电邮这篇文章 THE HYBRID SURGICAL INTERVENTIONS IN PATIENTS WITH CRITICAL ISCHEMIA OF LOWER EXTREMITIES
- 作者: Temrezov M.B1, Kovalenko V.I.2, Bulgarov R.S1, Bakhmetev A.S2, Temrezov T.K.1, Botashev R.N1
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隶属关系:
- The regional vascular center of the Karachaevo-Cherkesskaya respublika
- The Russian medical academy of continuous professional education of Minzdrav of Russia
- 期: 卷 23, 编号 5 (2017)
- 页面: 233-236
- 栏目: Articles
- URL: https://journal-vniispk.ru/0869-2106/article/view/38389
- DOI: https://doi.org/10.18821/0869-2106-2017-23-5-233-236
- ID: 38389
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详细
The purpose of study is to evaluate efficiency of hybrid surgical interventions under critical anemia of lower extremities in patients with multi-level atherosclerosis affection of arterial bed.The material and methods. The results of surgical treatment using hybrid technology are analyzed. The sampling consisted of 38 patients (33 males and 5 females) suffering from critical anemia of lower extremities because of multi-level atherosclerosis affection of main arteries. The average age was 69,6±2,5 years. The 21 patients (group 1) underwent balloon angioplasty with stenting of iliac arteries through direct access in femoral artery using balloon enlarging stents Asssurant and at the same time instant femoral popliteal stenting. The 17 patients (group 2) underwent stenting of iliac arteries combined with endarterectomy from common and deep arteries of thigh with profundoplastics.The results. The immediate and distant results of treatment in both groups had no differences. After endovascular interventions at iliac segment a primary technical success was achieved in 92.1% of cases and a clinical success - at 81.1% of cases. In the zone of open vascular interventions in femoral popliteal segment primary and secondary patency made up to 89.5% and 97.4% correspondingly. The rate of keeping of extremity in general made up to 92.1% and lethality - 7.9%. The distant results up to three years were monitored in 35 patients. The primary patency in the zone of endovascular intervention after 1, 2 and 3 years made up to 89,8, 76,2 and 68,5% correspondingly. In 5 patients (13.2%) repeated operations were implemented. The level of keeping of extremity after 1,2 and 3 years made up to 77.4%, 74.1% и 72.5%. The survival after 1,2 and 3 years made up to 94,3%, 88,6% and 85,7% correspondingly.The conclusion. The hybrid interventions (stenting of iliac arteries combined with surgical adjustment of femoral popliteal segment) under critical ischemia of lower extremities in the first place are effective and expedient for patients in severe condition and high surgical risk.
作者简介
M. Temrezov
The regional vascular center of the Karachaevo-Cherkesskaya respublika369014, Cherkessk, Russian Federation
Vladimir Kovalenko
The Russian medical academy of continuous professional education of Minzdrav of Russia
Email: vik-bakulev@yandex.ru
doctor of medical sciences, professor of the chair of cardiovascular surgery the Russian medical academy of continuous professional education of Minzdrav of Russia, 121522, Moscow, Russian Federation 121522, Moscow, Russian Federation
R. Bulgarov
The regional vascular center of the Karachaevo-Cherkesskaya respublika369014, Cherkessk, Russian Federation
A. Bakhmetev
The Russian medical academy of continuous professional education of Minzdrav of Russia121522, Moscow, Russian Federation
T. Temrezov
The regional vascular center of the Karachaevo-Cherkesskaya respublika369014, Cherkessk, Russian Federation
R. Botashev
The regional vascular center of the Karachaevo-Cherkesskaya respublika369014, Cherkessk, Russian Federation
参考
- Levy P.J. Epidemiology and pathology of peripheral arterial disease. Clin. Cornerstone. 2002; 4(5): 1-15
- Затевахин И.И., Цициашвили М.Ш., Шиповский В.Н. Новые перспективы сосудистой хирургии - сочетанные эндоваскулярные и открытые операции в реконструкции артериального русла. Анналы хирургии. 1999; (6): 77-84
- Hans S.S., De Santis D., Siddiqui R., Khoury M. Results of endovascular therapy and aortobifemoral grafting for TransAtlantic Inter-Socety type C and D aortoiliac occlusive disease. Surgery. 2008; 144(4): 583-9
- Троицкий А.В., Хабазов Р.И., Паршин П.Ю., Беляков Г.А., Лысенко Е.Р., Скруберт В.С. и др. Сочетанные операции при этажных поражениях аорто-подвздошного и бедренно-подколенного сегментов. В кн.: Коков Л.С., Капранов С.А., Долгушин Б.И., Троицкий А.В., Протопопов А.В., Мартов А.Г., ред. Сосудистое и внутриорганное стентирование. Руководство. М.: Грааль; 2003: 191-210
- Ozkan U., Oguzkurt L., Tercan F. Technique, Complication and Long-term Outcome for Endovascular Treatment of Iliac Artery Occlusion. Cardiovasc Intervent. Radiol. 2010; 33(1): 18-24.
