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Abstract:

Aim: was to show the role and possibilities of 128-slice computed tomography (MSCT) iirfhe dynamic observation of patients; after open and endovascular surgery of lower limb's arteries;

Material and methods: 1st group - 36 patients (30,5%) who (underwent endovascular procedures;, 2nd group - 51 patients; (44,2%) who underwent open reconstructive operations;, 3rd group - 31 patients; (26,3%) after hybrid operations;. 108 patients; were examined in post-operative period (7 women, 101 men), average age was 57,28±15,08. All patients underwent MSCT-angiography on the background of the contrast bolus;. 55 patients; had standard procedure, other patients; underwent examination with low-close protocol.

Results: obtained images of low-close protocol had satisfactory condition of information: arterial walls were visualized well, inner lumen and para-prosthesis space, atherosclerotic lesions were also visualized. Obtained results of MSCT-angiography during low-dose protocol were confirmed ntraoperatively Obtained data of MSCT-angiography: all patients; of 1st group had passable stents; but 2 patients; who had hernodynarnically non-significant stenosis. In 2nd group 5 patents; had restenosis of prosthesis and grafts;, 20 patients; had thrombosis. In 3rd group, 2 patients; had restenosis of prosthesism femoral-popliteal segment, 13 patient had thrombosis of prosthesis/grafts, 6 patients; had restenosis of stents;, 1 patient had stent thrombosis in femoral-popliteal segment, n case of hernodynarnically significant stenosis (50%) of the stent or prosthesis in the absence of clinical manifestations; we made correction of drug therapy. If the patent had a detected boundary stenosis (50-74%) with the absence of complaints;, the patient had correction of drug therapy, with the appointment of a dynamic MSCT-angiography in 3-6 months. Patents; with occlusion of the prosthesis, or a stent with a satisfactory distal vessels clue to good collaterals; we performed thrombectomy or repeated prosthetics. Patients who according to the MDCT-angiography, had identified thrombosis of prosthesis/grafts with poor distal vessels, absence of good collaterals; and the presence of clinical manifestations; of critical ischemia - amputation of the affected limb.

Conclusion: MSCT-angiography is a highly informative method of nornnvasive imaging of patency of stent, prosthesis/graft of mam arteries; of lower limbs;. Our study showed that using of a low-close protocol is; possible for the dynamic monitoring of patents; for the detection of postoperative complications;, early diagnosis and prevention of restenosis and thrombosis of prosthesis/grafts and stents Timely diagnosis of stenosis of stents; or grafts/prostheses of mam arteries; of lower limbs can determine tactics; and stages; of surgery (endovascular treatment, and re-open reconstructive vascular surgery, thrombectomy), not leading to the patient’s; disability. 

 

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