Factors influencing the results of open reconstructive operations on the arteries of the femoropopiteal segment in chronic obliterating diseases of the arteries of the lower extremities

Objective. To analyze the factors influencing the long-term results of reconstructive surgeries on the arteries of the lower extremities.

Materials and methods. Retrospective analysis of 98 medical records of patients with chronic obliterating diseases of the arteries of the lower extremities after open surgeries on the arteries of the femoral-popliteal region. Two groups of patients: the first group – with intermittent claudication (n = 34), the second group – with critical ischemia (n = 64). The results of the study were processed by applied statistics methods using MS Excel and the software package for statistical analysis Statistica v. 8.0. Differences were considered statistically significant at p < 0.05.

Results. According to angiography, stage III according to the GLASS classification was present in 58.82 % of patients with CLI 2b, in 71.31 % of patients with CLI 3, 4. The length of the SFA occlusion in patients with CLI 2b is 230 [200; 300] mm, with CLI 3, 4 – 300 [105; 300] mm. A positive result after surgery was observed in 79.41 % of cases in patients with intermittent claudication and in 46.88 % of cases in patients with chronic ischemia threatening limb loss (p < 0.05). Limb preservation within 2 years after revascularization is 88.24 % in patients of the first group, 70.31 % in patients of the second group. Patients taking antiplatelet drugs and abstaining from smoking were more likely to have a positive effect after surgery (p < 0.05).

Conclusion. Patients with atherosclerotic lesions of lower extremity arteries after open reconstructive surgeries have low adherence to conservative therapy and lifestyle changes (all recommendations were followed in 8.2 % of cases). Major adverse events in the extremities in patients not taking antiplatelet agents and not quitting smoking occurred significantly earlier than in patients following recommendations in the long-term period (p < 0.05).

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