OBJECTIVE

Purpose of the study: to compare early (complications and adverse events) and long-term (patency, limb salvage, survival) results in patients with CLI who underwent infrainguinal bypass surgery to the anterior tibial artery, depending on the access to this artery — anterior or medial.

MATERIAL AND METHOD:

A retrospective analysis of the early and long-term results of observation of 53 patients who underwent autovenous bypass on anterior tibial artery for chronic limb-threatening ischemia was carried out. Two groups were formed: 1 — medial approach (30.2% of cases), 2 —anterior approach (59.8%). Follow up is 36 months.

RESULTS:

Early postoperative complications. Wound complications: group 1 — 12.5%, group 2 — 5.4% (p=0.575). Major bleeding: group 1 — 12.5%, group 2 — 5.4% (p=0.575). Bypass fail: group 1 — 6.2%, group 2 — 8.1% (p=1.000). Major amputation: group 1 — 12.5%, group 2 — 10.8% (p=0.859). Mortality: group 1 — 6.2%, group 2 — 5.4% (p=0.903). The median survival of patients in group 1 was 34 months; in group 2, the median survival was not reached during 36 months of observation. The median limb salvage in group 1 was 27 months, in group 2 — 20 months. The median bypass patency in the groups was identical and was 12 months.

CONCLUSION:

Indicators of early postoperative complications and indicators of survival, limb salvage and patency in the long-term period after autovenous bypass operations did not have statistically significant differences depending on the access to the anterior tibial artery.