The Results of Reconstruction of Popliteal Artery and Tibial Arteries in Acute Limb Ischemia

Vladimir Zolkin, Ivan Bogomazov, Vladimir SHYPOVSKII, Ivan Korotkov, Nikita MAKSIMOV, Ivan Tischenko

State budgetary healthcare institution of Moscow “State clinical hospital n.a.D.D.Pletneva of Moscow Healthcare department” , Moscow, Russia

Date, time and location: 2018.05.26 13:30, Exhibition area, 1st Floor. Zone – B

Abstract

Objective: to Assess the results of arterial reconstructions and endovascular interventions in patients with acute arterial thrombosis of the popliteal artery and tibial arteries

Materials and methods: 107 patients with acute arterial thrombosis underwent 110 arterial reconstructions or endovascular interventions in the popliteal-tibial segment. IHD- 60.5 %, postinfarction cardiosclerosis - 29.1 %, hypertension - 81.4%, diabetes - 20.9%. 75% of patients were operated on for primary arterial thrombosis of the popliteal artery and tibial arteries. In 12% of patients were found acute thrombosis of aneurysm of the popliteal artery. Stages of acute limb ischemia: I - 70 (65%); IIa - 24 (22%), IIb - 13 (13%). All patients before surgery was performed ultrasound duplex study. Preoperative angiography was performed in 89 % of cases.

Results: Early postoperative thrombosis - 24 (22%), thrombectomy of shunt was effective in 4 patients. In I stage of acute limb ischemia early postoperative thrombosis occurred in 19.6% of cases, stage II - 29% of patients. 3 patients had bleeding from postoperative wound. In 1 case was diagnosed infection of postoperative wounds. Major amputations - 10.3% (11 patients),  necrectomy or amputation at the level of the foot - 4 (3,7%). Postoperative mortality - 2%. Long-term results in a period of 5 years assessed in 32 patients, limb salvage - 84.4%.

Discussion: Arterial reconstructions and endovascular interventions in the popliteal artery and tibial arteries in acute arterial thrombosis allow you to save the limb in 90% of patients. Primary patency of endovascular interventions areas is 92%. Deaths and major amputation in this group is not marked.

Conclusions: Surgical treatment of acute arterial thrombosis of the popliteal-tibial areas is an effective method of restoring circulation and saving limb. The best results are achieved after endovascular interventions.