Results of surgical treatment of patients with ischemic form of diabetic foot syndrome with lesion of the arteries of the popliteo-tibial segment
Abstract
Objective — to carry out the analysis of results of surgical treatment of patients with diabetes mellitus with chronic critical ischemia of the lower limb and lesion of arteries of the popliteo-tibial segment.
Materials and methods. The analysis of results of surgical treatment of 275 patients with type 2 diabetes mellitus with chronic critical ischemia of the lower limb treated in the center of vascular surgery of Clinical Hospital «Feofaniya» during 2010–2016. Men were 74 (62.7 %), women —
44 (37.3 %), aged 62 to 83 years (the average age was (68.6 ± 5.4) year). The first group consisted of 42 (35.6 %) patients who performed an open arterial reconstruction, the second group included 76 (64.4 %) patients who had balloon angioplasty.
Results. Primary patency of the arterial reconstruction zone in patients which the open arterial reconstruction was performed was 92.9 %, secondary patency — 97.6 %, high amputation rate — 2.4 %, mortality during the observation period — 4.8 %, in patients, which was performed to restore the patency of the popliteal-arterial segment through balloon angioplasty, accordingly 86.8, 96.1, 4.0 and 1.3 %.
Conclusions. The annual primary passage of the arterial reconstruction zone is better after open operations on the arteries of the popliteo-tibial region than after endovascular interventions, but the secondary patency rates are comparable. High amputation after endovascular interventions on the arteries of the popliteo-tibial segment was performed almost twice as much as after open operations. Postoperative lethality during the observation period is almost 4 times higher after open operations on the arteries of the popliteo-tibial region than after endovascular interventions. Endovascular methods of treatment of patients with diabetes mellitus with chronic critical ischemia of the lower extremity against the background of stenotic-occlusive lesions of arteries of the popliteo-tibial region are appropriate for use in elderly patients with severe comorbid background.
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References
Iwanaga Y, Nishi I, Furuichi S et al. B-type natriuretic peptide strongly reflects diastolic wall stress in patients with chronic heart failure: comparison between systolic and diastolic heart failure. J. Am. Coll. Cardiol. 006;47:742 -8. Epub 2006 Jan 26.
Naqvi TZ, Padmanabhan S, Rafii F et al. Comparison of usefulness of left ventricular diastolic versus systolic function as a predictor of outcome following primary percutaneous coronary angioplasty for acute myocardial infarction. Am. J. Cardiol. 2006;97:160-6.
Daniels LB, Maisel A. B-type natriuretic peptide: time to incorporate natriuretic peptides in our practice. J. Cardiovas. Med. 2006;7:414-5.
Spertus JA, Winder JA, Dewhurst TA et al. Development and evaluation of the Seattle Angina Questionnaire: a new functional status measure for coronary artery disease. J. Am. Coll. Cardiol. 1995;25(2):333-41.
Lam CS, Donal E, Kraigher-Krainer E et al. Epidemiology and clinical course of heart failure with preserved ejection fraction. Eur. J. Heart. 2011;13:18-28. doi: 10.1093/eurjhf/hfq121.
Hashemi SR, Motamedi M, Khani M et al. Evaluation of the effect of elective percutaneous coronary intervention as a treatment method on the left ventricular diastolic dysfunction in patients with coronary artery disease. The Journal of Tehran University Heart Center. 2010;5(4):194-8.
Lagerqvist B, Husted S, Kontny F et al. Fast Revascularisation during In Stability in Coronary artery disease (FRISC-II) Investigators 5-year outcomes in the FRISC-II randomised trial of an invasive versus a non-invasive strategy in non-ST-elevation acute coronary syndrome: a follow-up study. Lancet. 2006 Sep;16:998-1004.
Farahani E, Saadat H. The effect of percutaneous coronary intervention on isolated left ventricular diastolic dysfunction in patients with coronary artery disease assessed by using strain rate imaging. J. Cardiol. Clin. Res. 2014;2(3):1037.
Seok-Jae H, Vojtech M, Barry A et al. Implications of coronary artery disease in heart failure with preserved ejection fraction (Mayo clinic). J. Am. Coll. Cardiol. 2014 Jul 1;63(25 Pt A):2817-27. doi: 10.1016/j.jacc.2014.03.034. Epub 2014 Apr 23.
Redfield MM, Rodeheffer RJ, Jacobson SJ et al. Plasma brain natriuretic peptide to detect preclinical ventricular systolic or diastolic dysfunction: a community-based study. Circulation. 2004 Jun 29;109(25):3176-81. Epub 2004 Jun 7.
Schannwell CM, Schneppenheim M, Plehn G et al. Parameters of left ventricular diastolic function 48 hours after coronary angioplasty and stent implantation. J. Invasive Cardiol. 2003;15:326-33.
Maisel AS, Krishnaswamy P, Nowak RM et al. Rapid measurement of B-type natriuretic peptide the emergency diagnosis of heart failure. N. Engl. J. Med. 2002;347:161-7.
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