A CLINICAL CASE OF SUCCESSFUL COMBINATION OF ENDOVASCULAR AND SURGICAL CORRECTION OF MULTIFOCAL ATHEROSCLEROTIC SIGNS IN AN ELDERLY PATIENT

S.P. Semitko, A.S. Yaroshchuk, S.A. Tsygelnikov, I.S. Arabadzhyan, I.Yu. Kostyanov, D.G. Ioselianiy
Department of Roentgenosurgical Methods of Diagnosis and Treatment, Department of Vascular Surgery, Scientific and Practical Center of Interventional Cardioangiology,
Moscow, Russia

Combination of the methods of interventional cardioangiology with current techniques of vascular surgery allows a considerable broadening of the potential for the treatment of different signs of multifocal atherosclerosis in "high risk" patients. For instance, a 70-year-old patient (height 152 cm, weight 32 kg; initial concentration of serum creatinine 174 mol/l) with the clinical evidence of progressing angina pectoris and critical ischemia of the lower extremities underwent angioplasty (the first stage) using a transradial access and stenting of the critically narrowed circumflex branch of the left coronary artery and angioplasty of the proximal segment of the right coronary artery. Good angiographic and clinical results were obtained. This provided a possibility of accomplishing aortofemoral bifurcation bypass grafting. So, the staged combined treatment made it possible to eliminate the life- threatening signs of multifocal atherosclerosis and to improve disease prognosis in an elderly patient classified with a group of inoperable subjects.

KEY WORDS: coronary stenting, aortofemoral bifurcation bypass grafting, "high risk" patients.

P. 128

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