OP 73. Controlled Reperfusion of Infrarenal Aorta Decreased Ischaemic- Reperfusion Injuries after Aortic Clamping in Vascular Surgery

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J. Werling, T. Nagy, V. Kovács, L. Sínay, E. Arató, T. Veress, I. Takács, I. Szelechman, P. Hardi, K. Sárvári, G. Jancsó

Chair(s): Roland Demaria, Mustafa Cikirikcioglu & Violetta Kékesi

9:10 - 9:20h at Buda Room (B)

Categories: Cardiac and Vascular Surgery, Oral Session

Session: Oral Session VIII - Cardiac and Vascular Surgery II

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Background
Long aortic clamping in vascular surgery induces reperfusion injury accompained with oxidativestress and inflammatory responses. The hypothesis of this study was that the aortic occlusion followed by controlled reperfusion (CR) can reduce the ischaemia-reperfusion injury, the systemic and local inflammatoric response induced by oxydative stress.

Material and Methods 
Animal model was used. Control group: animals undervent a 4-hour infrarenal aortic occlusion followed by continuous reperfusion. Treated group: animals were treated with CR: after a 4-hour infrarenal aortic occlusion we made CR for 30 minutes with the crystalloid reperfusion solution (blood:crystalloid solution ratio 1:1) on pressure 60 Hgmm. Blood samples were collected
different times. The developing oxydative stress was detected by the plasma levels of malondialdehyde, reduced glutathion, thiol groups and superoxide dismutase. The inflammatoric response was measured by phorbol myristate acetate-induced leukocyte reactiv oxygene species production and detection of change in myeloperoxidase levels. The animals were anaesthetised
one week after terminating ligation and biopsy was taken from quadriceps muscle and large parenchymal organs.

Result
CR significantly reduced the postischaemic oxydative stress and inflammatoric responses in early reperfusion period. Pathohistological results: The rate of affected muscle fibers by degeneration was significantly higher in the untreated animal group. The infiltration of leukocytes in muscle and parenchymal tissues was significantly lower in the treated group.

Conclusion
CR can improve outcome after acute lower-limb ischaemia. The results confirm, that CR might
be also a potential therapeutic approach in vascular surgery against reperfusion injury in acute limb ischaemia.
Supported by OTKA K108596.