Journal «Angiology and Vascular Surgery» •
1998 • VOLUME 4 • №2
SURGICAL TREATMENT OF MULTIFOCAL ATHEROSCLEROSIS
V.E. Rudush
Department of Cardiovascular Surgery, City Hospital №2,
Togliatti, Russia
Associated pathology of the branches of the aortic arch, of the coronary arteries, abdominal aorta and great arteries of the lower limbs present in the same patient and requiring surgical correction accounts for not less than 50%o of the total number of patients suffering from atherosclerosis. Among vascular surgeons, there is no uniform opinion as regards the problem of surgical treatment of multifocal atherosclerosis. The present work is a summary of the experience gained over 3.5 years at the Department of Cardiovascular Surgery (the city of Tolgiatti). Altogether 118 (18.4%) patients with lesion of different arterial beds were operated on. The patients were distributed into three groups in terms of the character of lesion and types of surgical intervention. 38 patients with primary lesion of aortic arch branches subjected to reconstruction were entered into the first group. The second group (n=52) included the dominant number of patients with primary lesion of the abdominal aorta and great arteries of the lower limbs. They underwent different reconstructive operations on these segments. The third group comprised 28 patients who underwent one-stage reconstruction of the arterial beds. Analysis was made of the basic parameters in order to compare traumatic injury as a result of surgical treatment of multifocal atherosclerosis in all three groups. The data obtained indicate relatively little traumatic injury and the efficacy of one-stage operations. The treatment policy and anesthesia methods used at the Department made it possible to reduce the total postoperative lethality to 2.1%. In patients with multifocal atherosclerosis, it could be decreased to 4.2%.
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