[Results of the treatment of patients with Leriche's syndrome and ulcerous-necrotic foot changes].

A comparative analysis of two groups of patients with Leriche's syndrome was conducted: 88 patients suffered only from intermittent claudication (stage III of the disease), while 128 patients had pyo-necrotic changes on the feet (stage IV). All patients were subjected to revascularization of the ischemic extremities by restorative operations with the use of a synthetic prosthesis. The necrotic lesions of the feet were encountered mostly in patients with a combined affection. Due to the severe condition of the patients, however, one-stage operations on the ++aorto-popliteal and femoropopliteal segments were not undertaken. An aortic deep femoral shunt was formed, but if ischemia of rest was maintained reconstruction in the femoropopliteal segment was performed in a second stage. Comparative analysis of the immediate and late-term results in patients of these two groups was conducted. It is shown that the operative risk is higher in stage IV than in stage III. But operations in patients with necrotic changes can be considered well grounded because the late-term results (preservation of the extremity, frequency of deep suppurations) hardly differ from those in patients with intermittent claudication.