Abstract
The OBJECTIVE was to study the patency of the internal iliac artery and its effect to gluteus muscles blood supply and frequency of buttock claudication occurrence in the remote period after open infrarenal aortic aneurysm repair. MATERIAL AND METHODS. Examination of 37 patients after open infrarenal aortic aneurysm repair included collection of complaints, anamnesis, making CT scan with contrast and pelvic perfusion tomography. These methods allowed to assess the patency of the prosthesis and iliac arteries, calculate average blood flow rate in buttock muscles and frequency of buttock claudication occurrence depending on the lesion of the internal iliac arteries. RESULTS. Five-year patency of the internal iliac artery was 93 %. In case of passable internal iliac artery, the average blood flow rate in the ipsilateral buttock muscles was authentically higher than the same indicator in groups with stenotic or occlusive lesion of the internal iliac artery and its branches. In case of the disturbed internal iliac artery patency, the frequency of occurrence of the buttock claudication in the same side reached 50 %. CONCLUSION. High five-year internal iliac artery patency after open infrarenal aortic aneurysm repair attested the necessity of preservation the main blood flow in these arteries during the open infrarenal aortic aneurysm repair for the purpose of buttock claudication prevention. The CT scan allowed to evaluate the internal iliac artery patency and the average blood flow rate in the buttock muscles through perfusion tomography method which was necessary for differential diagnosis of the buttock claudication syndrome.
Highlights
Федеральное государственное бюджетное образовательное учреждение высшего образования «Первый Санкт-Петербургский государственный медицинский университет имени академика И
Received 22.04.19; accepted 26.06.19 The OBJECTIVE was to study the patency of the internal iliac artery and its effect to gluteus muscles blood supply and frequency of buttock claudication occurrence in the remote period after open infrarenal aortic aneurysm repair
Examination of 37 patients after open infrarenal aortic aneurysm repair included collection of complaints, anamnesis, making CT scan with contrast and pelvic perfusion tomography. These methods allowed to assess the patency of the prosthesis and iliac arteries, calculate average blood flow rate in buttock muscles and frequency of buttock claudication occurrence depending on the lesion of the internal iliac arteries
Summary
и /и ли подвздошных артерий и проявляющийся болью в ягодичных мышцах и мышцах бедер при ходьбе, может встречаться и у больных АИСА, однако точная частота его неизвестна. По характеру клинических проявлений синдром ВПХ чаще представлен не типичным болевым синдромом перемежающейся хромоты, а жалобами на дискомфорт, слабость в области тазобедренного сустава и бедра и жалобами, что ноги «устают» или «отказывают» после прохождения определенного расстояния. Больные с коксартрозом и дегенеративно-дистрофическими заболеваниями пояснично-крестцового отдела позвоночника могут предъявлять сходные жалобы, что затрудняет клиническую дифференциальную диагностику, особенно при их сочетании с нарушением проходимости ВПА. Данные пациенты могут обследоваться на предмет неврологических или ортопедических заболеваний и в ряде случаев подвергаются необоснованным хирурги-
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