International Medical Journal, Vol. 24., Iss. 3, 2018, P. 20−23.
RESULTS OF SURGICAL TREATMENT OF PATIENTS WITH ISCHEMIC FORM OF DIABETIC FOOT SYNDROME AND LESION OF THE ARTERIES OF THE POPLITEO-TIBIAL SEGMENTS
Feophania Hospital of State Administration of Affairs, Kyiv
V. T. Zaitsev Institute of General and Urgent Surgery of NAMS of Ukraine, Kharkiv
Research and Practice Centre for Preventive and Clinical Medicine of State Administration of Affairs, Kyiv, Ukraine
It is known that diabetes mellitus, as a rule, is accompanied by a lesion of the cardiovascular system. In persons suffering from diabetes for more than 20 years, the incidence involvement of the lower limb arteries exceeds 80 %. More than half of all nontraumatic amputations of the lower extremities are performed in patients with diabetes, often repeatedly, and postoperative lethality in these patients remains high. The results of surgical treatment of patients with ischemic form of diabetic foot syndrome with the lesion of the arteries of the popliteo−tibial segments who were treated at hospital N1 (Kyiv) within 2001−2009, Center for Vascular surgery of Feophania Hospital within 2010−2016 were analyzed. Materials and methods. The analysis of the results of surgical treatment of 275 patients with type 2 diabetes mellitus with ischemic form of diabetic foot syndrome with a stenotic−occlusive lesion of the arteries of the popliteo−tibial segments with chronic critical ischemia of the lower limbs treated in Clinical Hospital N1 in Kyiv during The investigation showed that primary patency of the arterial reconstruction zone in patients who underwent an open arterial reconstruction for the purpose of correction of chronic critical ischemia of the lower limbs was 94,4 %, secondary patency − 97,6 %, the proportion of high amputations was 2,4 %, mortality − 4,0 %. Primary patency of the arterial reconstruction zone in patients who were performed restoration of patency of the popliteo−tibial segments using balloon angioplasty amounted to 85,9 %, the secondary patency was 96,0 %, the proportion of high amputations was 4,0 %, mortality − 1.3 %. The findings of the investigation allow the conclusion that endovascular methods of surgical treatment of stenotic−occlusive lesions of the arteries of the popliteo−tibial segments with critical ischemia in patients with diabetes mellitus are appropriate for use in elderly and old patients with severe comorbid background.
Key words: diabetes mellitus, diabetic foot syndrome, chronic critical ischemia of the lower limb, arterial reconstruction, balloon angioplasty.