ASSESSMENT OF THE EFFECTIVENESS OF MEASURES TO PREVENT COMPLICATIONS OF SURGICAL TREATMENT IN PATIENTS WITH OCCLUSION OF THE AORTO-ILIAC SEGMENT
Introduction: In modern vascular surgery, occlusive lesions of the aortoiliac segment (AIS) represent one of the most pressing problems. It is generally accepted that the detection of AIS occlusion indicates the severity and prevalence of the atherosclerotic process, and therefore a high probability of combined occlusive lesions in other arterial basins. Of particular importance in this regard is the lesion of the arterial bed of vital organs – the heart and brain.
Objective. To conduct a comparative analysis of the results of surgical treatment of occlusive lesions of the AIS with and without correction of predictors of complications from vital organs, and to evaluate their effectiveness.
Materials and methods: Study design — prospective non-randomised clinical observation. The analysis included 143 patients with occlusive lesions of the aortoiliac segment (AIS) who underwent surgery in 2018–2024 in the cardiovascular surgery department of the NCJSC «Semey Medical University» University Hospital.
Depending on the tactics used, patients were divided into two groups: Group 1 (n = 64) — patients who underwent emergency reconstructive interventions on the AIS without prior correction of coronary and carotid artery lesions, without pelvic revascularisation, and without treatment for renal failure. Group 2 (n = 79) — patients who, if indicated, underwent preliminary correction of cardiac and cerebrovascular pathology, revascularisation of the pelvic arteries, and stabilisation of renal function before the main operation.
Results: In the early postoperative period (30 days), complications were recorded in 43.8% of patients in the first group and in 10.1% in the second group (p = 0.0002). Systemic complications (myocardial infarction, ACA stroke, multiple organ failure) were significantly more common in the first group (p < 0.01). The 30-day mortality rate decreased from 12% in the first group to 2.5% in the second. In the long term (5 years), the overall complication rate was 40.7% versus 11.5% (p = 0.0003). Cumulative Kaplan-Meier survival reached 80% in the first group and 95% in the second, with statistically significant differences (Log-Rank p = 0.029).
Conclusion: The implementation of this tactic not only improved the immediate results of treatment, but also significantly increased the long-term survival of patients. Comprehensive preoperative preparation aimed at correcting functional disorders of vital organs and optimising the staging of vascular interventions have proven their effectiveness and can be recommended as a safe and clinically justified method of treating occlusions of the aorto-iliac segment in patients with severe concomitant pathology.
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Imanbaev M.N., Dyussupov A.А., Toleutayev T.A., Toleutayeva D.M., Kozhakhmetov Zh.O., Kazymov Ye.M., Salmenbaev Ye.A. Assessment of the effectiveness of measures to prevent complications of surgical treatment in patients with occlusion of the aorto-iliac segment // Nauka i Zdravookhranenie [Science & Healthcare]. 2025. Vol.27 (5), pp. 70-77. doi 10.34689/SH.2025.27.5.009Related publications:
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