Surgical treatment of chronic limb ischemia in patients with stenotic-occlusive process of infrainguinal arterial segment

Authors

  • I. K. Venger I. Horbachevsky Ternopil National Medical University
  • S. Y. Kostiv I. Horbachevsky Ternopil National Medical University
  • D. V. Kovalskyi I. Horbachevsky Ternopil National Medical University
  • B. P. Selskyy I. Horbachevsky Ternopil National Medical University
  • D. V. Khvalyboha I. Horbachevsky Ternopil National Medical University

DOI:

https://doi.org/10.11603/2414-4533.2021.1.12020

Keywords:

chronic limb ischemia, atherosclerosis, infrainguinal segment, revascularization, thrombosis, graft, anastomosis

Abstract

The aim of the work: to improve the results of surgical treatment of chronic limb ischemia, which threatens the loss of the lower extremity, in the conditions of stenotic-occlusive process of the tibial arteries.

Materials and Methods. Surgical revascularization on the femoral-popliteal-tibial arterial chanel with stenotic-occlusive process of the tibial arteries was performed in 95 patients. Duplex ultrasound scanning and vascular contrast-enhanced computed tomography were used to determine the prevalence rate of occlusive-stenotic process of infrainguinal segment.

Results and Discussion. The main reason for the interruption of the anastomosis functioning in the remote postoperative period was thrombosis, which was diagnosed in 9 (9.68 %) patients. Most often (3 cases) it was detected in the period of 4–5 months of the remote postoperative period. At the end of the second month, one case of thrombosis of the reconstruction segment was observed. In the middle of 9 and 10 months of the postoperative period, two cases of thrombosis were detected. And in the period between 19 and 33 months of the remote postoperative period 3 manifestations of thrombosis of the reconstruction segment were diagnosed.

After analyzing the surgical treatment of chronic limb ischemia, which threatens the loss of the lower extremity, in patients with occlusive-stenotic process of the tibial arteries, it was found that at 36 months of postoperative observation, the cumulative patency of preserved extremities was 92.63 %, bypass patency – 73.57 %. This was achieved due to a differentiated approach to the choice of the location of the distal anastomosis of the autovenous graft (distal, proximal segment of the tibial arteries) and the inclusion in the blood flow of the dorsalis pedis artery and in the vast majority of distal anastomosis type "end to end".

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Published

2021-04-30

How to Cite

Venger, I. K., Kostiv, S. Y., Kovalskyi, D. V., Selskyy, B. P., & Khvalyboha, D. V. (2021). Surgical treatment of chronic limb ischemia in patients with stenotic-occlusive process of infrainguinal arterial segment. Hospital Surgery. Journal Named by L.Ya. Kovalchuk, (1), 44–49. https://doi.org/10.11603/2414-4533.2021.1.12020

Issue

No. 1 (2021)

Section

EXPERIENCE OF WORK

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