REVASCULARIZATION OF THE INFRAINGUINAL ARTERIAL BED IN CONDITIONS OF STENOTIC-OCCLUSIVE LESION USING ENDOVASCULAR AND HYBRID METHODS
DOI:
https://doi.org/10.11603/2414-4533.2024.4.15068Keywords:
atherosclerosis, endovascular revascularization, hybrid revascularization, diabetesAbstract
The aim of the work: to study and evaluate the results of endovascular and hybrid methods of revascularization in patients with peripheral artery disease with concomitant diabetes.
Materials and Methods. An analysis of the examination and surgical treatment of 241 patients with stenotic-occlusive atherosclerotic lesions of the infrainguinal segment was carried out. Patients were divided into 2 groups. The first group included 144 patients (59.7 %) with atherosclerotic stenotic-occlusive process of the infrainguinal segment, the second group – 97 (40.2 %) patients with atherosclerosis of the infrainguinal segment with concomitant type 2 diabetes. According to the types of surgical interventions performed, the patients of each group were divided into two subgroups – endovascular (A) and hybrid (B). Among the patients of the I group, 98 (40.6 %) patients were included in the IA subgroup, and 46 (19.0 %) patients were in the IB subgroup. Among patients of the II group, the IIA subgroup included 63 (26.1 %) patients, and 34 (14.1 %) patients of the IIB. For a reliable assessment of the results of operations, only patients with open methods of reconstruction were excluded from the study.
Results. Both in the preoperative stage and in all periods after the surgical intervention, a tendency to a lower ankle-brachial index (ABI) value relative to the norm was observed in both subgroups, but relative to baseline indicators, after revascularization, the index increased in both subgroups. In patients with a duration of diabetes of more than 10 years at the preoperative stage, the ABI values exceeded the norm, in contrast, the indicators of the ABI in patients with concomitant diabetes, the duration of which was less than 10 years, were below the norm. However, in this group of patients, at all stages of the postoperative period, regardless of the choice of operative treatment method, the ABI index increased. When comparing TcpO2 levels of groups I and II, it was found that oxygen tension levels were lower in patients with diabetes, compared to people without concomitant diabetes, both at baseline and after surgery.
Conclusions. The use of modern methods of revascularization in patients with stenotic-occlusive lesions of the infrainguinal arterial bed allows to significantly improve the blood supply of the ischemic segments of the lower limb, especially with concomitant diabetes.
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