ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Effectiveness of the cascade filtration technique in the management of inoperable leg ischemia
Sinan Demirtaş1, Celal Yavuz1, Ahmet Çalışkan1, Oğuz Karahan1, Ahmet Hakan Vural2, Ahmet Fatih Özyazıcıoğlu2
1Department of Cardiovascular Surgery, Medical Faculty of Dicle University, Diyarbakır, Turkey
2Department of Cardiovascular Surgery, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
DOI : 10.5606/tgkdc.dergisi.2013.7409
Background: This study aims to investigate the effectiveness of the cascade filtration technique in individuals with peripheral vascular disease who are candidates for amputation.

Methods: Twelve patients (9 males, 3 females; mean age 62.4±7.2 years; range 45 to 75 years) were included in the study. For the evaluation of the efficacy of this procedure, measurements of serum albumin, fibrinogen, immunoglobulin M, alpha-2 macroglobulin, low density lipoprotein (LDL) cholesterol, fibronectin, von Willebrand factor levels, blood viscosity, and transcutaneous oxygen saturation (tcPO2) were obtained before and after the procedure at sessions 1, 4, and 7.

Results: A statistically insignificant increase in tcPO2 values and a significant decrease in viscosity were determined (p=0.019). Fibronectin, von Willebrand factor, and viscosity levels were significantly decreased at the end of protocol, compared to baseline values. Various degrees of improvement were noted in seven of the 10 patients. After the completion of the protocol, amputation from a more distal level than previously planned was performed in three patients.

Conclusion: Cascade filtration, despite its high cost, appears to be an effective treatment alternative which limits or prevents amputation.

Keywords : Cascade filtration; hemorheotherapy; ischemic leg; peripheral artery disease; rheopheresis
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