Hybrid surgical interventions in occlusive stenotic lesions of distal arteries in patients with diabetes mellitus

S.M. Didenko

Abstract


Background. The purpose of the study is to evaluate the effectiveness of hybrid surgical interventions in patients with combined lesion of the arteries of the lower leg with damage to the iliac and/or femoropopliteal segment. Materials and methods. The research was conducted at the center of vascular surgery of Clinical Hospital “Feofaniya” of the Agency of State Affairs during 2013–2014. Fifty four diabetic patients with occlusion of the femoropopliteal arterial segment and ischemia of the lower limb (Fontaine’s degree IV) received medical treatment. All of them underwent segmental pressure and ankle brachial index measurements, duplex scan of the lower extremity arteries with a study of the blood flow pattern on the Flex focus device manufactured by BK medical. Angiography was performed in 42 patients using the EuroАmpli Alien angiographic system manufactured by Eurocolumbus S.r.l. Results. The article presents the experience of 8 hybrid surgical interventions in the occlusive stenotic lesions of distal arteries in patients with diabetes mellitus. According to the results of preoperative studies, almost 72 % of diabetic patients had a combination of occlusive and stenotic lesions of the tibial arteries with damage to the iliac and/or femoropopliteal segment. The patency of the femoral reconstruction zone with inadequate capacity of the femoropopliteal arterial bed using the methods of hybrid surgery during the observation period was 87.5 %, compared with the isolated reconstruction of the femoral arterial segment under the same conditions — 42.9 %. The patency of the femoral reconstruction zone with adequate capacity of the femoropopliteal arterial bed during the observation period was 90 %. Conclusions. Thus, hybrid surgical interventions in this group of patients allow increasing the capacity of the femoropopliteal arterial bed and, thus, improving the results of surgical treatment.


Keywords


hybrid surgery; occlusion of femoropopliteal arteries; occlusion of tibial arteries; diabetes mellitus

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DOI: https://doi.org/10.22141/2224-0586.3.90.2018.129492

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