Repeated revascularization of a chronic arterial failure recurrence after Aortoiliac-femoral segment reconstruction

Authors

  • I. K. Venher I. Horbachevsky Ternopil National Medical University
  • M. O. Husak I. Horbachevsky Ternopil National Medical University
  • D. V. Kovalskyi I. Horbachevsky Ternopil National Medical University
  • S. Ya. Kostiv I. Horbachevsky Ternopil National Medical University
  • A. R. Vaida I. Horbachevsky Ternopil National Medical University
  • N. I. Herasymiuk I. Horbachevsky Ternopil National Medical University

DOI:

https://doi.org/10.11603/2414-4533.2019.4.10715

Keywords:

obliterating atherosclerosis, repeated revascularization, complications of reconstructive interventions

Abstract

The aim of the work: to improve results of revascularization of the lower extremity arterial bed in patients with relapse of chronic arterial insufficiency by applying endovascular angioplasty methods in the complex of re-operative surgery.

Materials and Methods. The results of surgical treatment of 522 patients with atherosclerotic occlusion of the aortoiliac-femoral segment mere studied. 231 patients were diagnosed with stage IIIA arterial insufficiency, 191 had chronic critical arterial ischemia stage IIIB-IV, and 100 had chronic stage IIB. In the analysis of primary surgical interventions, three groups of patients were identified in patients with recurrent chronic arterial ischemia. Group I included 22 observations (28.2 %) – primary surgery – reconstruction of the aortoiliac-femoral area in the absence of hemodynamically significant atherosclerotic process of the femoral-distal segment, group II – 43 observations (55.1 %) – primary surgery – reconstruction aortoiliac-femoral segment in the presence of stenotic-occlusive process of the femoral-popliteal zone. Group III – 13 observations (16.7 %) – primary surgery – reconstruction of the aortoiliac-femoral area with autogenous femoral-distal bypass grafting.

Results and Discussion. Revascularization of the lower limb trunk at relapse of chronic arterial ischemia was performed taking into account the features of the primary surgical intervention, localization of the stenotic-occlusive process, prevalence and combination with other segments of the lower extremity arterial bed. Progressive lesions of the atherosclerotic process of the zone of distal anastomosis of the aortoiliac-femoral alloprosthesis were detected in 36 (48.7%) observations, the tibia zone – in 61 (78.2 %) patients. The main intervention at revascularization was femoral-distal shunting operations, which in 32 cases were supplemented with endovascular balloon angioplasty of the tibial artery, of which in 19 interventions angioplasty of two arteries was performed. In the occlusive-stenotic process of the tibial arteries, 23 popliteal-posterior-tibial (anterior-tibial) shunts were performed. The postoperative period in 10 (12.8 %) patients was complicated by the development of reconstruction segment thrombosis and in 2 cases the thrombosis developed after endovascular balloon angioplasty.

References

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Published

2020-01-11

How to Cite

Venher, I. K., Husak, M. O., Kovalskyi, D. V., Kostiv, S. Y., Vaida, A. R., & Herasymiuk, N. I. (2020). Repeated revascularization of a chronic arterial failure recurrence after Aortoiliac-femoral segment reconstruction. Hospital Surgery. Journal Named by L.Ya. Kovalchuk, (4), 78–84. https://doi.org/10.11603/2414-4533.2019.4.10715

Issue

No. 4 (2019)

Section

EXPERIENCE OF WORK

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