SHORT-TERM RESULTS OF ENDOVASCULAR TREATMENT FOR OBLITERATING ATHEROSCLEROSIS OF THE LOWER EXTREMITIES ARTERIES IN PATIENTS OVER 70 YEARS OF AGE

Objectives. To analyze short-term results of endovascular treatment for obliterating atherosclerosis of the lower extremities arteries in patients over 70 years of age. Material and methods. From 2015 to 2019, 75 lower limbs were revascularized in 72 patients. Their mean age was 74.7±4.51 years. There were 67 (93%) patients with ischemia of the 3rd - the 4th degree according to Fontaine-Pokrovsky classification. Revascularization of the iliac segment was performed in 35 (48.6%) patients, of the iliofemoral segment - in 5 (7%), the femoral-popliteal segment - in 24 (33.4%), the tibial segment - in 8 (11%) patients. Results. Technical success was attained in 97.2% of cases. The limb preservation was achieved in 100% of cases. Thrombosis of the revascularized artery developed in 2 (2.7%) cases (it was repaired endovascularly). Two patients (2.77%) died of acute cardiac failure. Conclusions. Our study has shown good early results of endovascular treatment for obliterating atherosclerosis of the lower limbs arteries in patients over 70 years of age. High amputations were avoided in 100% of cases. However, an assessment of long-term results is required.

Limb Preservation with Balloon Angioplasty in Critical Limb Threatening Ischemia: A Case Report

Introduction: Chronic limb-threatening ischemia (CLTI) is a syndrome that represents the end-stage of peripheral artery disease (PAD) that increased the risk of major amputation and cardiovascular events. The initial treatment for CLTI may significantly impact the risk of major amputation or death. Objective: This case report aims to describe limb preservation with balloon angioplasty in a Critical Limb Ischemia patient. Case Presentation: A hypertensive 72-years old female complained of left leg pain followed by a wound on her left toe four months ago. Her toe was amputated, but the wound persists. On physical examination, the pulsation was diminished in her left foot. Duplex ultrasound showed monophasic spectral doppler from left popliteal artery to distal left anterior tibial artery (ATA) and distal posterior tibial artery (PTA). CT-Angiography showed short total occlusion (2cm) at the distal left Superficial Femoral artery (SFA), multiple stenoses with maximal 90% stenosis at the left ATA, and chronic total occlusion at the proximal-mid left posterior tibial artery (PTA). She was diagnosed with CLTI left inferior extremity Fontaine IV Rutherford 5. The angiography result was similar to the CT-angiography result. The patient was successfully treated with plain balloon angioplasty from distal left SFA to distal left ATA and drug-coated balloon angioplasty from the distal left SFA to the popliteal artery. Her wound was also consulted to the surgical department. Conclusion: Appropriate revascularization is fundamental to limb preservation. We successfully perform endovas- cular strategy with TIMI flow 3 from left SFA to distal left ATA and distal PTA in our patient, but we still need further holistic CLTI management.