Recovery of endothelial function in microvessels in patients with peripheral artery disease (PAD) after conservative and surgery treatment

Purpose. The aim of the paper is to evaluate skin microcirculation in patients with lower extremity PAD before and after conservative therapy and endovascular revascularization by originally developed technique of wavelet analyses of skin temperature together with biochemical markers of endothelial dysfunction. Methods. The study included 17 healthy (44-61 years) and 38 pathological subjects (58-75 years). Patients with PAD were divided into four groups according to the stage of chronic limb ischemia. The study protocol contained biochemical and instrumental methods for the assessment of the functional state of the microcirculation. Results. Significant differences in biochemical and instrumental markers of endothelial dysfunction were observed in the pathological group in comparison with the control group. Examination of patients with PAD two weeks after treatment showed that the levels of inflammation and endothelial dysfunction markers, namely homocysteine, von Willebrand factor and endothelin, became lower. Conclusion. The results of the wavelet analysis of skin temperature applied together with the local heating test indicated the adequate responses of the microcirculation system to physiological stimuli. The outcome of medical PAD treatment is improvement of the microcirculatory function and specific biochemical markers of endothelial function.