Endovascular interventions in patients with multilevel steno-occlusive lesions of the infrarenal aortic arteries

Peripheral artery diseases are a worldwide medical and social problem. Approximately 30 % of patients with critical limb ischemia will undergo amputations and 25 % will die after 1 year. These patients require reconstructive and angioplastic interventions to preserve the limb. The aim of the stud...

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Autores principales:	Vasyl Shaprynskyi, Volodymyr Shaprynskyi, Vasylysa Suleimanova
Formato:	article
Lenguaje:	EN
Publicado:	Scientific Route OÜ 2021
Materias:	atherosclerosis obliterans revascularization balloon angioplasty endovascular intervention critical limb ischemia Medicine R
Acceso en línea:	https://doaj.org/article/6907b8a3eaba4dcfa291a76c74a5dbda
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spelling	oai:doaj.org-article:6907b8a3eaba4dcfa291a76c74a5dbda2021-12-03T07:43:49ZEndovascular interventions in patients with multilevel steno-occlusive lesions of the infrarenal aortic arteries2504-56602504-567910.21303/2504-5679.2021.002193https://doaj.org/article/6907b8a3eaba4dcfa291a76c74a5dbda2021-11-01T00:00:00Zhttp://journal.eu-jr.eu/health/article/view/2193https://doaj.org/toc/2504-5660https://doaj.org/toc/2504-5679Peripheral artery diseases are a worldwide medical and social problem. Approximately 30 % of patients with critical limb ischemia will undergo amputations and 25 % will die after 1 year. These patients require reconstructive and angioplastic interventions to preserve the limb. The aim of the study is to compare the effectiveness of different endovascular surgical technologies in patients with multilevel steno-occlusive lesions of the infrarenal aortic arteries. Materials and methods. Among 243 endovascular interventions, 51 patients were presented with multilevel steno-occlusive lesions of the infrarenal aortic arteries as a result of atherosclerosis obliterans. 42 patients (82.4 %) had two-level lesions and 9 (17.6 %) had three-level lesions. Results. Among 42 patients with a two-level lesion, 29 (56.9 %) ones had femoral arterial segment affection in combination with tibial artery affection. 13 (25.5 %) patients suffered from the lesion of the iliac segment in combination with the affection of the femoral segment arteries. In 9 (17.6 %) patients the lesions of three or more levels were determined: an iliac segment in combination with femoral and popliteal arteries – in 4 patients, and in 2 patients there were lesions of the femoral, popliteal and tibial segments, in 3 patients there was a lesion of the iliac, femoral, popliteal and tibial-foot segments in different degrees of severity. 7 balloon angioplasties and 13 stenting procedures were performed in two and three-level lesions in which the iliac arterial segment was affected. Only balloon angioplasty was used to revascularize the infraingvinal arterial segments. In the early postoperative period, the complications included thrombosis appeared in 6 patients. It was possible to restore the blood flow and save the limb only in 3 persons. For the other 3 ones, the attempts to restore the patency of the arteries were unsuccessful and resulted in the amputation of the lower extremity. Mortality in the early postoperative period was 3.9 % (2 death due to myocardial infarction). Conclusions. The persons with multilevel steno-obstructive lesions of the infrarenal aortic arteries are the most difficult category of patients with CLI. The surgical method of choice for patients with multilevel steno-occlusive lesions is the endovascular angioplasty with or without stenting.Vasyl ShaprynskyiVolodymyr ShaprynskyiVasylysa SuleimanovaScientific Route OÜarticleatherosclerosis obliteransrevascularizationballoon angioplastyendovascular interventioncritical limb ischemiaMedicineRENEUREKA: Health Sciences, Iss 6, Pp 24-29 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	atherosclerosis obliterans revascularization balloon angioplasty endovascular intervention critical limb ischemia Medicine R
