Experience with hybrid techniques of surgical treatment of patients with lower limb critical ischaemia

Uchkin I.G.^1,2,3, Shugushev Z.Kh.^1,3, Talov N.A.¹, Bagdasaryan A.G.^1,2, Gonsales A.K.¹, Khmyrova A.V.³

1) Department of Vascular Surgery No 2, N.A. Semashko Central Clinical Hospital No2, Open Joint-Stock Company «Russian Railways»,
2) Department of Vascular Surgery of the Scientific Research Centre, I.M. Sechenov First Moscow State Medical University,
3) Chair of Hospital Surgery, Medical Department, Russian University of Friendship of Peoples, Moscow, Russia

The authors present their original experience with the use of hybrid techniques of surgical treatment in a total of 19 patients with lower limb critical ischaemia (LLCI) on the background of complex lesions of the arteries of lower extremities. They describe various types of hybrid techniques of surgical treatment of patients with critical ischaemia on the background of chronic obliterating diseases of lower-limb arteries. Also discussed are 3 varieties of clinical situations in which it is appropriate to employ the hybrid method: thrombosis of the bypass graft, multi-storey lesions of lower-limb arteries, and the use of a hybrid technique in order to decrease the size of the surgical wound. The period of follow up varied from 2 to 36 months. The limbs were saved in all the patients during the whole follow-up period. Two patients were found to have thrombosis of the reconstructed segment after 1.5-5 months.

KEY WORDS: chronic obliterating diseases of lower-limb arteries, critical ischaemia, atherosclerosis obliterans of lower-limb arteries, bypass graft thrombosis, minimally invasive surgery, hybrid techniques, hybrid surgery.

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