SURGICAL TREATMENT OF THE AORTOILIAC OCCLUSION
Introduction. Treatment of occlusive lesions of the aorta-iliac segment (AIS) is difficult because of the presence of concomitant multifocal lesions of the arteries of the vital organs - the heart, brain, kidneys, visceral organs.
Purpose of the study. Scientific rationale for a set of measures to improve the results of open surgical treatment of patients with occlusive disease of AIS.
Methods of the study. A prospective non-randomized clinical study of the surgical treatment of 134 patients with AIS occlusive disease was performed, which, depending on the treatment tactics, are divided into 2 groups: without correction and with correction of predictors of complications. The 1-st group consisted of 70 patients with an unstable course of AIS occlusion, the 2-nd group included 64 patients who, if indicated, underwent preliminary surgical correction of coronary and carotid artery pathology, pelvic revascularization, and preliminary correction of renal failure.
Results. Complications in the 30-day postoperative period in patients of the 1-st group resulted in death in 4 (5.7%) cases, in the 2-nd group of patients in 1 (1.6%) case. 5-year mortality in patients of the 1-st group was 5 (7.7%) cases, in the 2-nd group - 2 (3.3%) cases.
Conclusion. Analysis of the end points of the study showed that the 30-day mortality was affected by the correction of predictors of complications and the development of multiple organ failure; in the 30-day postoperative period, the development of myocardial infarction depended on the correction of predictors of complications and ejection fraction, acute renal failure - from the level of creatinine in the blood; in the 5-year postoperative period, the development of myocardial infarction depended on the correction of predictors of complications, acute renal failure from the level of blood creatinine, and chronic ischemia of the left colon half - from stenosis of the internal iliac artery (IIA), antegrade or retrograde inclusion of the IIA in the main blood flow during reconstruction of the AIS; 5-year survival of patients was affected by the correction of predictors of complications and the development of such complications as myocardial infarction and acute renal failure.
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Dyussupov A.A., Imanbaev M.N., Dyussupova B.B., Abylkhairov K.T., Tlemissov A.S., Mukhametkhanov R.B., Amanzholov D.B. Surgical treatment of the aortoiliac occlusion // Nauka i Zdravookhranenie [Science & Healthcare]. 2020, (Vol.22) 6, pp. 18-25. doi 10.34689/SH.2020.22.6.003Похожие публикации:
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