Novosti
Khirurgii
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Year 2020 Vol. 28 No 1

REVIEWS

DOI: https://dx.doi.org/10.18484/2305-0047.2020.1.92   |  

E.V. NELIPOVICH 1, V.A. YANUSHKO 2, I.P. KLIMCHUK 1

HYBRID REVASCULARIZATION METHOD IN THE TREATMENT OF CRITICAL LOWER LIMB ISCHEMIA

4th City Clinical Hospital named after N.E. Savchenko 1, Minsk,
The Republic of Belarus

The cause of 50-70% of cases of the circulatory disorders decompensated forms with the development of critical lower limb ischemia (CLLI) is multilevel obliterating lesions of the peripheral arteries. During the first year from the diagnosis of CLLI, 25% of patients require primary high amputation. The use of small diameter arteries for the formation of a distal anastomosis, an increase in the length of the shunt with ultra-distal bypass surgery, diffuse damage to the artery wall, causes unfavorable hemodynamics in the shunt.
The frequency of early shunt thrombosis after open reconstructions is 25-35%; infectious complications make up 4-21%. A significant drawback of interventional procedures is the extreme difficulty or inability to carry out the intervention with multiple and extended occlusive lesions. A promising direction in solving this problem is the use of hybrid technologies. Despite the apparent simplicity of solving the problem, there is a high probability of developing restenosis after performing endovascular balloon dilatation (EBD). However, the widespread use of balloon catheters and drug-eluting stents has reduced the number of restenoses by 16%. The use of hybrid technologies for multilevel lesions ensures arterial patency of 76% of patients, preservation of the limb in more than 80% of patients, within 3 years after revascularization, which in turn led to a decrease in mortality to 11%

Keywords: critical ischemia, atherosclerosis, revascularization, hybridmethod, thrombosis, bypass
p. 92-99 of the original issue
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Address for correspondence:
220036, Republic of Belarus,
Minsk, Rosa Luxemburg Str., 110,
4th City Clinical Hospital
Named after N.E. Savchenko,
Vascular Surgery Department.
Tel. mobile: +375 29 1421893,
e-mail: nelipovich@mail.ru,
Evgenij V. Nelipovich
Information about the authors:
Nelipovich Evgenij V., Angiosurgeon, Vascular Surgery Department, 4th City Clinical Hospital named after N.E. Savchenko, Minsk, Republic of Belarus.
https://orcid.org/0000-0002-2921-6601
Yanushko Vyacheslav A., MD, Professor, Chief Researcher of the Laboratory of Vascular Surgery, Republican Scientific and Practical Center Cardiology, Minsk, Republic of Belarus.
https://orcid.org/0000-0002-2143-7485
Klimchuk Ivan P., PhD, Head of the Vascular Surgery Department, 4th City Clinical Hospital named after N.E. Savchenko, Minsk, Republic of Belarus.
https://orcid.org/0000-0001-9793-0084
Contacts | ©Vitebsk State Medical University, 2007