Journal «Angiology and Vascular Surgery» • 

2008 • VOLUME 14 • №3

SURGICAL MANAGEMENT OF PATIENTS WITH LOWER LIMB CRITICAL ISCHAEMIA INDUCED BY LESIONS OF INFRAINGUINAL ARTERIES

Gavrilenko A.V., Skrylev S.I.
Department of Vascular Surgery Russian Scientific Centre of Surgery named after Academician B.V. Petrovsky RAMS,
Moscow, Russia

The authors analyse their experience in surgical management of 325 patients diagnosed with lower limb critical ischaemia (LLCI) secondary to lesions of infrainguinal arteries. Of these, 216 (66.5%) patients (Group 1) were subjected to isolated bypass grafting operations defined as either "reconstructive", or "direct revascularisations". A further 35 (10.8%) patients (Group 2) underwent concomitant revascularizations accompanied simultaneously or in a stagewise manner (but within the time frame of one hospitalization) by reconstructive and palliative operations (e.g., femoropopliteal bypass grafting and lumbar sympathectomy), and 74 (22.7%) patients (Group 3) were subjected to only palliative operations alone (lumbar sympathectomy and revascularizing osteotrephination), i.e., "indirect revascularizations". The remote outcomes of surgical management were followed up within the terms of up to 5 years in 306 (94.2%) of the 325 patients operated on for LLCI. Of these: in 205 (94.9%) of the 216 Group 1 patients, in 33 (94.3%) of the 35 Group 2 patients, and in 68 of the 74 (91.9%) Group 3 patients. Amongst the Group 1 patients (n=205) over the 5-year follow-up period we had performed a total of 70 (34.1%) amputations of the postoperative extremity and encountered 121 (59.0%) cases of thromboses of the bypass grafts. Of the Group 2 patients (n=33), over the 5 year follow-up, the postoperative extremities were amputated in 7 (21.2%) patients. Thromboses of the bypass grafts over the same time period were noted to have developed in 11 (33.3%) patients. Amongst Group 3 patients (n=68) the postoperative extremities were saved in 37, with the limb salvage rate thus amounting to 54.4%.

KEY WORDS: lower limb critical ischaemia, remote results, direct revascularisation, concomitant combined revascularizations, indirect revascularizations.

P. 111-117

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