vascular bed. It is assumed that the tunneling of the ischemized extremity muscles concurrently with osteotrephination by high-intensive laser substantially restores blood flow in the distal segments of the ischemized extremities. Intensive development of the vascular network in the areas of the tunneling of the ischemized muscles of the hind extremities by exposure to high-intensive laser allows to compare this modality with universally used revascularization osteotrephination.