LONG-TERM RESULTS OF REVASCULARIZATION OF THE LOWER EXTREMITIES IN PATIENTS WITH CRITICAL ISCHEMIA AND DIABETES MELLITUS WITH LOCALIZATION OF THE OCCLUSIVE-STENOTIC PROCESS IN THE FEMORAL AND POPLITEAL ARTERIES

Abstract

Aim: to compare endovascular and open revascularizing interventions in patients with neuro-ischemic form of diabetic foot in order to choose the management tactics for this category of patients, which has the best results in the near and long term. Materials and Methods: The study involved 85 patients with critical lower limb ischemia of atherosclerotic genesis and diabetes mellitus, hospitalized for revascularization in a specialized department. The study participants were divided into two groups: the first group included 38 patients who underwent endovasal revascularization of the affected arterial segment, the second - 47 patients who underwent femoropoplitealautovenous bypass grafting below the knee joint. Results: during the dynamic observation of patients, it was found that the number of reoperations on a previously revascularized limb was significantly higher in the group of endovascular interventions than in the group of open reconstructions: 19 (50 %) and 7 (14,9 %), respectively. In the long-term period, three patients of the second group underwent amputation at the hip level, in contrast to the patients of the first group, in which not a single case of amputation was recorded at the indicated level (p = 0,05). Conclusions: for patients with diabetes mellitus and critical lower limb ischemia, endovasal revascularization can be recommended as the most preferable due to the existing features of arterial lesions, the possibility of repeated surgical intervention and preservation of the limb and its support ability.