- Indes J.E., Tuggle C.T., Mandawat A., Sosa J.A. Age stratified outcomes in elderly patients undergoing open and endovascular procedures for aortoiliac occlusive disease Surgery. 2010; 148(2): 420-8.
- Паршин П.Ю. Одномоментные рентгенэндоваскулярные и реконструктивные операции при этажных поражениях артерий аорто-подвздошного и бедренно-подколенного сегментов: Автореф. дисс. … канд. мед. наук. М.; 2004
- Chang R.W., Goodney P.P., Baek J.H., Nolan B.W., Rzucidlo E.M., Powell R.J. Long-term results of combined common femoral endarterectomy and iliac stenting/stent grafting for occlusive disease. J. Vasc. Surg. 2008; 48(2): 362-7.
- Norgren L., Hiatt W.R., Dormandy J.A., Nehler M.R., Harris K.A., Fowkes F.G. Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). Eur. J. Vasc. Endovasc. Surg. 2007; 33(1): 1-75.
- Rutherford R.B., Baker J.D., Ernst C., Johnston K.W., Porter J.M., Ahn S. et al. Recommended standards for reports dealing with lower extremity ischemia: Revised version. J. Vasc. Surg. 1997; 26(3): 517-38.
- Taylor S.M., Kalbaugh C.A., Blackhurst D.W., Cass A.L., Trent E.A., Langan E.M. et al. Determinants of functional outcome after revascularization for critical limb ischemia: an analysis of 1000 consecutive vascular interventions. J. Vasc. Surg. 2006; 44(4): 747-55.
- Cotroneo A.R., Iezzi R., Marano G., Fonio P., Nessi F., Gandini G. Hybrid therapy in patients with complex peripheral multifocal stenoobstructive vascular disease: two year results. Cardiovasc. Intervent. Radiol. 2007; 30(3): 355-61.
- Локацкий В. Надежда медицины: гибридные технологии. Эффективная фармакотерапия. Кардиология и ангиология. 2011; (2): 68-9
- Mousa A., Abdel-Hamid M., Ewida A., Saad M., Sahrabi A. Combined Percutaneous Endovascular iliac angioplasty and Infrainguinal Surgical Revascularization for Chronic Lower Extremity Ischemia: Preliminary Result. Vascular. 2010; 18(2): 71-6.
- Kim M.S., Joo Y.S., Park K.H. Results of Simultaneous Hybrid Operation in Multilevel Arterial Occlusive Disease. Ann. Vasc. Dis. 2015; 8(2): 144-86.
- Nishibe T., Kondo Y., Dardik A., Muto A., Koizumi J., Nishibe M. Hybrid surgical and endovascular therapy in multifocal peripheral TASC D lesions: up to three year follow up. J. Cardiovasc. Surg. 2009; 50(4): 493-9.
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