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Khirurgii

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Year 2010 Vol. 18 No 4

GENERAL AND SPECIAL SURGERY

I.N. IGNATOVICH, G.G. KONDRATENKO, S.N. KORNIYEVICH, D.A. TAGANOVICH, A.P. SHEPELKEVICH, I.M. KHRAPOV, G.A. SERGEYEV, N.M. MIKHAYLOVA

FOOT ANGIORECONSTRUCTIONS AND RESECTION OPERATIONS IN THE TREATMENT OF CRITICAL ISCHEMIA AT DIABETIC FOOT SYNDROME

Objectives. To study the application results of the conservative open endovascular and hybrid revascularization interventions at the critical ischemia of the lower limbs on the background of neuroischemic form of diabetic foot syndrome.
Methods. 47 patients were operated on from the total 108 observed ones suffering diabetes mellitus with the occlusive-stenotic lesions of the arteries and chronic critical ischemia of the lower limbs. 12 open reconstructive operations were carried out, 33 endovascular interventions, 2 hybrid revascularization operations combining both the transluminal endovascular dilatation and conservative open vascular operation.
Results. One managed to avoid high amputation and save a support function of 30 lower limbs (63, 8%) from 47 patients who underwent revascularization operations. In these patients the average duration of the foot lesion made up 1, 1 year, and the level of the glycated hemoglobin was 7,1±1,3 mmol/l. In the group consisting of 17 patients in whom high limb amputation was done after the revascularization the average duration of the foot lesion made up 2, 0 years, and the level of the glycated hemoglobin made up 9,6±0,8 mmol/l.
Conclusions. Angioreconstructions both open and endovascular at the neuroischemic form of diabetic foot syndrome are effective and justifiable. They permit to cut short the phenomenon of chronic critical ischemia of the lower limbs which inevitably results in high amputation.

Keywords: diabetic foot, treatment, endovascular surgery, angioreconstruction
p. 49-56 of the original issue
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