POSTOPERATIVE THROMBOSIS OF THE RECONSTRUCTION SEGMENT AFTER ENDOVASCULAR ANGIOPLASTY OF A MULTILEVEL STENOTIC-OCCLUSIVE LESION OF THE INFRAINGUINAL ARTERIAL BED
DOI:
https://doi.org/10.11603/2414-4533.2024.1.14640Keywords:
thrombosis, endovascular angioplasty, occlusion, revascularization, thrombectomy, hybrid revascularization, rheological thrombus extractionAbstract
The aim of the work: to improve the results of endovascular methods of revascularization of the multilevel stenotic-occlusive atherosclerotic process of the femoral-distal arterial bed by surgical treatment of postoperative thrombosis of the revascularization segment.
Materials and Methods. 164 patients underwent endovascular methods of revascularization of multilevel stenotic-occlusive atherosclerotic lesions of the femoral-distal arterial bed.73 patients, of which 28 (WIFI classification) were diagnosed with stage2, in 41 – stage 3 and 4 – stage 4, underwent two-level endovascular angioplasty of the infrainguinal arterial channel. 91 patients, of which 33 (WIFI classification) have stage 2, in 39 – stage, in 19 – stage 4. Hybrid revascularization of the femoral-distal arterial channel was performed.
Results and Discussion. Endovascular methods of revascularization of the femoral-distal arterial bed are accompanied by the development of postoperative complications, among which thrombosis of the reconstruction segment is diagnosed in 8–26 % of observations. In the study, after edovascular methods of revascularization of the multilevel stenotic-occlusive femoral-distal arterial bed, 34 (20.8 %) cases of thrombosis of the revascularization segment were diagnosed, of which: thrombosis of the popliteal-tibial segment was diagnosed in 31 (91.2 %) observations, thrombosis of the femoral popliteal segment – in 3 (8.8 %) cases. Thrombectomy from the popliteal-tibial segment in 12 (38.7 %) observations was performed by the endovascular stent thrombectomy method, including 4 patients who underwent two-level endovascular angioplasty, and 8 patients who underwent hybrid revascularization of the infrainguinal arterial bed. Thrombectomy from the popliteal segment with thrombosis of the popliteal segment in 19 (61.3 %) observations was performed by the method of minimally invasive rheological thrombus extraction with the Angiojet device. Rheological thrombus extraction was used in 10 (52.6%) patients after two-level endovascular angioplasty and in 9 (47.4 %) patients after revascularization by the hybrid method.
The results of endovascular stent thrombectomy and minimally invasive rheological thrombectomy resulted in 77.4 % good, 3.2 % satisfactory, and 19.4 % poor surgical intervention results.
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