THE NEAREST AND SHORT-TERM RESULTS OF TREATMENT OF PATIENTS WITH OCCLUSIVE-STENOTIC LESIONS OF THE MAIN ARTERIES OF THE INFRARENAL AORTA

Abstract

Resume. The aim of the study. To analyze the immediate and short-term results of treatment of patients with occlusive-stenotic lesions of the main arteries of the lower extremities after using modern types of surgical approaches and technologies. Materials and methods. The immediate and short-term results of treatment of 420 operated patients were analyzed. Since 2019, 198 patients (the main group) have been treated using the updated ESVS international guidelines. Both groups of patients (the main group and the comparison group) were comparable in terms of sex, age, location of the lesion, and type of surgical intervention. 98 (23.3 %) patients were operated on by the open method, 243 (57.9 %) by the endovascular method, 79 (18.8 %) by the hybrid method. We evaluated such indicators as: postoperative thrombosis, limb amputations, mortality, as well as repeated operations performed due to complications or unsatisfactory results of the primary operation. Results and their discussion. The analysis of the immediate results of surgical interventions showed that the largest number of complications was found in the group of patients with multilevel occlusive-stenotic lesions of arteries, which correlates with the data of international studies. The direct effectiveness of endovascular interventions is higher than that of open revascularization and hybrid operations, and the trauma of miniinvasive endovascular techniques is significantly less compared to the methods of open reconstructive surgery. As a result of the analysis of the short-term results of surgical interventions, it was found that the largest number of complications was found in the group of patients with multilevel occlusive-stenotic lesions of the arteries. The short-term effectiveness of endovascular interventions is higher than that of open revascularizations and hybrid operations, but has a clear tendency to decrease, unlike open operations, the results of which have a clear tendency to improve. Conclusions. The selected tactics and selected surgical intervention technologies allow to increase the efficiency of treatment of patients in the immediate postoperative period and reduce the number of postoperative complications in the main group from 10.5 % to 4.9 %, repeated operations from 9.72 % to 3.06 %, amputations from 5.4 % to 1.84 % and mortality from 3.89 % to 1.84 %. In the short-term postoperative period, the number of postoperative complications decreased from 11.59 % to 3.84 %, reoperations from 11.11 % to 3.04 %, amputations from 4.83 % to 2.3 %, and mortality from 3.38 % to 1.53 %.