Kovalskyi D. Formation of outflow pathways in the tibio-peroneal segment during open, hybrid and endovascular revascularization of the atherosclerotic stenotic-occlusive process of the infrainguinal arterial bed in conditions of stenotic-occlusive lesion of the lower leg arteries

The dissertation is devoted to the improvement of the results of open, hybrid and endovascular revascularization of atherosclerotic lesion of femoral-distal arterial bed in the conditions of stenotic-occlusive lesion of the tibial arteries by forming functionally capable outflow pathways in the tibioperoneal region. The obtained results of the scientific search contributed to the study of the problem of chronic arterial ischemia that threatens the loss of the lower limb, in patients with atherosclerotic stenotic-occlusive process of the infrainguinal arterial bed in the conditions of stenotic-occlusive lesion of the tibial arteries and to propose a complex diagnostic and treatment tactic. An advantage was established in the effective and long-term functioning of the outflow tracts during revascularization of the atherosclerotic stenotic-occlusive process of the infrainguinal arterial bed in conditions of stenotic-occlusive lesions of the tibial arteries by the method of forming a distal anastomosis of an autovenous shunt with a single functioning artery of the shin, giving preference to its distal segment. An advantage was established in the effective and long-term functioning of the outflow tracts during revascularization of the atherosclerotic stenotic-occlusive process of the infrainguinal arterial bed in the conditions of stenotic-occlusive lesion of the tibial arteries by means of endovascular revascularization of two arteries of the shin in comparison with revascularization of only one of the tibial arteries. It was established that in patients who underwent hybrid or endovascular revascularization of the arterial bed of the lower limb, the formation of hypercoagulable blood syndrome at the intraoperative stage occurs more intensively compared to patients who underwent open revascularization of the infrainguinal arterial bed. It was established that in patients who underwent hybrid and endovascular surgical treatment methods during the revascularization of the femoral-distal arterial bed, at the intraoperative stage of surgery, the speed of platelet aggregation was significantly higher, the degree of platelet aggregation with a significant reduction in the time of platelet aggregation was compared with patients who underwent open revascularization of the infrainguinal arterial channel.