EXPERIENCE IN THE USE OF THERAPEUTIC ANGIOGENESIS WITH PLASMID DEOXYRIBONUCLEIC ACID IN PATIENTS WITH NON-SHUNTABLE LESIONS OF LOWER LIMB ARTERIES

Abstract

Purpose of the Study: In this article, the team of authors shares their own experience of performing the procedure of therapeutic angiogenesis with plasmid DNA in the department of surgery. Materials and Methods: From November 2020 to December 2021, the department performed 64 procedures of therapeutic angiogenesis using plasmid DNA in 32 patients with distal steno-occlusive lesions of lower limb arteries, with CAI II-A - CAI III according to Pokrovsky-Fontaine. All patients included in the statistics of this work were questionnaired (SF-36) and thoroughly interviewed during the writing of this article. Results: Of the 32 patients, only two (6.25%) noted a deterioration in their condition, of which one patient with CAI III and diabetes underwent hip amputation after 1.5 months. In the second patient, three months after the repeated procedure of therapeutic angiogenesis, the distance of pain-free walking decreased from 350 to 250 meters, which can be associated with severe nicotine addiction and inability to quit smoking. Four patients did not note any significant changes in their condition in the period from 2.5 to 6 months after repeated administration of the drug. 12 patients (37.5%) noted moderate positive changes in the form of an increase in pain-free walking distance, a decrease in pain, and an improvement in quality of life. 14 patients (43.75%) claimed a significant increase in pain-free walking distance and assessed the results of the therapy as good. The greatest positive dynamics were observed in the groups CAI II-A and CAI II-B. The peak of positive dynamics of pain-free walking distance was noted 3-6 months after the second administration of the drug. Conclusion: As a result of treatment with plasmid DNA, we noted a significant positive effect from the procedure, especially in patients with intermittent claudication. In a group of patients with critical ischemia, the procedure of therapeutic angiogenesis became the only means to preserve the limb.