Results of surgical treatment of patients with ischemic form of diabetic foot syndrome with lesion of the arteries of the popliteo-tibial segment
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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