Lanhazo O. Indirect methods of revascularization with occlusive-stenotic lesions of the distal arterial system

The results of complex examination and surgical treatment of 109 patients were studied and analyzed. Accordingly, there were 28 (25,7 %) patients with IIB degree of ischemia, and 81 (74,3 %) with IIIIA degree. Atherosclerosis of contralateral lower limb was diagnosed in all pathients. All patients, depending on the type of surgical intervention, were divided into next groups: I group – 50 patients, for whom profundoplasty simultaneously with revascularizational osteotrepanation (ROT) were performed; II group – 20 patients, for whom lumbar sympathectomy simultaneously with ROT were performed; III group – 18 patients with lumbar sympathectomy; IV group – 21 patients with ROT. For the selection of patients for indirect methods of revascularization, it is necessary to be guided by the value of the deep-femoral-popliteal index (DFPI), which characterizes the degree of collateral system development of the deep femoral artery. As a result, it was shown, that if the DFPI is 0,35 and less, 5-year limb preservation in case of indirect revascularization reaches 74,2 %, and if DFPI is 0,45 – just 23,4 %. The data showed, that 3-year lower limb preservation after performing profundoplasty with ROT (I group) reached 72 %, after lumbar sympathectomy with ROT (II group) – 55 %, after lumbar sympathectomy (III group) – 38,8 %, after ROT (IV group) – 47,6 %.