Abstract: Introduction: about 200 million people in the world suffer from ischemia of lower limbs. This pathology occupies a large part in the structure of all lesions of the vascular bed. Most patients with lesions of lower limb arteries have critical lower limb ischemia (CLLI), which is characterized by pain at rest and/or trophic lesions of foot. CLLI is the final stage of lower limb vascular bed lesion and is always accompanied by a deterioration in the quality of life, high morbidity and mortality. The only effective way to treat this pathology is revascularization, however, the current lack of clinical data does not allow us to determine the optimal strategy in treatment of this pathology. Aim: was to determine advantages and disadvantages of using various methods of lower limb revascularization. Material and methods: literature data from information aggregators Cyberleninka, Pubmed and MEDLINE on this topic, published in Russian and English for the period from 2010 to 2021, were selected for analysis. Articles written in German and French were included in the study in case of available translation to English. Termins as an inclusion criteria: critical limb ischaemia, ischaemic pain, tissue loss, gangrene, hybrid intervention, open surgical recanalization, endovascular revascularization, claudication, stenosis. Results: it is determined that revascularization by open surgery showed better long-term results, however, it cannot be recommended for patients with severe comorbid diseases and defeat of lower limb and foot arteries, while endovascular revascularization techniques allow the procedure to be performed in almost all patients, regardless of the severity of their somatic status, however, extended multilevel lesions are poorly amenable to this method of treatment, and also have a relatively lower patency in the long-term period. Hybrid interventions combine advantages of both methods, however, they have high requirements for the equipment of the medical institution and the qualifications of the staff. In addition, hybrid methods are also more dangerous for the patient in comparison with revascularization by endovascular methods.
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 1. Patel S.N., Reilly J.P Persistent sciatic artery - a curious vascular anomaly. Catheter Cardiovasc. Interv. 2007; 70(2): 252-5 2. Sultan S.A. et al. Endovascular management of rare sciatic artery aneurysm. J. Endovasc. Ther. 2000; 7(5): 415-22. 3. van Hooft I.M. et al. The persistent sciatic artery. Eur. J. Vasc. Endovasc. Surg. 2009; 37, 585-591. 4. Shutze W., Garrett W., Smith B. Persistent sciatic artery: collective review and management. Ann. Vasc. Surg. 1993; 7: 303-10 5. Yang S. et al. Bilateral persistent sciatic artery with aneurysm formation and review of the literature. Ann. Vasc. Surg. 2014; 28: 264, 1-7 6. Pillet, J. et al. The sciaticopopliteal arterial trunk: Persistent axial artery. Bull. de l'Association des Anatomiste. 1980; 64: 97-110. 7. Gauffre S., Lasjaunias P, Zerah M. Sciatic artery: a case, review of literature and attempt of systemization. Surg. Radiol. Anat. 1994; 16: 105-9. 8. Ikezawa T. et al. Aneurysm of bilateral persistent sciatic arteries with ischemic complications: case report and review of the world literature. J. Vasc. Sur. 1994; 20: 96 -103. 9. Bower E.B., Smullens S.N., Parke W.W. Clinical aspects of persistent sciatic artery: report of two cases and review of the literature. Surgery. 1977; 81: 588-595. 10. Ahnc S. et al. Treatment Strategy for Persistent Sciatic Artery and Novel Classification Reflecting Anatomic Status. Eur. J. Vasc. Endovasc. Surg. 2016; 52: 360-369. 11. Rezayat C. et al. Ruptured persistent sciatic artery aneurysm managed by endovascular embolization. Ann. Vasc. Surg. 2010; 24: 115.e5-9. 12. Modugno P et al. Endovascular treatment of persistent sciatic artery aneurysm with the multilayer stent. J. Endovasc. Ther. 2014; 21:410-3.
