Strategy for the treatment of patients with compound atherosclerotic lesions of carotid and lower extremity arteries
https://doi.org/10.51922/2616-633X.2023.7.2.1937
Abstract
Objective – to improve the results of surgical treatment of patients with combined lesions of carotid arteries and lower extremiy arteries.
Materials and Methods. It was perfomed the prospective analysis of 220 patients with combined atherosclerotic lesions of carotid and lower extremity arteries. Тhe patients were divided into two groups by random sampling. In the first group surgical intervention was carried out according to proposed algorithm, in the second group - according to standard technique.
Results. Over a two-year observation period, the late postoperative mortality was as follows: in group 1 – 5.2%, in group 2 – 9.4%. Over a five-year observation period, in group 1 – 10.5%, in group 2 – 18.8%. The overall mortality over 2 years was 7.1%. Over 5 years – 14.2%.
Сonclusion. When appropriately indicated and with thorough preoperative preparation, single-stage surgeries can be performed with good results. The role of coronary angiography has been established in preventing the development of cardiovascular events. An algorithm for diagnosis and the selection of the sequence of surgical interventions on the carotid arteries and arteries of the lower extremities has been proposed.
About the Author
G. E. Kordzakhia
Republican Scientific and Practical Center of Cardiology; 4th City Clinical Hospital named after M. Saŭčanka
Belarus
Belarus
Minsk
References
1. Naylor R., Rantner B., Ancetti S., de Borst G.J., De Carlo M., Halliday A., Kakkos S.K., Markus H.S., McCabe D.J.H., Sillesen H. [et al.] Clinical Practice Guidelines on the Management of Atherosclerotic Carotid and Vertebral Artery Disease. Eur J Vasc Endovasc Surg, 2023, vol. 65, no. 1, pp. 7–111. doi: 10.1016/j.ejvs.2022.04.011.
2. Conte M.S., Bradbury A.W., Kolh P., White J.V., Dick F., Fitridge R., Mills J.L., Ricco J.B., Suresh K.R., Murad MH et al. Global vascular guidelines on the management of chronic limb-threatening ischemia. J Vasc Surg, 2019, vol. 69, no. 6S, pp. 3S–125S. e40. doi: 10.1016/j.jvs.2019.02.016.
3. Campia U., Gerhard-Herman M., Piazza G., Goldhaber S.Z. Peripheral artery disease: past, present, and future. Am J Med. 2019, vol. 132, no. 10, pp. 1133–1141. doi: 10.1016/j.amjmed.2019.04.043.
4. Tzoumas A., Giannopoulos S., Texakalidis P., Charisis N., Machinis T., Koullias G.J. Synchronous versus Staged Carotid Endarterectomy and Coronary Artery Bypass Graft for Patients with Concomitant Severe Coronary and Carotid Artery Stenosis: A Systematic Review and Meta-analysis. Ann Vasc Surg, 2020, vol. 63, pp. 427-438.e1. doi: 10.1016/j.avsg.2019.09.007.
5. Klimchuk I.P., Yanushko V.A., Kordzahia G.E. Multifocal atherosclerosis: problem of combined atherosclerotic lesions of several arterial territories [Multifocal atherosclerosis: problem of combined atherosclerotic lesions of several arterial territories]. Healthcare, 2020, vol. 9, pp. 39-47. (in Russian).
6. Pan Z., Wang R., Li L., Zhang H. Correlation between significant asymptomatic carotid artery stenosis and severity of peripheral arterial occlusive disease in the lower limb: a retrospective study on 200 patients. BMC Neurol, 2019, vol. 19, no. 1, pp. 259. doi: 10.1186/s12883-019-1485-1.
Review
For citations:
Kordzakhia G.E. Strategy for the treatment of patients with compound atherosclerotic lesions of carotid and lower extremity arteries. Emergency Cardiology and Cardiovascular Risks journal. 2023;7(2):1937-1944. (In Russ.) https://doi.org/10.51922/2616-633X.2023.7.2.1937
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