Journal «Angiology and Vascular Surgery» • 

2015 • VOLUME 21 • №4

Treatment of patients with acute lower limb ischaemia: selective thrombolysis or open surgical interventions?

Gadeev A.K.1, Bredikhin R.A.2,3

1) Municipal Clinical Hospital No 7,
2) Interregional Clinical and Diagnostic Centre,
3) Kazan State Medical University, Kazan, Russia

The study was aimed at bettering therapeutic outcomes in patients with acute arterial lower-limb insufficiency by means of improving the method of selective thrombolysis (STL).

We analyzed both immediate and remote results of treating a total of 118 patients presenting with acute lower limb ischaemia of not more than grade 2B (according to I.I. Zatevakhin, 2002) within the terms up to 2 months from the onset of the disease. The Study Group patients (n=67) were subjected to STL and the Control Group patients (n=51) underwent standard open surgical interventions.

The remote results of treatment were assessed within the terms up to 1 year in 38 patients of the Study Group and in 31 patients of the Control Group. The main criteria for efficacy of treatment were the incidence rate of amputation and mortality. In the immediate postoperative period in the Control Group, the frequency of amputations of lower limbs was more than 5-fold higher as compared with the Study Group (p<0.005); no significant differences on lethal outcomes were revealed (p>0.05). In the remote period of follow up, the incidence of amputations in the Study and Control Groups did not statistically differ (p>0.05), whereas mortality in Control Group was 4.3-fold higher as compared with the Study Group (p<0.05).

KEY WORDS: acute lower limb ischaemia, selective thrombolysis, urokinase.

P. 42

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