ULTRASONIC CRITERIA FOR ASSESSING TREATMENT OUTCOMES IN PATIENTS WITH ISCHEMIC FORM OF DIABETIC FOOT SYNDROME WHO UNDERWENT ENDOVASCULAR RESTORATIVE SURGICAL OPERATIONS

Abstract

The article highlights the effectiveness of ultrasound monitoring of outcomes of the endovascular restorative surgical interventions in patients with the ischemic form of diabetic foot syndrome, which resulted from occlusive-stenotic lesions of the popliteal-tibial segments. The purpose of the study was to investigate the findings of ultrasound monitoring following the endovascular treatment with various methods of occlusive-stenotic lesions of the popliteal and tibial arteries in patients with the ischemic form of diabetic foot syndrome and to assess the effectiveness of the treatment. The study included 112 patients, who received the inpatient treatment for the complicated ischemic form of diabetic foot syndrome at the Department of Vascular Surgery, Poltava Regional Clinical Hospital, for 2017-2021. The ultrasound and angiographic examination revealed significant hemodynamical occlusive-stenotic lesions of the popliteal and tibial arteries. These patients were indicated to have restorative endovascular surgical interventions. Depending on the methods of the interventions, patients were divided into two study groups. The first group included 58 (51.8%) patients, who underwent balloon angioplasty of the tibial arteries according to general standard techniques. The second group included 54 (48.2%) patients, who underwent staged dosed balloon angioplasty of the tibial arteries according to the technique we elaborated by ourselves. When analyzing the findings obtained by colour ultrasound scanning of the arteries of the lower extremities before performing endovascular operations and on the 2nd and 7th day of the postoperative period, we have found out that the blood flow has improved significantly that is confirmed by a reliable acceleration of the peak blood flow rate and the humeral index. This is quite pronounced in the patients of the second group, who underwent step-by-step dosed balloon angioplasty of the tibial arteries. The positive changes are supported by the occurrence of fewer thromboses in the operated sections of the arteries in the early postoperative period in the patients of the second group compared to patients in the first group.