spellingShingle	atherosclerosis obliterans revascularization balloon angioplasty endovascular intervention critical limb ischemia Medicine R Vasyl Shaprynskyi Volodymyr Shaprynskyi Vasylysa Suleimanova Endovascular interventions in patients with multilevel steno-occlusive lesions of the infrarenal aortic arteries
description	Peripheral artery diseases are a worldwide medical and social problem. Approximately 30 % of patients with critical limb ischemia will undergo amputations and 25 % will die after 1 year. These patients require reconstructive and angioplastic interventions to preserve the limb. The aim of the study is to compare the effectiveness of different endovascular surgical technologies in patients with multilevel steno-occlusive lesions of the infrarenal aortic arteries. Materials and methods. Among 243 endovascular interventions, 51 patients were presented with multilevel steno-occlusive lesions of the infrarenal aortic arteries as a result of atherosclerosis obliterans. 42 patients (82.4 %) had two-level lesions and 9 (17.6 %) had three-level lesions. Results. Among 42 patients with a two-level lesion, 29 (56.9 %) ones had femoral arterial segment affection in combination with tibial artery affection. 13 (25.5 %) patients suffered from the lesion of the iliac segment in combination with the affection of the femoral segment arteries. In 9 (17.6 %) patients the lesions of three or more levels were determined: an iliac segment in combination with femoral and popliteal arteries – in 4 patients, and in 2 patients there were lesions of the femoral, popliteal and tibial segments, in 3 patients there was a lesion of the iliac, femoral, popliteal and tibial-foot segments in different degrees of severity. 7 balloon angioplasties and 13 stenting procedures were performed in two and three-level lesions in which the iliac arterial segment was affected. Only balloon angioplasty was used to revascularize the infraingvinal arterial segments. In the early postoperative period, the complications included thrombosis appeared in 6 patients. It was possible to restore the blood flow and save the limb only in 3 persons. For the other 3 ones, the attempts to restore the patency of the arteries were unsuccessful and resulted in the amputation of the lower extremity. Mortality in the early postoperative period was 3.9 % (2 death due to myocardial infarction). Conclusions. The persons with multilevel steno-obstructive lesions of the infrarenal aortic arteries are the most difficult category of patients with CLI. The surgical method of choice for patients with multilevel steno-occlusive lesions is the endovascular angioplasty with or without stenting.
format	article
author	Vasyl Shaprynskyi Volodymyr Shaprynskyi Vasylysa Suleimanova
author_facet	Vasyl Shaprynskyi Volodymyr Shaprynskyi Vasylysa Suleimanova
author_sort	Vasyl Shaprynskyi
title	Endovascular interventions in patients with multilevel steno-occlusive lesions of the infrarenal aortic arteries
title_short	Endovascular interventions in patients with multilevel steno-occlusive lesions of the infrarenal aortic arteries
title_full	Endovascular interventions in patients with multilevel steno-occlusive lesions of the infrarenal aortic arteries
title_fullStr	Endovascular interventions in patients with multilevel steno-occlusive lesions of the infrarenal aortic arteries
title_full_unstemmed	Endovascular interventions in patients with multilevel steno-occlusive lesions of the infrarenal aortic arteries
title_sort	endovascular interventions in patients with multilevel steno-occlusive lesions of the infrarenal aortic arteries
publisher	Scientific Route OÜ
publishDate	2021
url	https://doaj.org/article/6907b8a3eaba4dcfa291a76c74a5dbda
work_keys_str_mv	AT vasylshaprynskyi endovascularinterventionsinpatientswithmultilevelstenoocclusivelesionsoftheinfrarenalaorticarteries AT volodymyrshaprynskyi endovascularinterventionsinpatientswithmultilevelstenoocclusivelesionsoftheinfrarenalaorticarteries AT vasylysasuleimanova endovascularinterventionsinpatientswithmultilevelstenoocclusivelesionsoftheinfrarenalaorticarteries
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Endovascular interventions in patients with multilevel steno-occlusive lesions of the infrarenal aortic arteries

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