Intraoperative hemodynamic monitoring of peripheral circulation in surgical decision making in lower extremity arterial disease

Abstract

Objective: to evaluate the results of correction of lower extremity arterial disease using invasive intraoperative hemodynamic monitoring of peripheral circulation and to assess the influence of this method on selection of surgical tactics.Material and methods. The outcomes of revascularization were compared in patients of two comparable groups: the patients of the first group had undergone interventions under intraoperative hemodynamic monitoring of peripheral circulation in addition to angiography, and for the patients of the second group a decision about the extent of correction had been made on the basis of angiography without intrapeorational functional evaluation.Results. The application of the above method made it possible to decrease the length of the performed reconstructions: 90 mm (80; 125) in the first group vs. 70 mm (112.5; 247.5) (p = 0.018) in the second group with a comparable satisfactory outcome. The postoperative ABI values after the interventions in the first and second groups amounted to 0.86 (0.78; 1) and 0.8 (0.7; 0.86), respectively, which was associated with a favorable clinical prognosis in these patients.Conclusion. The use of invasive intraoperative hemodynamic monitoring makes it possible to decrease the extent of reconstructions in multisegment lesions with the achievement of a satisfactory clinical outcome.