Results of Surgical Treatment of Elderly and Senile Patients With Acute Ischemia of the Lower Extremities of Embologenic Origin

Abstract

BACKGROUND Today, one of the urgent problems of emergency vascular surgery is the high mortality rate in acute ischemia of the lower extremities in elderly and senile patients.AIM OF STUDY To evaluate the incidence of complications in elderly and senile patients with acute ischemia of the lower extremities of embologenic origin.MATERIAL AND METHODS As an object of study, three groups of elderly and senile patients admitted with a clinical picture of acute ischemia of the lower extremities were studied. Group I — patients who underwent reconstructive interventions in the scope of the so-called proximal reconstruction; group II — patients who, for the purpose of complete revascularization, underwent extended reconstructive interventions using an additional surgical approach; group III — patients who underwent a “classic” embolectomy.RESULTS Good results were statistically significantly more common in group II. Satisfactory and poor results were observed in group III. Amputations were statistically significantly more common in group III. In 69.6% of cases, the use of plasmapheresis and infusion therapy prevented the development of acute renal injury.CONCLUSION Performing extended arterial reconstructions, including using an additional surgical approach, makes it possible to more fully restore the main blood flow in the ischemic limb and thereby completely restore the main blood flow in the ischemic limb and reduce the degree of ischemia, as well as reduce the severity of the manifestation and course of the post-ischemic syndrome.