Horlenko F. Combination of direct and indirect methods of revascularization in chronic ischemia of the lower extremities.

Were studied and analyze the results of a comprehensive examination and surgical treatment of 1098 patients with obliterating atherosclerosis of the aorta and vessels of the lower extremities (period 2004-2019). According to the localization of the pathological process, the studied contingent was divided into 3 groups: Group I - patients with lesions of the aorto-femoral segment - 263 patients (24,0%); Group II - patients with lesions of the femoral-popliteal segment - 748 patients (68,1%); Group III - patients with lesions of the patellar segment - 87 patients (7,9%). 893 direct revascularization operations and 205 indirect revascularization operations were performed. The five-year preserving lower extremity was 58,5% (after aorto-femoral bypass), 61,4% (after aorto-deep-femoral bypass), after femoral-popliteal bypass above (66,7%) and below (48,5%) of the knee joint slits, after femoral (popliteal) tibial bypass – 25,0%, when direct revascularization methods was performed. When performed indirect methods of revascularization, the 5-year presering of the lower extremity was 76,2% after isolated profundoplasty, after profundoplasty and ROT combination – 79,1%, lumbar sympathectomy in patients without diabetes – 10,5%, with independent ROT without diabetes. – 32,1%.