scholarly journals Comparative results of different methods of arterial reconstruction in the patients with critical stenosis of the femoral-popliteal-tibial segment

2017 ◽  
Vol 16 (3) ◽  
pp. 41-48 ◽  
Author(s):  
A. A. Koidan ◽  
I. V. Batalin ◽  
V. N. Vavilov ◽  
M. Y. Kaputin ◽  
A. V. Atmadzas ◽  
...  
Keyword(s):  
Critical Limb Ischemia ◽  
Lower Limb ◽  
Intervention Group ◽  
Lower Extremities ◽  
Limb Ischemia ◽  
Tissue Loss ◽  
Long Term Results ◽  
City Hospital ◽  
Research Institute

Introduction. Critical limb ischemia (CLI), which arises from atherosclerotic lesions of the arteries is quite often presently. This problem is actively discussed all over the world. In addition to the disability of the patients due to limb loss, the death rate from this disease is comparable to mortality from malignant tumors. Objective. Evaluate immediate and long-term results and optimize treatment tactics for patients with critical limb ischemia in multilevel lesions of lower limb arteries. Materials and methods. The examination and treatment of patients with CLI was carried out in the Research Institute of Surgery and Urgent Medicine of the First State Medical University of Saint-Petersburg named by I. P. Pavlov, as well as on the basis of the City Clinical Hospital «City Hospital No. 14» and St. Petersburg Research Institute of Emergency Care named by I. I. Dzhanelidze in the period from 2005 to 2016. The study is conducted in patients with atherosclerotic lesion of the main arteries of the lower extremities, which manifests itself as pain at rest and/or tissue loss (stage 3-4 of chronic arterial insufficiency of the limb according to Fontein-Pokrovsky classification). Results. Clinical success of all kinds of interventions was achieved in 166 (88.8 %) patients. However, the negative results were greater in the group where only angioplasty of the lower limb arteries was performed. Long-term results could be traced in 108 (57.8 %) patients for 6 months - 5 years. If we consider all groups as a whole, then the aggravation of ischemia occurred in endovascular intervention group in 62 % of patients, in the group of bypass operations - in 19.61 %, and in the group of hybrid interventions - in 17.65 %. Conclusion. Hybrid methods of treatment are the method of choice for patients with stage 4 ischemia of the lower limb with multilevel lesions of lower extremity arteries. Open surgery on the arteries of the lower extremities remains a very effective method of treating patients with critical ischemia. In turn, the use of endovascular methods is advisable in patients with severe concomitant pathology.

scholarly journals SIMULTANEOUS REVASCULARIZATION OF AORTOFEMORAL AND FEMOROPOPLITEAL ARTERIAL SEGMENTS BY SEMICLOSED LOOP ENDARTERECTOMY

2017 ◽  
Vol 176 (2) ◽  
pp. 28-32
Author(s):  
V. V. Shlomin ◽  
A. V. Gusinskiy ◽  
M. L. Gordeev ◽  
I. V. Mikhailov ◽  
D. N. Maistrenko ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Critical Limb Ischemia ◽  
Limb Ischemia ◽  
Arterial Occlusive Disease ◽  
Long Term Results ◽  
Single Level ◽  
Individual Approach ◽  
Chronic Limb Ischemia

OBJECTIVE. The authors would like to consider the possibility and feasibility of simultaneous revascularization of two arterial segments in patients with lower extremity arterial occlusive disease by method of semiclosed loop endarterectomy. MATERIALS AND METHODS. The research included 143 patients. Revascularization of aortofemoral segment was performed on 67 patients. The simultaneous revascularization of aortofemoral and femoropopliteal segments was carried out for 76 patients. The follow-up period was 5 years. RESULTS. There was revealed that the long-term results of multilevel reconstruction were worse that single-level reconstruction. This method requires an individual approach. The best results of simultaneous interventions were obtained in patients aged 60 and older with the III stage of chronic limb ischemia and 2 or 3 working shin arteries. The worst results were observed in patients younger than 50 year old with IV stage of critical limb ischemia and significant lesions of shin arteries.

scholarly journals Long-Term Results of Combined Aortoiliac and Infrainguinal Arterial Reconstruction for the Treatment of Critical Limb Ischemia

