Determination of indications for and long-term results of femoral-popliteal (distal) alloshunting using polytetrafluoroethylene implants in patients with obliterating atherosclerosis on the background of critical ischemia
Journal Title: Серце і судини - Year 2019, Vol 0, Issue 2
Abstract
The aim — improvement of the results of reconstructive operations in patients with obliterating atherosclerosis of the vessels of lower extremities with multiple occlusal‑stenotic lesions on the background of critical ischemia. Materials and methods. The distant results were analyzed of femoropopliteal (distal) alloshunting with the use of polytetrafluoroethylene (PTFE) implants in 121 patients with two‑level occlusive‑stenotic lesions of the lower extremities. The group of patients with «satisfactory» state of distal blood flow, according to Rutherford, was divided into 2 subgroups, depending on the level of distal retrograde blood flow (according to the indications of intraoperative debitometry). Results and discussion. A comparative retrospective analysis of the results of the reconstructions showed a direct dependence of early and distant results of operations on the level of lesion of shank and foot distal blood flow. A differentiated approach in patients with «satisfactory» distal blood flow, according to Rutherford, allowed optimizing the surgical tactics and determining the indications for surgical intervention due to the use of intraoperative debitometry. Conclusions. Determination of quantitative indices of retrograde blood circulation with intraoperative debitometry allows objectivizing the status of the distal bed of the lower extremities, improving the results of the femoro‑popliteal (distal) alloshunting in the remote observation period (up to 4 years). When diagnosing the retrograde blood flow to the popliteal artery less than 60 ml/min, the patient has a high risk of thrombosis of the femoro‑popliteal (distal) alloshunt in the first year of observation. The use of the «Gincor Forte» drug can effectively reduce the manifestations of secondary lympho‑venous insufficiency on the background of reperfusion syndrome in 85 % of patients after the femoro‑popliteal (distal) alloshunt.
Authors and Affiliations
A. M. Bytsai
Keywords
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- EP ID EP608126
- DOI 10.30978/HV2019-2-33
- Views 125
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