SURGICAL MANAGEMENT OF THROMBOSES AND ANEURYSMS OF THE RECONSTRUCTED VESSELS

A.D. Gaibov, N.U. Usmanov, D.D. Sultanov, A.N. Kamolov, S.A. Mirzoev
Republican Scientific Center of Cardiovascular and Thoracic Surgery,
Tajik State Medical University,
Dushanbe, Tajikistan

This paper analyses the results of reoperations in 52 patients with thromboses (n=42) and aneurysms (n=10) of the reconstructed vessels. The main causes of their development were progression of vascular disease and suppuration of a surgical wound. No relationship was established between complications and the type of suture materials. The diagnosis of the disease was made on the basis of the clinical data and duplex scanning. The operation of choice for thromboses of aortofemoral grafts was retrograde thrombectomy with reconstruction of the distal anastomosis, which was performed in 24 patients. Despite the controversial data on the possibility of thrombectomy from vein grafts the authors could accomplish it in 6 of 10 patients with thromboses of the femoro-popliteal vein bypasses. It is emphasized that the basic component of reoperations for occlusions of the femoro-popliteal segment lies in the formation of a tension-release arterio-venous fistula. In the postoperative period, rethrombosis of the reconstructed vessels occurred in 2 patients, arrosive bleeding in 3; limb amputation was performed in 3 patients, one of whom died from peritonitis.

KEY WORDS: vascular graft, false aneurysm, bypass thrombosis, surgical management.

P. 107

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