Abstract:

Persistent sciatic artery (SA) is recognized as a minority variant of embryogenesis of lower limb artery. Article describes a clinical case of complex treatment of a patient with persistent SA, critical ischemia of lower limb and with diabetic foot. The patient underwent diagnostics of lesion, that helped to find out possible ways of disease progression, endovascular revascularization and step-by-step surgery treatment that allowed to keep support function of the limb.

References

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Abstract:

The purpose of the study is to evaluate the immediate and long-term effectiveness of percutaneous transluminal angioplasty (PTA) in patients with diabetes mellitus (DM) and critical lower limbs ischemia (CLLI).

Since November 2004 till February 2008 42 PTA were performed in 40 patients with CLLI; 28 (70%) of them had ischemic ulceration, in 6 patients (15%) there were foot gangrene, and 6 patients suffered of ischemic rest pain. 30 patients (75%) had the insulin-dependent DM, 8 patients (20%) took antihyperglycemic drugs, 2 (5%) kept to antihyperglycemic diet. There were the following comorbidities: CAD - 30 patients (75%); arterial hypertension - 31 (77,5%); cerebrovascular insufficiency - 15 (37,5%); chronic renal failure - 8 (20%), and 3 patients (7,5%) were on chronic hemodialisis.

One patient (1,4%) had iliac localization of the lesion, 38 (51,4%) - femoropopliteal disease, and there were infrapopliteal lesions in 35 (47,3%) patients. There were prevalence of TASC type C and type D lesions (89,2%), and 81,5% of all infrapopliteal lesions were occlusions. Subintimal tracking was used in 31,5% of lesions. Stenting performed in 2 cases. Angiography success rate was 92,7% - 37 patients. Clinical improvement registered in 36 (90%) patients. 12-month follow-up showed absence of critical ischemia in 72,8% of cases. 

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Abstract:

Aim: was to combine results of surgical treatment of patients with primary reconstruction of arteries of lower limbs with patients who underwent reconstructive operations on early stented arteries.

Materials and methods: research included 93 patients with critical ischemia of lower limbs. All patients were devided into two groups with division to subgroups. Group 1a - 23 patients after stenting of iliac arteries. Group 1b - 23 patients with stenosis or occlusion of iliac arteries without previous operations. Group 2a - 22 patients with thrombosis or restenosis of arteries lower than inguinal ligament after previous endovascular treatment. Group 2b - 25 patients with primary atherosclerotic lesion of arteries of lower limbs lower than inguinal ligament .

Results: in early postoperative period and 6 months after reconstructive operation there were no difference in all groups and subgroups of treated patients. The level of complications in late post-operative period is lower in case of primary reconstruction of arteries lower than inguinal ligament in comparison with operations after endovascular interventions.  

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