Disease disease. Stenting of vessels

Disease disease is a rare disease, beginning with skin symptoms and often ending with a lethal outcome with the appearance of an "acute abdomen". It begins with the appearance on the skin of relapsing light pink. A few edematic papular eruptions, the central part of which after a while is noticeably retracted. At this time they become white. They are localized most often on the trunk and skin of the occiput. At this stage, the altered tissues are rejected, and ulcers with a border of hyperemia open in their place. A few weeks later, the patient has a sharp pain in the right epigastric region, fever, vomiting of blood. Attacks of pain appear after eating. Almost after each attack appears profuse diarrhea. Constant pains are accompanied by adynamy, loss of strength and exhaustion of the patient. Patients develop proteinemia, hypotension, bilirubinemia. The picture of blood in the sick, as a rule, normal. After the appearance of such symptoms, a lethal outcome may occur in a few days. During autopsy, thrombosis of intestinal veins and intestinal necrosis without perforation are detected.

Disease is a skin-abdominal syndrome, in which almost always doctors give a poor prognosis. Eruptions in this disease usually consist of several elements that have different stages of development. Papules exist for about a month, and the scar is formed over 0.5 year.

In histological studies , serious changes in the vascular system are noted in the dermis of the patient. So often there are thrombi, arteriolitis, endotheliitis, blockage of large and small vessels. In the collagenous tissues around the affected vessels and on their walls foci of fibrinoid necrosis are observed. In small capillaries thromboendotheliitis occurs. At the site of atrophic sites, collagen is highly compacted, and the epidermis is covered with scales and is thinned. On the circumference of the papular formations, there are enlarged vessels that are surrounded by a lymphohystocyte infiltrate. Dego's disease also seizes larger vessels located deep in the subcutaneous fat and dermis. This process with multiple infiltrates and degeneration of the vessels of the intestine, skin and other organs is very similar to the nodular panarteritis.

Although Dego's disease in case of acute development has a poor prognosis, there are also cases with prolonged course that are amenable to treatment. The disease is treated with antibiotics, blood transfusions, corticosteroids, heparin, vitamins, antihistamines. With an "acute abdomen" treatment is practically not giving positive results.

Any vascular disease, especially in older people, can have very serious consequences. Atherosclerotic changes sometimes affect the entire vascular system. When lesions of the coronary and carotid arteries, vessels of the extremities, restenosis of the artery, it is recommended to perform such operation as stenting of the vessels. This procedure is particularly indicated for high risk of myocardial infarction, circulatory disorders in the brain, limb function disorders, trophic changes.

Stenting is contraindicated with a small diameter of the arteries (less than 2.5 mm), diffuse stenosis (with large areas of vasoconstriction), renal and respiratory failure, pathologies in the blood coagulation system, allergies to iodine-containing drugs (used in contrast radiologic preparation).

Before the operation, such examinations of the patient's body are carried out: ultrasound intravascular study, ultrasound dopplerography, angiography, computed tomography, MRI, electroencephalography, echocardiography, electrocardiography. Before the operation, antiplatelet drugs are taken, which reduce the risk of thrombotic complications.

Vascular stenting is performed under local anesthesia, performed in the area of the location of a large artery on the leg or arm. For surgery, the radial, femoral or thoracic artery can be used. The surgeon performs a puncture of the wall of the peripheral artery and introduces into it an introducer (a tube through which other instruments are inserted).

A thin catheter delivers a stent with a balonchik through the peripheral vessels to the desired artery. In the balloon there is a contrast radiologic substance. It stretches and the stent, which is a folded, mesh-shaped metal structure, is straightened. The whole operation is reflected on the monitor screen. Fixation of the stent is carried out by pressing it into the walls of the artery. At the same time, several stents can be installed. Then the tools are pulled out of the lumen in the vessel. The operation lasts about an hour. The patient practically does not feel pain, and unpleasant sensations appear only at the moment of inflation of a balonchik. After the operation, the patient is left in the hospital for several days. At this time antiaggregant, antibacterial, anti-inflammatory therapy is prescribed.

Possible complications after surgery: damage to the walls of the arteries, formation of hematomas at the puncture site, bleeding, clogging of the artery, impaired renal function, allergic reactions, thrombosis of the stent area.