THE PROBLEM OF PHASING IN HYBRID SURGERY OF CRITICAL LOWER LIMB ISCHEMIA: CLINICAL EXAMPLES
Abstract
Hybrid operations on the arteries of the lower extremities with their multilevel lesion are currently a dynamically developing direction of vascular surgery. The ability to combine open and endovascular interventions in patients with severe concomitant pathology often makes hybrid operations the only means of saving a limb. However, when performing these operations, a number of issues arise, the main of which is the stage-by-stage performance of manipulations within the framework of hybrid reconstruction.
This article presents clinical examples of proximal and distal variants of hybrid reconstructions in which the intervention stages were uniquely determined by the clinical situation. These examples refute the well-established paradigm of vascular surgery about the need for the primary restoration of the receptive vascular bed.
About the Authors
A. G. Vaganov
ГБУЗ г. Москвы «Городская клиническая больница № 29 им. Н.Э. Баумана Департамента здравоохранения города Москвы»
Russian Federation
Russian Federation
M. S. Nochnoy
Институт клинической медицины им Н.В. Склифосовского ФГАОУ ВО «Первый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский университет)» Минздрава России
Russian Federation
Russian Federation
D. A. Lisitsky
ГБУЗ г. Москвы «Городская клиническая больница № 29 им. Н.Э. Баумана Департамента здравоохранения города Москвы»
Russian Federation
Russian Federation
A. V. Gavrilenko
Институт клинической медицины им Н.В. Склифосовского ФГАОУ ВО «Первый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский университет)» Минздрава России; ФГБНУ «Российский научный центр хирургии им. академика Б.В. Петровского»
Russian Federation
Russian Federation
References
1. Fistal E.Ya., Baziyan-Kukhto N.K., Fistal N.N. Surgical treatment of patients with critical ischemia of the lower extremities with ulcerative-necrotic lesions. Bulletin of emergency and reconstructive surgery.2021;6 (4):159-169 (in Russ)
2. Yuzifovich O.O. et al. The experience of using hybrid interventions in the treatment of patients with critical lower limb ischemia. Journal of scientific articles health and education in the XXI century. 2014; 16(4): 107-108(in Russ)
3. Temrezov M.B., Kovalenko V.I., Temerezov T.H., Bakhmetyev A.S., Loiko V.S., Rudakov M.O. Hybrid surgery in the treatment of patients with obliterating atherosclerosis of the arteries of the lower extremities. Translational medicine. 2020; 7 (1):33-38. (in Russ) doi: 10.18705/2311-4495-2020-7-1-33-38
4. Chernyavsky M.A. et al. A clinical case of hybrid treatment of a patient with multilevel atherosclerotic lesion of the arteries of the lower extremities. Сirculation pathology and cardiac surgery. 2018; 4: 82-87(in Russ)
5. Vachev A.N. et al. The sequence of the stages of hybrid operations in patients with Lerish syndrome with critical limb ischemia. Angiology and vascular surgery. 2016;22 (1):159-164. (in Russ)
6. Glushkov N.I. et al. The choice of the revascularization method in patients with multilevel lesion of the arteries of the lower extremities. Clinical and experimental surgery. 2019; 1: 167-172 (in Russ)
7. Glushkov N.I. et al. Results of various methods of revascularization in patients with critical lower limb ischemia against the background of peripheral atherosclerosis. Cardiology and cardiovascular surgery. 2017; 10 (1):56-62. (in Russ)
8. Kireev K.A., Fokin A.A., Rodnyansky D.V. Hybrid intervention in atherosclerotic lesion of the arteries of the ilio-femoral segment. Angiology and vascular surgery. 2018; 24(1):156-158. (in Russ)
9. Chernyavsky M.A. et al. A clinical case of hybrid treatment of a patient with multilevel atherosclerotic lesion of the arteries of the lower extremities. Pathology of blood circulation and cardiac surgery. 2018;22(4):103-110. (in Russ) doi: 10.21688-1681-3472-2018-4-103-11014.
10. Jorshery, S.D. et al. Hybrid femoropopliteal procedures are associated with improved perioperative outcomes compared with bypass. J. Vasc. Surg. 2018;68 (5):1447-1454. (in Engl) doi: 10.1016/j.jvs.2018.01.058
11. Gavrilenko A.V., Kochetkov V.A., Kravchenko A.A. Hybrid operations in chronic ischemia of the lower extremities. Thoracic and cardiovascular surgery. 2021;63 (5):413-8. (in Russ) doi: 10.24022/0236-2791-2021-63-5-413-418
12. Gavrilenko A.V., Kravchenko A.A., Kotov A.E., Kirichenko V.V. Hybrid reconstructions in patients with chronic lower limb ischemia and multilevel arterial lesion. Angiology and vascular surgery. The journal named after Academician A.V. Pokrovsky. 2018; 24(3):183- 188. (in Russ)
13. Puzdryak P.D. et al. Comparison of the results of hybrid and open surgical treatment of multilevel lesion of the arteries of the lower extremities. Cardiology and cardiovascular surgery. 2019:12(3):227-234. (in Russ) doi: 10.17116/kardio201912031227.
Review
For citations:
Vaganov A.G., Nochnoy M.S., Lisitsky D.A., Gavrilenko A.V. THE PROBLEM OF PHASING IN HYBRID SURGERY OF CRITICAL LOWER LIMB ISCHEMIA: CLINICAL EXAMPLES. Bashkortostan Medical Journal. 2023;18(6):64-68. (In Russ.)
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