Surgery on extracranial arteries in patients with atherosclerotic occlusion of the aorto-iliac-femoral arterial bed in conditions of chronic ischemia
DOI:
https://doi.org/10.11603/2414-4533.2023.4.14343Keywords:
extracranial arteries, atherosclerosis, occlusionAbstract
The aim of the work: to identify the causes of the development of ischemic disorders of the brain after surgical correction of blood flow along the ICA in patients with atherosclerotic stenosis/occlusion of the ICA with atherosclerotic occlusion aorto-iliac-femoral basin in conditions of chronic ischemia of the lower extremities.
Materials and Methods. 119 patients with atherosclerotic occlusion of the aorto-iliac-femoral basin with CAI IIb-IV stages (according to the Rutherfordclassification). Patients are divided into two groups: group I – 72 patients from the CAI IIb–IV stages with high in 58 observations and very high in 14 cases by the degree of risk of developing postoperative complications, group II – 47 patients with CAI of the III–IV stages with high in 7 observations and very high in 40 observation of the degree of risk of developing postoperative complications. group II includes patients with atherosclerotic occlusion of the aorto-iliac femoral segment and a high risk of development reperfusion-reoxygenation syndrome in the early postoperative period. In the period of preparation for revascularization of atherosclerotic occlusion of the aorto-iliac-femoral zone, a study of the state of the circle of Willis was carried out. Among 93 patients with atherosclerotic lesions of extracranial arteries 62 (64.41 %) people had a closed circle of Willis, and 31 (33.33 %) observations – an open Willis circle. Among patients, group I is open Circle of Willis was found in 15 observations (48.39 %), and among patients in
group II – in 16 (51.61 %) observations.
Results and Discussion. 32 patients underwent surgical correction of blood flow in the ICA, of which 18 patients were in the group I and 14 in group II. II stage of violation of cerebral blood flow was diagnosed in 18 observations – transient ischemic attack, in 7 patients – III stage of violation of cerebral blood flow, and in 3 people – V stage violation of cerebral blood flow. 32 surgical interventions on the ICA were performed: in 32 observations – carotid endarterectomy, in 6 and 4 cases, respectively, reversion and eversion restoration of blood flow along the ICA. In 3 observations endovascular stenting of the stenotic/occluded ICA was performed.
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