Features of treatment of patients with occlusive-stenotic diseases of the Arteries of the infrarenal aorta by the open method
DOI:
https://doi.org/10.11603/2414-4533.2021.3.12540Keywords:
atherosclerosis of the arteries of the lower extremities, chronic critical ischemia of the lower extremities, revascularization, shuntingAbstract
The aim of the work: to analyze the effectiveness of surgical treatment of occlusive-stenotic lesions of the arteries of the infrarenal aorta in patients with atherosclerosis by a differentiated approach to the use of open technologies of surgical interventions.
Materials and Methods. the results of treatment of patients with occlusive-stenotic diseases of the arteries of the lower extremities as a consequence of obliterating atherosclerosis were analyzed. Among 420 patients who underwent various methods, 98 (23.33 %) underwent open surgery. 14 (14.29 %) patients had previously undergone surgery. In 12 cases, multistage lesions were noted.
Results and Discussion. The largest number of surgical interventions in patients was performed in the femoral-popliteal (48.98 %) and popliteal-tibial (19.4 %) segments using shunts and prostheses. If in 1 and 2 segments as a shunt material almost 100 % used different synthetic prostheses then in 3,4,5 segments except endarterectomy (in 5 patients), different synthetic prostheses were used in 15 (22.73 %), autovenous shunting in 46 (69.7 %), their combination in 12 (18.2 %) patients. In 10 (10.2 %) patients in the early postoperative period, repeated surgical interventions were performed (in the comparison group in 7 – 12.7 % and in 3 – 6.5 % in the main group), due to rethrombosis of the revascularized segment. in 5 (9.09 %) patients in the comparison group, and in the main group in 1 (2.32 %) patient limb amputations were performed.
The use of the proposed diagnostic and treatment algorithm, the scale of prognosis of possible postoperative complications, treatment technology for patients, developed reconstructive surgery on arteries with occlusive-stenotic lesions of the arteries of the infrarenal aorta, reduced the number of postoperative complications, terms of stay in the hospital.
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