Analysis of clinical course and surgical treatment of patients with critical lower limb ischemia
DOI:
https://doi.org/10.11603/2414-4533.2020.2.10773Keywords:
occlusive diseases, critical limb ischemia of lower extremity, amputationAbstract
The aim of the work: to analyze the gender, clinical, anamnestic features of the course of occlusive diseases of the lower extremity arteries in patients who had non-traumatic amputations.
Materials and Methods. There were performed analysis of clinical examination and treatment of 189 patients with obliterating diseases of the lower extremity arteries. The retrospective phase of the study included 115 patients who underwent lower extremity amputations at various levels during 2010–2014. The prospective phase of the study included 74 patients in whom lower limb amputation was performed during 2015–2018.
Results and Discussion. The main causes of chronic lower extremity ischemia that led to the development of necrotic changes were not significantly different: the frequency of obliterating atherosclerosis and diabetes in patients at both stages was the same. Patients of the prospective stage had a shorter history of disease (p <0.05), significantly the number of patients decreased who had an amputation performed after unsuccessful open or endovascular reconstructive surgery on the vessels (p <0.05). Amputation at hip level decreased (p <0.001), knee amputation rate increased (p <0.001). Frequency of saving foot amputations changed insignificantly (p> 0.05). The number of patients requiring re-treatment was significantly reduced (p> 0.05).
Conclusions. The most common cause of non-traumatic limb amputation is type 2 diabetes. Between 2015 and 2018, the number of amputations above the knee decreased. The number of patients requiring re-treatment was significantly reduced (p> 0.05).
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