Endovascular surgery for critical ischemia of lower extremities with suppurative-necrotic lesion of the feet

Lipatov K.V.

Kafedra obshcheĭ khirurgii Moskovskoĭ meditsinskoĭ akademii im. I.M. Sechenova, GKB #23 im. «Medsantrud», Moskva

Permyakov S.V.

War Veterans' Hospital №1

Asatryan A.G.

Sechenov First Moscow Medical University, Ministry of Healthcare of the Russian Federation, Moscow, Russia

Borodin A.V.

Kafedra obshcheĭ khirurgii Moskovskoĭ meditsinskoĭ akademii im. I.M. Sechenova

Gostishchev V.K.

Kafedra obshcheĭ khirurgii Moskovskoĭ meditsinskoĭ akademii im. I.M. Sechenova, GKB #23 im. «Medsantrud», Moskva

Endovascular surgery for critical ischemia of lower extremities with suppurative-necrotic lesion of the feet

Authors:

Lipatov K.V., Permyakov S.V., Asatryan A.G., Borodin A.V., Gostishchev V.K.

More about the authors

Journal: Pirogov Russian Journal of Surgery. 2017;(9): 4‑16

DOI: 10.17116/hirurgia201794-16

Read: 1805 times

Download PDF (RU)

Contact the author

Table of contents

To cite this article:

Lipatov KV, Permyakov SV, Asatryan AG, Borodin AV, Gostishchev VK. Endovascular surgery for critical ischemia of lower extremities with suppurative-necrotic lesion of the feet. Pirogov Russian Journal of Surgery. 2017;(9):4‑16. (In Russ.)
https://doi.org/10.17116/hirurgia201794-16

Подписка 2025-2 (Pirogov Russian Journal of Surgery)

Использование инфографики авторами научных работ

Close metadata

Recommended articles:

Current approaches to the prevention and treatment of post-thrombotic syndrome. Russian Journal of Preventive Medicine. 2025;(5):111-116

Aim. To improve treatment of patients with grade IV chronic ischemia of lower extremities via endovascular angioplasty combined with surgical methods for suppurative-necrotic lesions of the feet. Material and methods. 51 patients with grade IV chronic ischemia of lower extremities underwent endovascular interventions (balloon angioplasty, stenting). A total of 23 stents were deployed in 16 patients including 12 stents in superficial and common femoral arteries, 5 in popliteal artery, 6 in iliac artery. There were no stents in crural arteries. The most perspective artery for wound healing was preferred in case of revascularization below popliteal segment. Necrectomy was performed along with angioplasty in patients with suppurative-necrotic lesion of the feet followed by delayed reconstructive operations if it was necessary. Results. Endovascular surgery for grade IV chronic ischemia of lower extremities was associated with good immediate results in most cases due to revascularization and organ-sparing interventions for suppurative lesions of the feet. Current endovascular methods allow to perform successful re-operations to restore blood flow in previously repaired arteries and implanted stents with restenosis or thrombosis.

Keywords:

balloon angioplasty

stenting of the arteries of lower extremities

grade IV chronic ischemia of lower extremities

Authors:

Lipatov K.V.

Kafedra obshcheĭ khirurgii Moskovskoĭ meditsinskoĭ akademii im. I.M. Sechenova, GKB #23 im. «Medsantrud», Moskva

Permyakov S.V.

War Veterans' Hospital №1

Asatryan A.G.

Sechenov First Moscow Medical University, Ministry of Healthcare of the Russian Federation, Moscow, Russia

Borodin A.V.

Kafedra obshcheĭ khirurgii Moskovskoĭ meditsinskoĭ akademii im. I.M. Sechenova

Gostishchev V.K.

Kafedra obshcheĭ khirurgii Moskovskoĭ meditsinskoĭ akademii im. I.M. Sechenova, GKB #23 im. «Medsantrud», Moskva

List of references:

