EVALUATION OF THE EFFECTIVENESS OF ENDOVASCULAR TREATMENT OF PATIENTS WITH OBLITERATING ATHEROSCLEROSIS OF LOWER LIMB ARTERIES WITH LONG OCCLUSIONS OF THE SUPERFICIAL FEMORAL ARTERY

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Abstract


The article presents 2-year results of endovascular treatment of 68 patients with peripheral arterial disease, chronical limb ischemia stage 2B-4 (by Fontain-Pokrovsky), with the vascular lesions of type D according to TASC II classification, which is characterized by long, over 20 cm occlusion of the superficial femoral artery, popliteal artery involvement and/or arteries of the lower leg. The rationale to perform endovascular recanalization and stenting of extended occluding lesions of the arteries infrainguinal segment in our study were the results of the analysis of the literature data on the treatment of patients with occlusions of the femoro-popliteal segment, namely the development of postoperative complications after femoral-popliteal bypass surgery, such as lymphorrhea, primary thrombosis of the bypass, bleeding, acute renal failure and infection complications; occlusion of femoro-popliteal bypass grafts at 2 years after surgery reaching 60%, the need to perform repeated operations in 45% of patients; prolonged postopera-tive rehabilitation and therefore low quality patients. Analyzing treatment results testified the effectiveness and safety of endovascular method. Technical success of recanalization, angioplasty and stenting of arteries was successfully performed in all patients. Restenosis occurred in 13 patients (15%) at 1 year. After 2 years restenosis was revealed in another 4 patients. Primary patency during the first year of follow-up was 74.7 per cent, for 2 years - 72%. Secondary patency after 2-year follow-up after performing balloon angioplasty in patients with restenosis segment was 100%. Fatal complication of retroperitoneal bleeding developed in 1 patient. The overall incidence of complications was 6%. Most patients were discharged after 3 days. We continue to accumulate clinical observation and study long-term results of endovascular treatment of patients with peripheral arterial disease, with the vascular lesions of type D according to TASC II classification.


R S Goloshchapov-Aksenov

Principal contact for editorial correspondence.
mzmo-endovascular@mail.ru
Central city clinical hospital of Reutov, Moscow Reg., Russia; RUDN University, Moscow, Russia

кандидат медицинских наук, доцент кафедры сердечно-сосудистой хирургии ФГАОУ ВО «Российский университет дружбы народов», заведующий отделением рентгенохирургических методов диагностики и лечения ГАУЗ МО «ЦГКБ г. Реутов»

Z Kh Shugushev

konovalov_oe@rudn.university
RUDN University, Moscow, Russia; Central clinical hospital № 2 named after N.A. Semashko Russian Railways, Moscow

D V Matveev

konovalov_oe@rudn.university
Central city clinical hospital of Reutov, Moscow Reg., Russia

D A Maximkin

konovalov_oe@rudn.university
RUDN University, Moscow, Russia; Central clinical hospital № 2 named after N.A. Semashko Russian Railways, Moscow

K Yu Lakunin

konovalov_oe@rudn.university
Central city clinical hospital of Reutov, Moscow Reg., Russia

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