POST-OPERATIVE COMPLICATIONS OF ENDOVASCULAR REVACULARIZATION OF MULTIPLE-HOSTENOTIC-OCCLUSIVE ATHEROSCLEROTIC PROCESSOF THE INFRAINGUINAL-ARTERIAL COURSE AND THEIR TREATMENT TACTICS

Authors

  • S. Ya. Kostiv I. Horbachevsky Ternopil National Medical University
  • I. K. Venher I. Horbachevsky Ternopil National Medical University
  • M. P. Orlov I. Horbachevsky Ternopil National Medical University
  • B. P. Selskyi I. Horbachevsky Ternopil National Medical University
  • N. I. Tsiupryk I. Horbachevsky Ternopil National Medical University
  • I. V. Faryna I. Horbachevsky Ternopil National Medical University

DOI:

https://doi.org/10.11603/1811-2471.2022.v.i3.13290

Keywords:

endovascular revascularization, atherosclerosis, complication, stenotic-occlusive process

Abstract

SUMMARY. Occlusive-stenotic lesions of the infrainguinal arterial bed in 35.1–64.7 % of observations lead to the development of critical ischemia of the lower extremities. Endovascular angioplasty of the femoral-distal arterial bed and especially of the tibial arteries in chronic critical ischemia remains the only chance to postpone or avoid amputation of the lower limb.

The aim – to study the conditions for surgical treatment of complications of endovascular revascularization of the multilevel stenotic-occlusive process of the infrainguinal arterial bed.

Material and Methods. 171 patients underwent endovascular revascularization of the multilevel stenotic-occlusive atherosclerotic process of the infrainguinal arterial bed. Hybrid revascularization of the multilevel stenotic-occlusive atherosclerotic process of the femoral-distal arterial bed was performed in 94 patients. Endovascular revascularization of the multilevel stenotic-occlusive atherosclerotic process of the femoral-distal arterial bed was performed in 77 patients. According to the WIfI classification, clinical stage 2 was established in 25 patients: (W0I2fI0 (13 patients), W0I2fI1 (12 patients)), in 37 patients clinical stage 3: (W0I3fI1 (16 patients), W0I3fI2 (15 patients), W2I2fI0 (7 patients )), 15 people were diagnosed with the 4th clinical stage: (W1,I2,fI2 (9 patients), W2I2fI2 (6 patients)).

Results. Endovascular revascularization of the multilevel stenotic-occlusive process of the infrainguinal arterial bed in 171 patients was accompanied by the development of postoperative complications in 75 (43.89 %) observations. Of these, 29 (11.69 %) patients developed thrombosis of the popliteal segment, and 2 (1.16 %) patients developed thrombosis of the femoral-popliteal segment, 3 (1.75 %) patients had preservation and progression after surgery ischemia of the lower extremity, in 41 (23.98 %) observations, a gradual cessation of blood flow in the popliteal-shin arterial segment was diagnosed. 64 (85.33 %) patients with complicated forms of endovascular revascularization of the multilevel stenotic-occlusive process of the infrainguinal arterial channel underwent operative treatment. During the repeated surgical treatment of complicated forms of endovascular revascularization of stenotic-occlusive lesions of the femoral-distal arterial bed, 45 (70.31 %) received satisfactory results of their surgical treatment.

Conclusions. 1. Complicated forms of endovascular revascularization of the multilevel stenotic-occlusive process of the infrainguinal arterial bed develop 2.2 times more often in patients who underwent endovascular angioplasty of only one of the tibial arteries, in contrast to observations in which endovascular angioplasty of two tibial arteries was performed.

  1. Satisfactory results of their surgical treatment were obtained in 70.31 % of complicated forms of endovascular revascularization of stenotic-occlusive lesions of the femoral-distal arterial bed.

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Published

2022-11-14

How to Cite

Kostiv, S. Y., Venher, I. K., Orlov, M. P., Selskyi, B. P., Tsiupryk, N. I., & Faryna, I. V. (2022). POST-OPERATIVE COMPLICATIONS OF ENDOVASCULAR REVACULARIZATION OF MULTIPLE-HOSTENOTIC-OCCLUSIVE ATHEROSCLEROTIC PROCESSOF THE INFRAINGUINAL-ARTERIAL COURSE AND THEIR TREATMENT TACTICS. Achievements of Clinical and Experimental Medicine, (3), 67–72. https://doi.org/10.11603/1811-2471.2022.v.i3.13290

Issue

No. 3 (2022)

Section

Оригінальні дослідження

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