[Activation of intravascular microcoagulation of blood in patients with atherosclerotic gangrene of the lower limbs].

A prospective study was carried out in order to investigate the system of haemostasis in a total of sixty patients presenting with atherosclerotic gangrene of a lower extremity who were then subjected to high amputation. The operative intervention was preceded and followed by determining the following parameters: antithrombin III (AT-III), fibrinogen (FG), thrombin time (TT), activated partial thromboplastin time (APTT), prothrombin time (PT), the number of the soluble fibrin-monomeric complexes (SFMC) and D-dimers, euglobulin fraction clot lysis time, the amount and aggregation activity of blood platelets. The findings obtained while studying haemostasis in patients with irreversible ischaemia of the lower limbs demonstrated activation of the intravascular microcoagulation of blood prior to the operation. The immediate postoperative period was marked by preservation of the shortened APTT, high concentration of fibrinogen, elevated euglobulin clot lysis time, high concentrations of SFMCs and D-dimers of blood, which created conditions for the development of thrombotic complications even in a relatively stable course of the postoperative period. The authors underline the necessity of determining an optimal mode of prescribing and administering appropriate doses of direct anticoagulants in the early and immediate postoperative period, as well as that of making an appropriate decision of whether or not to use indirect anticoagulants for correction of haemostasis in these patients during the remote postoperative period.