RESULTS OF SURGICAL TREATMENT OF PATIENTS WITH CHRONIC ISCHEMIA OF THE LOWER EXTREMITIES. SHORT-TERM DATA

Abstract

Summary. The aim of the study. To analyze the results of surgical treatment of patients with chronic ischemia of the lower extremities after using modern types of surgical approaches and technologies in the short term. Materials and methods. The results of surgical treatment of 420 patients were studied. Since 2019, 198 patients (the main group) have been treated using the updated ESVS international guidelines. Both groups of patients (the main group and the comparison group) were comparable in terms of sex, age, location of the lesion, and type of surgical intervention. A total of 98 (23.3 %) patients were operated on by the open method, 243 (57.9 %) by the endovascular method, and 79 (18.8 %) by the hybrid method. We studied such indicators as: postoperative thrombosis, limb amputations, mortality, as well as repeated operations performed due to complications or unsatisfactory results of the primary operation. Results and their discussion. The most recent results of surgical interventions revealed that the largest number of complications was found in the group of patients with multilevel occlusive-stenotic lesions of arteries, which correlates with the data of international studies. The direct effectiveness of endovascular interventions is higher than that of open revascularization and hybrid operations, and the trauma of miniinvasive endovascular techniques is significantly less compared to the methods of open reconstructive surgery. When analyzing the short-term results of surgical interventions, it was found that the largest number of complications was found in the group of patients with multilevel occlusive-stenotic lesions of arteries. The short-term effectiveness of endovascular interventions is higher than that of open revascularizations and hybrid operations, but has a clear tendency to decrease, unlike open operations, the results of which have a clear tendency to improve. Conclusions. The selected technologies and the selected tactics of surgical intervention allow to increase the efficiency of treatment of patients in the immediate postoperative period and reduce the number of postoperative complications in the main group from 10.5 % to 4.9 %, repeated operations from 9.72 % to 3.06 %, amputations from 5.4 % to 1.84 % and mortality from 3.89 % to 1.84 %. In the postoperative period, in the short term, the number of postoperative complications decreased from 11.59 % to 3.84 %, reoperations from 11.11 % to 3.04 %, amputations from 4.83 % to 2.3 %, and mortality from 3, 38 % to 1.53 %.