Year 2017 Vol. 25 No 1




FSBEE HE "Russian National Research Medical University Named After N.I.Pirogov"1 , Moscow,
FSBE "A.V.Vishnevsky Institute of Surgery"2,
The Russian Federation

Objectives. To develop a new restorative method of the main lower limb blood flow in the chronic arterial insufficiency provided an adequate blood flow in occlusion of the superficial femoral artery and the popliteal artery at the knee joint fissure.
Methods. A combined approach designed to restore the blood flow has been developed. The semi-closed endarterectomy is performed from the posterior access of popliteal artery in the patients pronepositio, and after turning a patient on his back the femoral-popliteal bypass above the knee joint fissure is carried out. According to the proposed method 34 patients have been operated on, mean an average age 64,610,6 [42-85] years. The indications for surgery were the intermittent claudication (n=20), pain at rest (n=8) and trophic ulcers of the lower limbs (n=6). All patients had occlusive disease of the superficial femoral artery of TASC C or D with pathological process involving of P1, P2 or of all popliteal artery segments.
Results. The technical success of interventions was 100%. After the surgery 25 patients (73,5%) had no clinical symptoms of chronic arterial insufficiency, 8 (23,5%) transferred into the stage I IIA. In the immediate postoperative period the primary patency of grafts was 91,2%, the secondary 97,0%. No lethal outcomes were registered within 30 days after the operation. Thrombotic complications occurred in 3 patients, which in 2 cases were successfully eliminated by thrombectomy. Amputation at the middle third of the thigh was necessary in 1 patient.
Conclusion. The proposed method of the main arterial blood restoration in the lower limbs may be considered as a quite effective and physiological in a long-lasting popliteal artery disease. It should be noted that further studies of the results in the remote postoperative period are required.

Keywords: femoral-popliteal bypass, endarterectomy, popliteal artery, peripheral artery disease, posterior access, thrombotic complications, postoperative period
p. 31-37 of the original issue
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Address for correspondence:
117997, the Russian Federation,
Moscow, Ostrovityanov str., 1,
Pirogov Russian National
Research Medical University.
Department of faculty surgery N1.
Maksim R. Kuznetsov
Information about the authors:
Kuznetsov M.R. MD, Professor of the faculty surgery department N1, the medical faculty, FSBEE HE "Russian National Research Medical University Named After N.I.Pirogov".
Sapelkin S.V. MD, Leading researcher of FSBE "A.V.Vishnevsky Institute of Surgery", Professor of the faculty surgery department N1, the medical faculty, FSBEE HE "Russian National Research Medical University Named After N.I.Pirogov".
Virgansky A.O. MD, Professor of the faculty surgery department N1, the medical faculty, FSBEE HE "Russian National Research Medical University Named After N.I.Pirogov".
Magnitsky L.A. Post-graduate student of the faculty surgery department N1, the medical faculty, FSBEE HE "Russian National Research Medical University Named After N.I.Pirogov".
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