Koshelev Iu M, Varnavskikh V I, Dem'ianov A M
Vestn Khir Im I I Grek. 2005;164(3):75-8.
The work presents an experience with surgical treatment of 32 patients with critical ischemia of the lower extremities developed against the background of two-levels occlusive lesion of the arterial bed of the lower extremities. All the patients had atherosclerosis. Occlusion of the abdominal part of the aorta was the cause of reconstruction of the aorta and iliac arteries in 15 patients, occlusion of the iliac artery - in 14 patients, aneurysm of the abdominal aorta - in 3 patients. In all the patients the proximal lesion was associated with occlusion of the femoral arteries. In addition to proximal reconstruction, retrograde endarterectomy was made with a special instrument from the femoral arteries through the arteriotomy opening intended for distal anastomosis of a synthetic prosthesis. Complete revascularisation of the arterial bed of the lower extremities was obtained in all the patients. There were no lethal outcomes.
该研究介绍了对32例下肢严重缺血患者进行手术治疗的经验,这些患者的下肢动脉床存在两级闭塞性病变,且均患有动脉粥样硬化。15例患者因腹主动脉闭塞而行主动脉及髂动脉重建术,14例因髂动脉闭塞,3例因腹主动脉瘤。所有患者近端病变均与股动脉闭塞有关。除近端重建外,还使用特殊器械通过用于人工合成假体远端吻合的动脉切开开口,对股动脉进行逆行内膜切除术。所有患者下肢动脉床均实现完全血运重建,无死亡病例。