Published: 2017-01-25

Improvement of surgical treatment of patients with critical ischemia of the lower extremities

Shavkat Karimov, Akmal Irnazarov, Uktamkhon Askarovich Asrarov, Ulugbek Alijanov, Abdurasul Yulbarisov, Saidamir Djafarov, Rustam Muminov


Background: The choice of tactics of surgical treatment in patients with lesions of the femoral-popliteal-tibial segment with the CILE is the actual problem, which is far from being solved. Aim of the study was to found improved treatment of patients with critical ischemia of the lower extremities by improving the surgical approach.

Methods: 79 patients with critical ischemia of the lower extremities with lesions of the carotid and coronary arteries were observed and surveyed. To determine the tactics of treatment of these patients, we used non-invasive methods of imaging vessels, and only with probable therapeutic purposes used the contrasting of the vessels.

Results: The used treatment allowed reducing the number of complications to a minimum. Among observable patients, in one case was determined acute myocardial infarction. 19 (24%) patients with stenosis and CILE managed to achieve regress of clinical manifestations of lower limb ischemia with medical therapy. In 12 (63.1%) patients were completed the installation of long catheter for intra-arterial catheter therapy, after that we performed carotid endarterectomy. Of these, 9 (47.3%) patients at 7 days underwent reconstructive operations on arteries of the lower extremities. In 5 (26.3%) patients after carotid endarterectomy, endovascular interventions implemented at ALE.

Conclusions: The suggested diagnostic low and stages of surgical interventions significantly increase the detection of associated lesions of other arterial basins and expands the indications for surgical treatment with the use of combined interventions.


Critical limb ischemia, Multifocal atherosclerosis, Staged intervention

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