Journal «Angiology and Vascular Surgery» • 

2015 • VOLUME 21 • №2

Choosing the method of reconstruction for lower-limb critical ischemia

Kazakov Yu.I.1,2, Lukin I.B.1,2, Kazakov A.Yu.1,2, Efimov S.Yu.2, Velikov P.G.2

Tver State Medical Academy of the Ministry of Public Health of the Russian Federation Regional Clinical Hospital, Tver, Russia

Presented herein are long-term outcomes of surgical treatment of 74 patients with atherosclerotic occlusive-stenotic lesions of the femoral-popliteal-tibial segment and critical ischaemia. 51 (68.92%) patients underwent femoropopliteal shunting into the isolated segment of the reversed great saphenous vein. Of these, three patients were subjected to a hybrid operation consisting of femoropopliteal bypass grafting and balloon angioplasty of the popliteal and one tibial artery. 23 (31.08%) patients endured percutaneous balloon angioplasty with stenting of the superficial femoral artery and balloon angioplasty of one tibial artery. Two-year patency of the zone of reconstruction of the femoropopliteal segment in these groups was identical, amounting to 64.71 and 56.52%, respectively. However, the group of patients with endovascular intervention demonstrated rather a high rate of intraoperative complications – 21.74%, technical success in balloon angioplasty of arteries of the crus amounted to 65.22%. Once the method of operative treatment is chosen, preference is given to shunting in the isolated popliteal artery with sufficient collateral blood flow. Further studies are required to determine angiographic indications for endovascular intervention on tibial arteries.

KEY WORDS: critical ischaemia, femoropopliteal bypass grafting, balloon angioplasty, surgical decision making.

P. 158

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