The implementation of new prophylactic and interventional methods for critical ischemia from lower extremity atherosclerosis, EPICA

• a cognitive-behavioural psychological intervention to reduce the pain and distress for life quality improvement on short and long term, after a surgical intervention;
• treatment and diagnosis guide based on a clear, logical and simple algorithm for the therapeutical evaluation and behaviour of patients with critical ischemia;
• setting up a National Register and a national integrated network for these patients;
• articles in journals of high impact;
• PC7 project proposal.

• development of new prophylactic and interventional methods for critical ischemia of the lower extremities atherosclerosis: a set of objective criteria for the evaluation of the best level of amputation to prevent the iterative interventions;
• investigation of relationship between medical variables (ex. disease stage, amputation level, associated diseases) and psychological ones (e.g. type of disfunctional cognitions, distress level) and psychological intervention;
• the analysis of mediator factors role for the post-surgical recovery and of their interaction with the phychological intervention;
• the significant increase of operated patients life quality, from the physical and psychological point of view.

The present project represents a novelty in Romania because there is no such study or paper in the specialized literature in our country that would confirm the state of the amputation indication on objective bases, using evaluation algorithms. No study in our country uses the method of measuring the oxygen transcutaneous pressure for the tissue metabolism evaluation as an indicator of the amputation level. At a national level, the interest in the tissual ischemia can be seen in Project CEEX nr. 638/2006, title: “Translation Of Genomic Research Into The Development Of Innovative Therapies Based On The Stem Cells Transplant In Atherothrombotic Diseases – Study Integrated Within European Experience Of Excellency Research (TRANSCARDIOSTEM)”, which refers to totally different aspects of research, i.e. the inducing of neoangiogenesis through stem cells transplant at the level of ischemic tissues, including critical ischemia.

Novelty elements:

• the first study of this kind in Romania;
• multidisciplinary study (UMF, UBB, SCJU, ICIA Cluj-Napoca) for an integrated approach and evaluation of critical ischemia, useful both for those who offer the primary medical care and the specialized one;
• usage of method of metodei TCPO2 measuring to evaluate the tissual metabolism as indicator of the amputation level;
• evaluation of costefficiency ratio in the management of critical ischemia, ending in the draw up of a diagnosis and treatment guide, being the first integrated study that proposes an evaluation of life quality, of psychotherapy and socioprofessional re-integration of patients with critical ischemia;
• National register of lower extremity artheriopathy;
• set up of an integrated national system of critical ischemia management by connecting the vasscular surgery centers with the hospitals and primary medical care network.

• new prevention and interventional methods in critical ischemia of lower extremity atherosclerosis;
• protocol of therapeutical indication evaluation;
• cost evaluation protocol;
• protocol of evaluation of psychotherapeutical efficiency;
• questionnaire intragroup and intergroup analyses;
• factors of risk and comorbidities associated to critical ischemia of lower extremity atherosclerosis;
• comparative study on treatment outcomes;
• study on the mechanisms of change;
• cost-effectiveness study of the suggested treatment;
• clinical guide of psychological evaluation and intervention in the case of amputated patients;
• medical and psychological service range for the amputated patients;
• printed courses;
• monograph;
• articles;
• scientific communication;
• web page;
• CD-presentation;
• feasability study;
• reference system;
• PC7 project proposal.