Endovascular technologies: reconstruction of deep femoral artery and revascularization of stenotic-occlusive process of infrainguinal arterial bed
SUMMARY
Background: The main stage in the complex treatment of stenotic-occlusive lesions infrainguinal arterial bed is a conduction of reconstructive intervention. But nowadays there is no generally accepted tactics for the treatment of patients with atherosclerotic stenotic-occlusive process of infrainguinal arterial.
Aim: To improve results of the revascularization of infrainguinal arterial bed by using reconstructive interventions on the deep femoral artery and endovascular methods of recanalization of outflow arteries.
Materials and methods: Study is based on the results of investigation and operative treatment of 206 patients with stenotic-occlusive process infrainguinal arterial bed. Character of atherosclerotic lesion, degree of stenotic-occlusive process and condition of hemodynamics of the arterial bed of lower limbs were assessed by the Doppler scanning and computed tomography in vascular mode.
Results: In conducted study shunting reconstructive interventions on the infrainguinal bed had a leading position, they were performed in 76.1 % of patients, who were included in the study. The part of hybrid revascularization interventions consisted 15.4 % from all observations. Endovascular methods of revascularization prevailed in 11.2 % of cases. From 59 patients with multilevel stenotic-occlusive process of infrainguinal arterial bed 44 (75.8 %) had stenosis of the DFA orifice (I portion), and 15 (24.2 %) had stenosis at the II portion of DFA at duplex scan. In given circumstances femoral-distal shunting was accompanied by the simultaneous profundoplasty of DFA, and in 15 cases endovascular intervention at the level of SFA (6 cases) and tibial arteries (9 cases) was combined with the subintimal balloon angioplasty of the II DFA portion. Early postoperative period was complicated in 5 (2.26 %) cases by the thrombosis of reconstructed segment. In our investigation cumulative patency of femoral/popliteal-tibial segment in 1 and 3 years after the operation was 73.8 % and 54.8 % correspondingly. The use of combination of shunting interventions with profundoplasty or subintimal angioplasty of DFA promotes an increase if cumulative patency score or revascularized segment, reaching 91.1 % and 79.7 % in 1 and 3 years after the operation correspondingly.
Conclusions: Use of endovascular methods of revascularization and reconstructive interventions on DFA combined with the femoral-distal shunting operations promotes good and satisfactory results of the surgical treatment of stenotic-occlusive processes infrainguinal arterial bed.
Key words: balloon angioplasty, obliterative atherosclerosis, reconstructive intervention, stenotic-occlusive process.
Lek Obz, 2022, 71 (2): 55-59
Ihor VENGER 1, Sviatoslav KOSTIV 1, Dmytro KOVALSKIY 1, Boryslav SELSKIY 1, Olga KOSTIV 1, Olga ZARUDNA 1, Oleksandr DOBROVANOV 2,3, Dmytro DMYTRIIEV 4, Kostiantyn DMYTRIIEV 4
1 I. Horbachevskyi Ternopil National Medical University, head prof. M.M. Korda, MD, PhD, Ternopil, Ukraine
2 A. Getlik Clinic for Children and Adolescents, Slovak Medical University and University Hospital of Medicine, head assoc. prof. MUDr. K. Furkova, CSc., Bratislava, Slovakia
3 Slovak Medical University, head prof. MUDr. P. Šimko, CSc., Bratislava, Slovakia
4 Vinnytsia National Pirogov Memorial Medical University, head academician prof. V.M. Moroz, PhD., Sc.D., Vinnytsya, Ukraine
Citácia:
VENGER I., KOSTIV S., KOVALSKIY D. a kol.: Endovaskulárne technológie: rekonštrukcia hĺbkovej femorálnej tepny a revaskularizácia stenoticko-oklúzneho infraingvinálneho procesu. Lek Obz, 2022, 71 (2): 55-59
CITE:
VENGER I., KOSTIV S., KOVALSKIY D. a kol.: Endovascular technologies: reconstruction of deep femoral artery and revascularization of stenotic-occlusive process of infrainguinal arterial bed. Lek Obz, 2022, 71 (2): 55-59
