Journal «Angiology and Vascular Surgery» • 

2021 • VOLUME 27 • №1

Amputation as an anticipated consequence of peripheral artery disease and ways to improve the prognosis of limb salvage

Arakelyan V.S.

Department of Surgery for Arterial Pathology, National Medical Research Centre named after A.N. Bakulev under the RF Ministry of Public Health, Moscow, Russia

Peripheral artery disease is a common and acute social burden worldwide. The main method of treatment of PAD consists in open surgical or endovascular revascularization. However, despite steady growth of the number and quality of interventions, the incidence of lower-limb amputation still remains at a high level. Lower-limb amputation is a severe psychological blow for the patient and leads to significant deterioration of his or her quality of life, as well as has an extremely negative prognosis concerning the frequency of subsequent complications and survival. Consequences of amputations include not only severe disability but also an unfavourable prognosis of life, thus determining the necessity of adequate prevention of such events. Reconstructive and endovascular operations, as well as amputations are associated with a significant increase of the probability of the development of major adverse cardiovascular events, the frequency of repeat hospitalizations and, finally, the cost of treatment.

Prescribing pathogenetically substantiated antithrombotic therapy is considered to be one of the methods to improve the results of surgical treatment and prognosis for the patient. Presented in the article is a literature review making it possible to assess the risks and consequences of amputations in patients with PAD, as well as to determine therapy capable of improving the prognosis.

KEY WORDS: atherosclerosis, peripheral artery disease, revascularization, amputation, repeat interventions, antithrombotic therapy, rivaroxaban.

P. 190

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