ОЦЕНКА ВЛИЯНИЯ КАРДИАЛЬНЫХ ФАКТОРОВ РИСКА НА ТАКТ ИКУ ЛЕЧЕНИЯ БОЛЬНЫХ С СОЧЕТАННЫМ АТЕРОСКЛЕРОТИЧЕСКИМ ПОРАЖЕНИЕМ АОРТО-ПОДВЗДОШНОГО СЕГМЕНТА И КОРОНАРНЫХ АРТЕРИЙ

Abstract

Purpose. To assess the impact of cardiac risk factors on the treatment strategy for patients with multiple atherosclerotic lesions. Materials and methods. The study presented the results of the treatment of 97 patients with aortoiliac lesions and coronary artery disease. 51 patients had infrarenal aortic aneurysm and 46 patients were diagnosed with chronic lower limb ischemia. All the patients had ECG, echocardiography and coronary angiography performed. The additional studies performed were Holter and blood pressure monitoring, stress echo and thallium myocardial perfusion scintigraphy. Results. Open-heart myocardial revascularization as the first stage procedure was done in 10 aneurysm patients and 8 lower limb ischemia patients, transluminal balloon angioplasty (PTCA) with stenting was done in 12 and 11 patients, respectively. Aortoiliac lesions were treated during the second-stage procedure. After the interventions for aortic lesions there was one death in the abdominal aortic aneurysm group; the lower limb ischemia group had no fatal outcomes. Conclusions. 1.Most patients with abdominal aortic aneurysms and chronic ischemia have significant cardiac risk factors with coronary artery lesions being the leading one. 2. Coronary angiography remains the most accurate technique for coronary lesion assessment. 3. Patients with severe coronary lesions require myocardial revascularization (coronary artery bypass surgery, stenting) as the first-stage procedure. 4. In patients at a high risk of cardiac complications the surgery for abdominal aortic aneurysms or chronic lower limb ischemia can be performed only if there exist life-saving indications.