REPEATED REVASCULARIZATION OF CHRONIC ARTERIAL FAILURE RECURRENCE IN PATIENTS AFTER AORTO/ILIOFEMORAL REGION RECONSTRUCTION
DOI:
https://doi.org/10.11603/bmbr.2706-6290.2019.1.10496Keywords:
revascularization of the arterial vessel, obliterating atherosclerosis, chronic arterial insufficiency, repeated revascularizationAbstract
The aim of the work. To improve the results of repeated revascularization of the arterial bed of the lower extremities in patients with relapse of chronic arterial insufficiency in the late postoperative period after aorto/iliofemoral region.
Materials and Methods. The results of surgical treatment of 522 patients were monitored during 2006–2019. 353 patients were subjected to surgery, 260 of whom had disturbed blood flow in the thigh-popliteal segment. 159 patients were treated in the specified time for occlusive-stenotic lesion of the iliofemoral zone, 94 of whom had blood flow disorder along the femoral and popliteal arterial bed. At the time of primary surgery, 228 patients were diagnosed with chronic arterial insufficiency (CAI) degree IIIA (according to the Fontaine R. classification, taking into account the criteria of the European Working Group (1992)), in 189 – KhKINC IIB-IV degree, in 98 – CAI degree IIB. 92 (17.6 %) patients were diagnosed with hemodynamically significant stenosis of the extracranial arteries, 75 of them patients underwent surgery on the vessels of the neck in the conditions of surgical treatment of atherosclerotic lesions of the aorto/iliofemoral-popliteal arterial area.
Results and Discussion. In 78 patients with recurrent chronic arterial insufficiency of the lower extremities in the distant postoperative period, re-operative intervention was performed taking into account the features of primary revascularization of the arterial bed, localization of the stenotically occlusive process, its combination and the prevalence of atherosclerotic. Re-revascularization was complicated by the development of the thrombosis of the reconstruction segment (10 cases, representing 12.8 % of observations).
Conclusions. Non-standard, technically sophisticated, multilevel surgery is the major revascularizing intervention in patients with relapsed chronic arterial insufficiency. For revascularization of the tibial arterial segment, thigh/popliteal and tibial autovenous bypass was used and endovascular balloon angioplasty was used.
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