Optimization of surgical treatment for lower extremities and infrarenal aorta atherosclerosis

Abstract

Background. Atherosclerosis of the infrarenal aorta and lower extremities is a disease caused by hyperlipidemia, arterial hypertension, tobacco smoking, hyperglycemia, metabolic disorders, and physical inactivity The research aims to optimize surgical treatment and its effectiveness in patients with occlusions of the distal aorta and lower extremities. Materials and methods. For patients from the main group, diagnostic and prognostic tactics were used, addressing 18 major risk factors, which allowed to predict the presence or absence of risk for recurrent postoperative thrombosis, which could end in surgery to eliminate thrombosis, amputation, or death. For patients with severe calcification of the arterial wall, an improved surgical technique was used to reduce the rate of significant complications. Results. The results of treatment were analyzed in 98 patients with occlusive stenotic lesions of the main arteries as a consequence of obliterating atherosclerosis who were operated by the open method. Conclusions. The research outcomes indicated the importance of determining individual risk before surgery, as this allowed for planning the scope of the operation and choose appropriate access. These measures reduced the rate of postoperative complications. In addition, it became possible to gather patients into a group of standard treatment and those who need special monitoring, which improved early postoperative outcomes in the future such as early postoperative mortality and amputation rates. The study also analyzed the importance of active tactics for treating postoperative complications which reduce the risk of complications that lead to reoperation or amputation.

Keywords

• arteriosclerosis obliterans
• critical ischemia
• revascularization
• radical surgery
• risk factors