Choice of method of revascularization of lower extremities for occlusive lesions of femoropopliteal arteries
AbstractObjective. The purpose of our study was to assess the results of using a modified technique of blood flow restoration in patients with lesions of the femoropopliteal arterial segment in the absence of an autovein suitable for a reconstructive operation and the impossibility of endovascular recanalization.
Patients and methods. The study included a total of 91 patients with lesions of femoropopliteal segment. The patients were divided into three groups: Group 1 comprised patients who underwent a modified procedure in the form of semiclosed loop endarterectomy from the superficial femoral artery in a combination with popliteal-distal autovenous bypass grafting (n=21), Group 2 consisted of patients subjected to femoral-distal autovenous bypass grafting (n=33) and Group 3 was composed of patients who endured roentgenosurgical operations (balloon angioplasty with stenting of the superficial femoral and popliteal arteries) (n=37).
Results. In the early postoperative period, thrombosis of the femoropopliteal segment developed in 1 (4.7%) patient of Group 1, shunt thrombosis in 2 (6.1%) patients of Group 2, and in Group 3 thrombosis occurred in 1 (3.7%) patient. The primary patency of the arterial channel at 12 months amounted to 80.9, 81.8 and 83.7% in Groups 1, 2 and 3, respectively. The limb salvage rates at 1 year were 90.4, 87.87 and 89.1% in Groups 1, 2 and 3, respectively.
Conclusion. The obtained results demonstrated efficacy of the developed technique of operative treatment of patients with femoropopliteal lesions in the absence of an autovenous graft and the impossibility of endovascular correction.
Keywords:obliterating atherosclerosis of arteries of lower extremities; femoral-popliteal bypass grafting; autovenous bypass; loop endarterectomy; balloon angioplasty; critical ischemia of lower extremities
Funding. The study had no financial support.
Conflict of interest. The authors declare no conflicts of interest.
Authors’ contribution. Study conception and design – Kitachev K.V., Yakovlev N.N., Zelenin V.V.; data collection and handling – Fomin V.S., Kudryavtsev O.I., Suvorov S.A., Al-Hasanat M.M., Hong Kimheang; draft manuscript preparation – Fomin V.S., Gulmetov P.E., Dzhumaeva A.A.; manuscript revision – Hubulava G.G., Sazonov A.B.
For citation: Fomin V.S., Sazonov A.B., Kitachev K.V., Yakovlev N.N., Zelenin V.V., Kudryavtsev O.I., Gulmetov P.E., Suvorov S.A., Dzhumaeva A.A., Al-Hasanat M.M., Hong Kimheang, Hubulava G.G. Choice of method of revascularization of lower extremities for occlusive lesions of femoropopliteal arteries. Angiology and Vascular Surgery. 2023; 29 (1): 109–14. DOI: https://doi.org/10.33029/1027-6661-2023-29-1-109-114 (in Russian)
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