Pokrovskii AV. Klinicheskaya angiologiya. Rukovodstvo dlya vrachei. M.: Meditsina. 2004. (In Russ.).
Zatevakhin II, Shipovskii VN, Zolkin VN. Ballonnaya angioplastika pri ishemii nizhnikh konechnostei. Rukovodstvo dlya vrachei. M.: Meditsina; 2004. (In Russ.).
Komarov AL, Panchenko EL, Deev AD i dr. Techenie peremezhayushchei khromoty i prognoz bol’nykh ateroskleroticheskim porazheniem arterii nizhnikh konechnostei. Angiologiya i sosudistaya khirurgiya. 2000;6:2:9-18. (In Russ.).
Fomin AA. Vozmozhnosti primeneniya revaskulyariziruyushchikh operatsii s tsel’yu snizheniya urovnya amputatsii u bol’nykh s khronicheskimi okklyuzionnymi zabolevaniyami arterii nizhnikh konechnostei. Angiologiya i sosudistaya khirurgiya. 2010;16:4:368-369. (In Russ.).
Krotovskii GS, Zudin AM. Taktika lecheniya patsientov s kriticheskoi ishemiei nizhnikh konechnostei. M.: Meditsina; 2005. (In Russ.).
Losev RZ, Kulikova AN. Sovremennye vzglyady na diabeticheskuyu angiopatiyu nizhnikh konechnostei. Angiologiya i sosudistaya khirurgiya. 2005;II:3:14-20.(In Russ.).
Galstyan GR, Tokmakova AYu, Bondarenko ON i dr. Zabolevaniya arterii nizhnikh konechnostei u patsientov s sakharnym diabetom: sostoyanie problemy i perspektivy lecheniya. Sakharnyi diabet. 2011;1:74-79. (In Russ.).
Chernov VN, Anisimov AB, Gusarev SA. Pokazaniya k amputatsii nizhnei konechnosti i opredelenie ee urovnya pri «diabeticheskoi stope». Khirurgiya. 2009;7:38-42. (In Russ.).
Belov YuV. Khirurgicheskoe lechenie bol’nykh s mnozhestvennym porazheniem arterii nizhnikh konechnostei. Angiologiya i sosudistaya khirurgiya. 2002;8:1:72-79. (In Russ.).
Shipovskii VN, Zolkin VN, Magomedov ShG. Ballonnaya angioplastika arterii goleni. Diagnosticheskaya interventsionnaya radiologiya. 2008;2:4:53-60. (In Russ.).
Kuznetsov MR, Komov MV, Teplyakov SA i dr. Sovremennoe sostoyanie problemy reokklyuzii posle rekonstruktivnykh vmeshatel’stv na arteriyakh taza i nizhnikh konechnostei u bol’nykh obliteriruyushchim aterosklerozom. Angiologiya i sosudistaya khirurgiya. 2009;15:4:141-151. (In Russ.).
Kazanchyan PO, Popov VA, Debelyi YuV i dr. Khirurgicheskaya revaskulyarizatsiya nizhnikh konechnostei pri kriticheskoi ishemii. Angiologiya i sosudistaya khirurgiya. 2000;6:3:75. (In Russ.).
Eroshkin SN, Kut’ko AP, Bulavkin VP. Effektivnost’ metodov revaskulyarizatsii nizhnikh konechnostei u patsientov s gnoino-nekroticheskimi formami sindro- ma diabeticheskoi stopy. Novosti khirurgii. 2013;21:3:61-68. (In Russ.)
Francisco Acín, César Varela, Ignacio López de Maturana, et al. Results of Infrapopliteal Endovascular Procedures Performed in Diabetic Patients with Critical Limb Ischemia and Tissue Loss from the Perspective of an Angiosome-Oriented Revascularization Strategy. International Journal of Vascular Medicine. 2014;13. https://doi.org/10.1155/2014/270539
Sun NF, Tian FL, Tian YL, et al. The interventional therapy for diabetic peripheral artery disease. BMC Surgery. 2013;13-32. https://doi.org/10.1186/1471-2482-13-32
Wolfle KD, Bruijnen H, Loeprecht H, et al. Graft patency and clinical outcome of femorodistal arterial reconstruction in diabetic and non-diabetic patients: results of a multicentre comparative analysis. Eur J Vasc Endovasc Surg. 2003;25:3:229-234. https://doi.org/10.1053/ejvs.2002.1849
Graziani L, Silvestro A, Bertone V, et al. Vascular involvement in diabetic subjects with ischemic foot ulcer: a newmorphologic categorization of disease severity. Eur J Vasc Endovasc Surg. 2007;33:4:453-460. https://doi.org/10.1016/j.ejvs.2006.11.022
Varela C, Acin F, De Haro J, et al. Influence of surgical or endovascular distal revascularization of the lower limbs on ischemic ulcer healing. Journal of cardiovascular Surgery. 2011;52:3:381-389. https://doi.org/10.1177/1538574410376601
Armstrong EJ, Bishu K, Waldo SW. Endovascular Treatment of Infrapopliteal Peripheral Artery Disease. Curr Cardiol Rep. 2016;18(4):38. https://doi.org/10.1007/s11886-016-0708-y
Huang ZS, Schneider DB. Endovascular intervention for tibial artery occlusive disease in patients with critical limb ischemia. Semin Vasc Surg. 2014;27(1):38-58. https://doi.org/10.1053/j.semvascsurg.2014.12.003
Ohmine T, Iwasa K, Yamaoka T. Strategy of Revascularization for Critical Limb Ischemia Due to Infragenicular Lesions-Which Should Be Selected Firstly, Bypass Surgery or Endovascular Therapy? Ann Vasc Dis. 2015;8(4):275-281. https://doi.org/10.3400/avd.oa.15-00076
Dattilo PB, Casserly IP. Critical limb ischemia: endovascular strategies for limb salvage. Prog Cardiovasc Dis. 2011;54(1):47-60. https://doi.org/10.1016/j.pcad.2011.02.009

Close metadata