Reshetylo V. Comprehensive surgical prevention and treatment of bypass graft thrombosis after reconstructive surgeries about obliterative artery diseases

The analysis of the results of examination and treatment of 296 patients (339 lower extremities) with obliterating atherosclerosis of the arteries of the lower extremities, who were in inpatient treatment in 2007-2019 in the surgical department of the Central City Clinical Hospital in Ivano-Frankivsk. According to the study design, the criteria for inclusion of patients were the presence of chronic arterial insufficiency IIB, III and IV degree (Fontaine, 1954), which had indications for open reconstructive surgery on the arteries of the lower extremities, regardless of the affected arterial segment, and these operations were performed. At the first stage, we observed 93 patients from the moment of establishing the indications to open surgery and obtaining consent to the implementation of one of conditions: 1) if 3 years have passed since the operation; 2) if there was a shunt thrombosis; 3) if the patient dies. Patients to whom shunt thrombosis occurred within 3 years after surgery were included in the main group (group of persons with shunt thrombosis), and patients to whom shunt thrombosis did not occur within this time were referred to the comparison group (group of persons without shunt thrombosis). Comparing their initial clinical and laboratory-instrumental characteristics, as well as intra- and postoperative features, these 2 groups of patients studied the causes of shunt thrombosis and developed a set of preventive measures to prevent them.