zdorПроблемы здоровья и экологииHealth and Ecology Issues2220-09672708-6011Gomel State Medical University10.51523/2708-6011.2020-17-1-3zdor-170Research ArticleКЛИНИЧЕСКАЯ МЕДИЦИНАCLINICAL MEDICINEЭффективность эндоваскулярной коррекции выраженных степеней хронических облитерирующих заболеваний нижних конечностей при многоуровневых пораженияхEfficiency of the Endovascular Correction of Clinically Evident Degrees of Chronic Obliterating Lower Limb Diseases in Multisegment Lesionshttps://orcid.org/0000-0002-0596-1391ГороховскийС. Ю.GorokhovskyS. Yu.

Гороховский С.Ю., врач-рентгенэндоваскулярный хирург (заведующий) рентгеноперационной учреждения «Гомельский областной клинический кардиологический центр»

Gorokhovsky S.Yu., roentgen-endovascular surgeon (head) at the Interventional Radiology Ward of the institution “Gomel Regional Clinical Cardiology Center”

s.gorokhovsky@mail.ruhttps://orcid.org/0000-0003-0639-121XЛызиковА. А.LyzikovA. A.

Лызиков А.А., заведующий кафедрой хирургических болезней №1 с курсом сердечно-сосудистой хирургии, д.м.н., профессор, УО «Гомельский государственный медицинский университет»

Lyzikov A.A., Doctor of Medical Sciences, Professor, Head of the Department of Surgery No.1 with the course of Cardiovascular Surgery, EI “Gomel State Medical University”

noemail@neicon.ruhttps://orcid.org/0000-0001-7782-3281КапланМ. Л.KaplanM. L.

Каплан М.Л., доцент кафедры хирургических болезней №1 с курсом сердечно-сосудистой хирургии, к.м.н., доцент, УО «Гомельский государственный медицинский университет»

Kaplan M.L., Candidate of Medical Sciences, Associate Professor, Associate Professor at the Department of Surgery No.1 with the course of Cardiovascular Surgery, EI “Gomel State Medical University”

noemail@neicon.ruhttps://orcid.org/0000-0002-3486-9113ТихмановичВ. Е.TihmanovichV. E.

Тихманович В.Е., ассистент кафедры хирургических болезней №1 с курсом сердечно-сосудистой хирургии, УО «Гомельский государственный медицинский университет»

Tihmanovich V.E., MD, assistant lecturer at the Department of Surgery No.1 with the course of Cardiovascular Surgery, EI “Gomel State Medical University”

noemail@neicon.ruУчреждение образования "Гомельский государственный медицинский университет"; Учреждение «Гомельский областной клинический кардиологический центр"Gomel State Medical University; Gomel Regional Clinical Cardiology CenterУчреждение образования «Гомельский государственный медицинский университетGomel State Medical University202028032020011420Copyright © Гороховский С.Ю., Лызиков А.А., Каплан М.Л., Тихманович В.Е., 20202020Гороховский С.Ю., Лызиков А.А., Каплан М.Л., Тихманович В.Е.Gorokhovsky S.Y., Lyzikov A.A., Kaplan M.L., Tihmanovich V.E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.gsmu.by/jour/article/view/170Цель

Цель: оценить эффективность и объем эндоваскулярной реваскуляризации у пациентов с многоуровневым поражением при хронических облитерирующих заболеваниях артерий нижних конечностей.

Материал и методы

Материал и методы. Проанализированы исходы рентгенэндоваскулярной коррекции при многоуровневых поражениях артерий нижних конечностей у 10 пациентов.

Результаты

Результаты. На фоне лечения отмечалось статистически достоверное изменение (рост значения) лодыжечно-плечевого индекса (ЛПИ) (p = 0,001). Значение ЛПИ после оперативного вмешательства в группе составило 0,81 (0,71; 0,87), что сопряжено с удовлетворительным прогнозом у таких пациентов. Результатом вмешательств по установленным критериям стало уменьшение степени хронической артериальной недостаточности (p < 0,01), все пациенты выписаны с разрешением клинических проявлений критической ишемии нижних конечностей и уменьшением выраженности перемежающей хромоты.

Заключение

Заключение. Большинство пациентов с клинически выраженной ишемией нижних конечностей страдает многоуровневым поражением (число пораженных сегментов превышает два), что влечет необходимость множественных коррекций у одного пациента. При этом оценка результата вмешательства возможна только в послеоперационном периоде по косвенным признакам. Таким образом, возникает необходимость разработки метода объективной интраоперационной оценки объема и эффективности выполненной коррекции поражений сосудов посегментно в ходе операции.

Objective

Objective: to evaluate the efficiency and extent of endovascular revascularization in patients with multisegment lesions in chronic obliterating diseases of the lower limb arteries.

Material and methods

Material and methods. The outcomes of the endovascular correction of multisegment lesions of the lower limb arteries were analyzed in 10 patients.

Results

Results. After the treatment the patients revealed a statistically significant change (increase of the value) of the ankle-brachial index (ABI) (p = 0.001). The ABI value after the surgical intervention amounted to 0.81 (0.71; 0.87), which was connected with a favourable prognosis for such patients. Аccording to the established criteria, the outcomes of the interventions comprised the decrease of the degree of chronic arterial insufficiency (p < 0.01), all the patients were discharged having no clinical manifestations of critical lower limb ischemia or decreased evidence of intermittent claudication.

Conclusion

Conclusion. The majority of patients with clinically evident ischemia of the lower limbs suffer from multisegment arterial lesion (the number of the segments exceeds 2), which entails the need of multiple corrections in one patient. Meanwhile, the evaluation of the treatment results is possible only in the postoperative period according to the indirect criteria. Therefore, during the operation there arises the need to develop a method of the objective intraoperative evaluation of the extent and efficiency of the performed correction of arterial lesions on each segment.

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The authors declare that there are no conflicts of interest present.