2015 ◽  
Vol 8 (1) ◽  
pp. 14-20 ◽  
Author(s):  
Takuya Miyahara ◽  
Kunihiro Shigematsu ◽  
Ayako Nishiyama ◽  
Takuya Hashimoto ◽  
Katsuyuki Hoshina ◽  
...  
Keyword(s):  
Critical Limb Ischemia ◽  
Limb Ischemia ◽  
Long Term Results ◽  
Arterial Reconstruction

scholarly journals Surgical treatment of lower limb ischemia in diabetic patients – long-term results

2013 ◽  
Vol 6 ◽  
pp. 1078-1082 ◽  
Author(s):  
Bekir Inan ◽  
Unal Aydin ◽  
Murat Ugurlucan ◽  
Cemalettin Aydin ◽  
Melike Elif Teker
Keyword(s):  
Surgical Treatment ◽  
Lower Limb ◽  
Limb Ischemia ◽  
Long Term Results ◽  
Diabetic Patients ◽  
Lower Limb Ischemia

Long-Term Results and Risk Analysis of Redo Distal Bypass for Critical Limb Ischemia

2020 ◽  
Vol 68 ◽  
pp. 409-416
Author(s):  
Taira Kobayashi ◽  
Masaki Hamamoto ◽  
Masamichi Ozawa ◽  
Takumi Harada ◽  
Shinya Takahashi
Keyword(s):  
Risk Analysis ◽  
Critical Limb Ischemia ◽  
Limb Ischemia ◽  
Long Term Results

Is initial success of thrombolytic therapy with rt-PA in patients with lower limb ischemia durable? A long-term follow-up series

VASA ◽  
2007 ◽  
Vol 36 (2) ◽  
pp. 114-120 ◽  
Author(s):  
Geier ◽  
Mumme ◽  
Köster ◽  
Marpe ◽  
Hummel ◽  
...  
Keyword(s):  
Thrombolytic Therapy ◽  
Success Rate ◽  
Lower Limb ◽  
Limb Ischemia ◽  
Long Term Results ◽  
Bleeding Complications ◽  
Acute Ischemia ◽  
Lower Limb Ischemia

Background: Catheter-directed intraarterial thrombolytic therapy with rt-PA has been established as an alternative to surgery in selected patients with lower limb ischemia. The purpose of this study is to evaluate its long-term results and to try to identify patient variables influencing outcome. Patients and methods: The results of thrombolytic treatment for acute or subacute lower limb ischemia in 82 patients (51 male, 31 female) were retrospectively analysed. Clinical data (time of symptoms onset, clinical stage, type of affected vessel, anatomical localisation) as well as comorbidities were recorded. The success rate of thrombolysis as well as the incidence of adverse events was evaluated. Patients with initial success were followed up after a median of 52,5 months. Results: Thrombolytic therapy was successful in 67 cases (82%). An additional endovascular or surgical procedure was necessary in 39 of these patients (48%). The overall bleeding rate was 18% and the mortality and major amputation rate was 1%. 42 patients with early clinical success were available for follow-up. 34 of them (81%) were free of ischemic symptoms and the overall limb salvage rate was 96%. We could not identify factors significantly influencing early or long-term results, although there was a trend towards better results in patients with acute ischemia and in patients with occluded native arteries. Conclusions: Intraarterial local thrombolytic therapy has a relatively high initial success rate in selected patients with lower limb ischemia, but is associated with a significant number of bleeding complications. Furthermore, additional procedures are required in almost half the patients. Initial success is durable at the long-term in the majority of cases. Better selection of patients and refinements of the thrombolytic therapy might help to further improve results and lower the bleeding complications.

Long-term results of pl-VEGF165 intramuscular gene transfer in patients with atherosclerotic chronic lower limb ischemia

2015 ◽  
Vol 8 (4) ◽  
pp. 43 ◽  
Author(s):  
R. V. Deev ◽  
R. E. Kalinin ◽  
Yu. V. Chervyakov ◽  
I. N. Staroverov ◽  
I. L. Plaksa ◽  
...  
Keyword(s):  
Gene Transfer ◽  
Lower Limb ◽  
Limb Ischemia ◽  
Long Term Results ◽  
Lower Limb Ischemia
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